To Explore The Distribution Of Syndromes Of Insomnia With Depression And Anxiety

Objective:By studying the distribution of TCM syndromes in insomnia patients with depression and anxiety,this paper summarizes the common TCM syndromes,and compares the correlation between insomnia,depression,anxiety and syndromes,so as to provide theoretical basis for syndrome differentiation and treatment of such diseases,so as to improve the clinical efficacy.Methods:According to the inclusion criteria,151 patients from December 2017 to December 2018 were selected from the outpatient department of neurology and psychiatry of Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine.Epidemiological investigation was carried out and recorded in Execl database.Descriptive analysis and chi-square test were used to compare the degree of insomnia,depression and anxiety of patients in different groups;Person correlation coefficient was used to compare the degree of insomnia,depression and anxiety;cluster analysis was used to classify and analyze the combination of symptoms element related to insomnia with depression and anxiety,so as to obtain the combination characteristics of symptoms element and syndromes element.The disordered multi-classification logistic regression was used to analyze the syndrome elements and the degree of insomnia depression and anxiety.Results:Distribution of syndrome elements:There are 135 cases of disease location syndrome elements containing heparin and 114 cases of heart and mind syndrome elements.Other disease location elements involved are kidney,heart,spleen and stomach.Among the pathological feature of syndrome elements,qi stagnation and yin deficiency account for the highest proportion,followed by dampness,blood deficiency,yang hyperactivity,qi deficiency,phlegm,yang deficiency,heat,blood stasis and blood heat.Among thedisease location combinations,the single viscera was most involved in the liver,15 cases;the most involved two viscera were liver,heart and mind,50 cases,the rest were liver and spleen,liver and kidney,liver and stomach;there were also more involved three viscera,34 cases,involving liver,heart,heart and mind,14 cases,involving liver,kidney,heart and mind,11 cases.Among all disease location syndrome elements,liver,heart and mind are most involved in the combination of viscera and organs.Among the pathological feature of syndrome elements,the proportion of five disease-related syndromes is the highest,among which the highest proportion is qi stagnation,yin deficiency,yang hyperactivity,dampness and heat;while qi stagnation,yin deficiency,yang hyperactivity,dampness,heat,phlegm and qi stagnation,yin deficiency,yang hyperactivity,yang deficiency,qi deficiency,blood deficiency,phlegm and dampness all appear six times,with the most occurrences.Among all the pathological feature of syndrome elements,qi stagnation and yin deficiency are the most involved pathogenic combination.Main TCM syndromes:liver depression and qi stagnation syndrome,heart and mind dystrophy syndrome,heart and spleen deficiency syndrome,phlegm-dampness-heat syndrome and yang hyperactivity.Relationship between Syndrome Elements and Degree of Insomnia,Depression and Anxiety:There is no specific syndrome element associated with the degree of insomnia.On the basis of TCM syndromes,blood stasis syndrome elements are more common in patients with mild depression,stomach syndrome elements are more common in patients with moderate depression,and dampness and yang deficiency syndrome elements are more common in patients with severe depression.Heart syndrome elements,liver syndrome elements,blood-heat syndrome elements,spleen syndrome elements and stomach syndrome elements are more common in patients with moderate anxiety,heart and mind syndrome elements are more common in patients with severe anxiety,qi stagnation and yin deficiency syndrome elements are more common in patients with more severe anxiety.Conclusion:The location syndromes of insomnia patients with depression and anxiety are liver,heart and mind,kidney,heart,spleen and stomach,and the pathological feature of syndrome elements are qi stagnation,yin deficiency,dampness,blood deficiency,yang hyperactivity,qi deficiency,phlegm,yang deficiency,heat,blood stasis and blood heat.Disease location combination syndrome elements are mainly liver,heart and mind,and the pathological feature of syndrome elements’s combination are mainly qi stagnation and yin deficiency.Insomnia patients with depression and anxiety’s main TCM syndromes are liver depression and qi stagnation syndrome,heart and mind dystrophy syndrome,heart and spleen deficiency syndrome,phlegm-dampness-heat syndrome and yang hyperactivity.Based on the TCM syndromes in insomnia patients with depression and anxiety,blood stasis syndrome elements in mild depression patients are more common,stomach syndrome elements in moderate depression patients are more common,and dampness and yang deficiency syndrome elements in severe depression patients are more common.The syndromes of heart,liver,blood heat,spleen and stomach were more common in moderate anxiety patients,psychotropic syndromes were more common in severe anxiety patients,qi stagnation and yin deficiency were more common in more severe anxiety patients.There is no specific syndrome element associated with the degree of insomnia.