Qualitative Research And Data Mining Research On Insomnia In Patients With Chronic Kidney Disease

ObjectiveThe purpose of this study is to do qualitative research on insomnia in patients with chronic kidney disease(CKD)to understand the psychological and physiological conditions,so as to help the medical staff to grasp the common laws of the physiological,psychological and social development of CKD patients with insomnia,and provide reference for clinical intervention.Besides,through the combing of ancient books of traditional Chinese medicine(TCM),looking for traditional Chinese medicine(TCM)treatment of CKD patients with insomnia means and methods.Methods:Study one:Qualitative research method were conducted with semi-structured face-to-face in-depth interview.Purposeful sampling method was used to selected interviewees from CKD3-5 non-dialysis patients suffered from insomnia who were followed up for a long-term CKD management in Guangdong Provincial Hospital of TCM.Demographic characteristics and clinical information were also collected.When the interview data reached saturation,no more respondents.The interview content was recorded,transcribed and analyzed by using NVivo 11.0.Study two:This thesis uses the fifth edition of "Encyclopaedia of Traditional Chinese Medicine" as the search tool,then establish the database,and standardize the drug information of the data.Using "TCM Inheritance Computing Platform V3.0" analyze the medication rules.ResultsStudy one:18 patients with CKD3-5 were interviewed.Through data collection and analysis,four themes were extracted,which were influencing factors,consequences,attitudes and expectations,coping strategies.Theme one "influencing factors" can be divided into psychological physical factors,physiological factors and social factors.The second theme "consequences" is divided into two sub-themes:physiological and social.The third theme is "attitudes and expectations".Attitude contained three sub-themes:positive,fear and compromise.Expectation includes three sub-themes:full of confidence,lack of confidence and let it be.Theme 4 "coping strategies" is divided into three sub-themes,namely behavior change,multi-party support and specific measures.Study two:There were 261 effective prescriptions for treating CKD sleep disorder,involving 369 flavors of Chinese medicine.The top 10 medicines ranked in the frequency of medication were Poria cocos,Rehmanniae Radix Praeparata,Pericarpium citri reticulatae,Fructus Schisandrae,Chinese yam,Ophiopogon japonicus,Alisma orientalis,Radix Paeoniae Alba,Atractylodis Macrocephalae and cinnamon.The main treatment based on lung,spleen and kidney,followed by heart.The main association was modified Liuwei Dihuang pill.3 core combinations for new clustering were extracted.ConclusionFirst,through interviews,we found that CKD patients often fall into negative emotions because of their illness,leading to insomnia.Therefore,medical staff should not only pay attention to health education,but also formulate corresponding psychological intervention measures when necessary.Second,CKD patients generally lack confidence in insomnia and its treatment,and some patients adopt avoidance or negative attitude.Therefore,we can build a theoretical framework such as health belief model to find solutions with the cooperation of clinicians and patients.Thirdly,in the process of improving insomnia symptoms of CKD patients,family,social and medical support are essential.Fourthly,some patients widely collect ways to promote sleep in order to improve insomnia,among which they prefer traditional Chinese medicine in the choice of treatment.Therefore,we should actively explore the treatment of insomnia.Fifth,Through the research and analysis of TCM ancient literature in the treatment of CKD insomnia,we found that the treatment of insomnia of CKD focuses on lung,spleen and kidney,followed by heart.The treatment methods include strengthening the spleen and dispersing the lung,tonifying the kidney and calming the heart,and promoting water and dampness.Common drug combinations are Poria cocos-Rehmanniae Radix Praeparata-Fructus Schisandrae,Poria cocosRehmanniae Radix-Chinese yam,Tinglizi-Alisma orientalis-Pericarpium citri reticulatae;prescription can be Liuwei Dihuang pill.It provides certain reference value for such diseases.