Insomnia Characteristics Of Cancer Patients And Tcm Clinical Research

Objective:Research on characteristics and the TCM differentiations of sleeping disorders in cancer patients, by using of sophisticated measuring scale associated with sleep.Methods:Designing the questionnaires basing on the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the insomnia symptom rating scale for Chinese to conduct a survey about sleep in patients with malignant tumors, Insomnia syndrome diagnostic criteria refer to "the clinical syndromes of guiding principles" and " Chinese medical science 7th Edition, The excel form and spss13.0 software were used for statistics.Results:210 cases of cancer patient were investigated in this study, excluding 10 cases,200 cases of valid cases, in which 60 were males, 140 were females,155 were outpatients and 45 were inpatients. Patients age ranged from 56 to 75 years old, most of cases received college education. Other basic information of objects included:spouses of 132 and no spouse of 68; they were mainly civilian employment, of which cadres accounted for 66%, white-collar workers accounted for 71.5%; for course of the disease,49 cases were within half a year,68 were half to two years,83 more than two years; the types of primary tumors were mainly lung cancer and breast cancer, with rates of 30.5% and 27.35% respectively,the rest were in proportion to the level of 22% of gastrointestinal cancer,7.5% gynecological cancer,6.5% urinary tract cancer,2% parotid gland cancer, of the total nasopharyngeal carcinoma and NHL each was 1%, breast cancer, Osteosarcoma, brain tumor and skin cancer each accounted for 0.5%; in respect of TNM stage,11 cases were stageⅠ,33 cases were stageⅡ,66 cases were stageⅢand 90 cases were stageⅣ; 83.5% of them received surgical treatment; KPS score was mainly in the group of 70 to 80 points (80%). The results of PSQI evaluation showed that most patients got 8-10 points (59%), with the highest scores of sleep time and sleep efficiency; clinical symptoms of insomnia were difficulty to fall asleep (48.5%), light sleep and dreaminess (22.5%), easy to wake up and early awakening (36%), short sleep time (10%), day residual symptoms (16%), often accompanied by other symptoms such as palpitations, fatigue, fear, heat sensation in chest, palms and soles; syndrome differentiation of insomnia patients were 26 (13%) with excess liver qi leading to fire syndrome, 16 (8%) with phlegm and heat disturbing syndrome,37 (18.5%) with qi deficiency of heart and gallbladder,89 (44.5%) with qi deficiency of heart and spleen and 32 (16%) with yin asthenia causing fire. Among all clinical syndromes difficult to sleep and easy to awake were major problem; excess syndrome and deficiency had various degrees of insomnia with significant difference (P<0.01), evidence of insomnia was more severe in deficiency; evidence of insomnia was the same in the syndrome of excess liver qi leading to fire syndrome and phlegm and heat disturbing syndrome with no significant difference (P> 0.05); the degrees of insomnia in deficiency syndrome had statistical difference (P<0.05), in that insomnia in qi deficiency of heart and gallbladder group was more severe than qi deficiency of heart and spleen and yin asthenia causing fire syndrome.Conclusion:Patients with cancer insomnia mostly were female, spouses, and the elderly, the majority of them had high educational level, job occupation with less manual labor civilian career oriented, most of which were the cadres, or white-collar workers, It was a long course of disease generally;the types of primary tumors were mainly lung cancer and breast cancer, in respect of TNM stage, stage IV was the highest probability of the Insomnia in patients, Most patients received surgical treatment, and KPS score was higher than we thought; PSQI evaluation showed a lesser extent in patients with insomnia, and difficulty falling asleep and sleep efficiency with low was the main; insomnia clinical manifestations were difficulty falling asleep and easy to wake up early awakening, often accompanied by other symptoms such as palpitations, fatigue, fear, five upset hot and so on. Cancer syndrome in patients with insomnia characterized by excess and deficiency mixed, with deficiency syndrome main, It was mainly in syndrome of qi deficiency, including heart qi, spleen qi and gallbladder qi, the most common was qi deficiency of heart and spleen, otherwise excess syndrome was mainly in liver qi Yu and liver qi leading to fire syndrome, Symptoms became more severe if hepatobiliary symptoms had appeared together.