Study On The Correlation Between Sleep Characteristics, Circadian Rhythm And TCM Syndrome Factors In Patients With Insomni

Background:Insomnia is a common disorder that seriously affects the lives of patients.More than two-thirds of patients report symptoms for at least 1 year.Modern medical research has found that the circadian rhythm of insomnia patients has a stable synchronous relationship with body temperature and melatonin rhythm in the human body,and is closely related to neurological,endocrine and immune mechanisms.In traditional Chinese medicine,there is also a saying that the circadian rhythm of the human body is closely related to the circulation of Yingwei qi and blood.Some clinical studies have achieved certain curative effect by using drugs directed to meridians and zangfu organs according to the circadian rhythm of patients.However,there is still a lack of systematic research on the sleep characteristics of insomnia patients and the circadian rhythm and TCM syndrome differentiation.Objectives of the study:Explore the correlation between sleep characteristics,circadian rhythm and TCM syndrome differentiation.Methods:(1)Semi-structured interviews were conducted with TCM experts with rich clinical experience.The interview contents included three aspects:(1)views on the syndrome elements;② Key points of clinical syndrome differentiation of insomnia;③ The correlation between circadian rhythm and syndrome differentiation.Recordings were obtained and transcribed verbatim within 24 hours.Carefully read the verbatim manuscript and analyze the data after a comprehensive understanding.The written data were logged in using grounded theory three-level coding(open coding,axial coding,selective coding)to construct a conceptual framework,and then summarized and sorted out.(2)A cross-sectional study was conducted to investigate the patients with insomnia in the Department of Encephalopathy,Dongzhimen Hospital,Beijing University of Chinese Medicine.The survey indicators were:(1)a basic information questionnaire(including gender,age,past history,and other personal information,as well as the onset pattern,course of insomnia,and sleep characteristics.Sleep characteristics were divided into difficulty falling asleep,easy to wake up at night,early awakening,multiple dreams,nightmares,daytime fatigue,and nocturia.Pittsburgh sleep Quality Index scale;The Morning and evening Type questionnaire-5(MEQ-5)and the information collection form of the four diagnosis of insomnia in traditional Chinese Medicine(TCM).Then a database was established,and the data were entered according to the rules.Spearman rank correlation analysis was used to analyze the correlation between sleep characteristics,circadian rhythm and syndrome factors.Results:(1)In 201 patients,the frequency of disease-site syndrome factors from more to less was liver,spleen,heart,stomach,kidney,lung and gallbladder,and the frequency of disease-related syndrome factors from more to less was Yin deficiency,blood deficiency,Yang excess,qi deficiency,Yang deficiency,dampness,qi stagnation,fire and heat,phlegm turbidity,blood stasis and dyspepsia.(2)The age of insomnia patients was significantly positively correlated with Yin deficiency,blood deficiency and Yang excess.The frequency and severity of blood deficiency syndrome in female insomnia patients were higher than those in male insomnia patients,and the frequency and severity of phlegm turbidity syndrome in male insomnia patients were higher than those in female insomnia patients.(3)The incidence of insomnia was in the order of "acute","intermittent" and "chronic",and the frequency and severity of kidney and blood deficiency syndrome increased in sequence.The course of disease was positively correlated with Yin deficiency,blood deficiency and Yang excess.(4)In terms of the sleep characteristics of patients with insomnia,there was no significant correlation between difficulty in falling asleep and the location and nature of the disease.The symptoms of easy to wake up at night were significantly positively correlated with heart,liver,kidney and Yin deficiency,the symptoms of early waking up were significantly positively correlated with gallbladder,daytime fatigue was significantly positively correlated with spleen and qi stagnation,and nocturia was significantly positively correlated with kidney and qi deficiency.The symptoms of multiple dreams were positively correlated with Yin deficiency,blood deficiency,Yang excess and Yang deficiency,while nightmares were related to blood deficiency and blood stasis.In terms of circadian rhythm,patients with "morning type" are more likely to have spleen and Yin deficiency syndrome factors,and patients with"evening type" are more likely to have qi stagnation syndrome factors.Conclusions:there are some correlation between Sleep characteristics,circadian rhythm and TCM syndrome differentiation.