The Research On The TCM Symdrom Distribution And Clinical Characteristic Of Insomnia With Liver-Stagnation

Objectives:The main objectives of this research is to study the general information,TCM syndrome distribution, the grade of anxiety and depresstion, common clinical manifestation of the primary insomnia with liver stagnation.On the basis of this, the goal is to make prepare for the treatment of insomnia with liver stagnation based on syndrome differentiation, by Exploring the crowd characteristics and its clinical characteristic, screening the valuable symptoms for the diagnosis of patterns.Methord:This is a cross-sectional study, of which object comes from the neurology clinic of Fu jian academy of chinese medicine and the second people’s Hospital of Fu jian province from june 2012 to October 2014. On the basics of filling in general data table, pisttsburgh sleep quality index scale(PSQI), self-Rating anxiety scale(SAS), Self-Rating depression scale (SDS), further study will be done according to the diagnostic criteria setted in this research by statistical method.Results:1. General data:This study totally collected 851 cases of primary insomnia. Among them, the number of primary insomnia with liver stanagtion(abbreviate as liver stanagtion) is 435,which takes 51.1%. The number of primary insomnia with no liver stanagtion(abbreviate as no liver stanagtion) is 416, which takes 48.9%. Among liver stagnation, female takes 68.5% and male takes 31.5%. Grouping by age, the youth and middle age people take 81.8%, and the old people takes 18.2%; Grouping by education background, the low-levels of education takes 19.8%, the mid-levels of education take 51.0% and the high-levels of education takes 29.2%. Grouping by the course of disease, subacute insomnia takes 23.7% and chronic insomnia takes 76.3%. Grouping by profession, the people with unstable job and mental job occupy the most, which takes 42.5% and 31.5% respectively. The difference between the group of liver stngnation and no liver stagnation is significant in formation and course of disease.2. The distribution of TCM syndrome types:In this study, deficiency syndrome with liver stagnation takes 69.2%,solid syndrome with liver-stagnation takes 30.8%, the deficiency syndrome is consist of liver-stngnation and spleen-deficiency syndrome(32.7%),liver-stagnation and Yin-deficiency syndrome (26.4%), liver-stagnation and kidney-deficiency syndrome (4.8%), liver-stagnation and blood-deficiency syndrome (5.3%). The solied syndrome include liver-stagnation and Generating pathogenic fire syndrome(21.6%), liver-stagnation and blood stasis syndrome(9.2%).3. The comparison of scale grade:Comparing the difference in scale grade of PSQI, SAS, SDS between liver-stagnation and no liver-gtagnation by using T test (according to the alpha=0.05 standard), It shows that the differences are statistically significant in each scale. Namely, the group of insomnia with liver-gtagnation get higher grade than the one with no liver-gtagnation in PSQI, SAS and SDS.4. The relationship between TCM syndrom and symptoms:The relationship between common symptoms and iver-stngnation and Yin-deficiency syndrome is:Logit(P)=-5.702+ 1.233 depressive mood+1.686 upset and irritability+0.961 chest stufly+0.659 dry mouth +2.170 hectic fever+2.027 dysphoria in chestpalms-soles+2.219 thready rapid pulse; The relationship between common symptoms and liver-stngnation and spleen-deficiency syndrome is:Logit(P)=-4.074+1.30 depressive mood+1.009 upset and irritability+0.520 be easily wakened+0.959 pale tongue+0.615 stomach discomfort+0.783 dilute feces+1.193 eat little+0.931 abdominal distention+1.346 foreign body sensation inpharynx; The relationship between common symptoms and Liver-stngnation andspleen-deficiency syndrome is:Logit (P)=-4.201+0.816 depressive mood+1.383upset and irritability+1.146 bitter mouth+1.271 flushing+0.865 red tongue+1.445 rapid and string pulse.Conclusion:1. Deficiency syndrom is more common than solid syndrom in insomnia with Liver stngnation, The deficiency syndrom mainly contains liver-stagnation and spleen-deficiency syndrome, liver-stagnation and Yin-deficiency syndrome, and the solid syndrom mainly contain liver-stagnation and generating pathogenic fire syndrome.2. Patients with insomnia of liver-stagnation have a tendency of anxiety and depression Compared with patients wiht no liver-stagnation syndrome, and the former are more serious in a degree of sleeplessness.3. Screening the preliminary diagnostic symptom for the main patterns of primary insomnia with liver-stagnation:the preliminary diagnostic symptom of liver-stngnation and spleen-deficiency syndrome is depressive mood, be upset and irritability, be easily wakened, pale tongue, stomach discomfort, dilute feces, abdominal distention, foreign body sensation in pharynx. The preliminary diagnostic symptom of liver-stngnation and Yin-deficiency syndrome is depressive mood, be upset and irritability, chest stufly, dry mouth, hectic fever, dysphoria in chestpalms-soles, thready rapid pulse. The preliminary diagnostic symptom of liver-stagnation and Generating pathogenic fire syndrome is depressive mood, be upset and irritability, bi-tter mou-th, flushing, red tongue, rapid and string pulse.