| Objective:This study was to survey the PCI postoperative coronary heart disease patients of insomnia,the extent of insomnia and PCI correlation with coronary heart disease,insomnia,types and distribution of TCM syndrome type and quality of life,so as to understand the status of the PCI perioperative patients with insomnia and the proportion of TCM syndrome types.Methods:This study used a cross-sectional survey research approach,in August 2016 to April 2017 at dongzhimen hospital cardiovascular internal medicine outpatient and the inpatient treatment after coronary stent with 40 patients with insomnia,and included in 20 patients with CHD no stent with insomnia,the CHD of 20 patients with cardiovascular diseases associated with insomnia as two control group patients' information collected through questionnaire,collecting the basic data,history of disease and the treatment situation and risk factors control situation,pathogenesis and treatment of insomnia,anxiety,depression,quality of living survey and TCM symptom diagnosis.Establish a database,using SPSS 17.0 statistical software for data statistics and analysis,according to the data in the control group,analyses the reason of the research object of insomnia,types and distribution of TCM symptoms and the correlation of PCI.Results:1.The basic situation:the study included 80 cases of patients,including coronary heart disease after stent with 40 patients with insomnia,including 3 patients with rehabilitation stage ?,4 patients with rehabilitation stage ? and 33 patients with rehabilitation stage ?;Coronary heart disease without stent there were 20 patients with insomnia,20 patients with coronary heart disease and 20 patients with insomnia.All the patients including 38 males and 42 females;The mean age at 80 patients was 66.99±11.049 years,with a minimum age of 42 years and a maximum age of 91 years.The age distribution of all patients was statistically significant.There was no significant difference in age distribution among the three groups.The age of male patients with coronary heart disease was significantly lower than that of female patients.2.Risk factors control situation:in this study 61 people(76.25%)in all patients diagnosed with hypertension,34 people(42.5%)in all patients diagnosed with diabetes,In all patients,60(75%)were diagnosed with hyperlipidemia,The prevalence of hypertension and hyperlipidemia in patients with postoperative coronary heart disease and those with hypertension and arrhythmia was higher than that of diabetes mellitus.In this study,the proportion of patients with a history of smoking in the PCI group was 42.5%,30%in the coronary heart disease group and 25%in the non-coronary heart disease group.The proportion of patients with drinking history was 30%and above.3.The illness and treatment:In the PCI group,32 patients had angina pectoris before surgery;1 In the CHD group,9 patients had angina pectoris.Statistical analysis of coronary heart disease in patients with angina pectoris in patients with coronary heart disease was significantly higher than the probability of coronary heart disease patients without coronary heart disease.60-69 years old patients with the highest incidence of angina pectoris.There was no significant difference in the incidence of angina in different age groups.Twenty patients with PCI were enrolled in this study.Twenty patients with single-vessel disease were enrolled in this study.Seven patients with double-vessel disease were enrolled in this study.4.With arrhythmia:Patients with coronary heart disease were enrolled in arrhythmia;10 patients in the CHD group were associated with arrhythmia,and a total of 23 had arrhythmias.The incidence of arrhythmia in the three groups was statistically significant,and the incidence of arrhythmia in the PCI group was significantly lower than that in the coronary heart disease group.5.Insomnia situation:The average age of 80 patients with insomnia was 54.388±16.044,the youngest age was 13 years old and the oldest age was 86 years.Age is the risk factor of insomnia in this study has been statistically supported,different age stages of the incidence of insomnia is different.Patients in the 50-59 age group more prone to insomnia.The age of onset of insomnia in male patients with coronary heart disease was significantly lower than that in female patients with insomnia.Included in the majority of patients with chronic insomnia,accounting for 83.75%.80 cases of insomnia in patients with symptoms of sleep for 62 people,sleep lightly,easy to wake up to 62 people,the dream of more than 42 people,from the night more than 36 people,wake up hard to re-sleep 57 people,sleep more Adequate,awake still tired after 5 people.The difference between the three groups in the insomnia symptoms was statistically significant.The incidence of difficulty in sleep in the PCI group was higher than that in the other two groups.The incidence of sleep disorder was the highest among the patients after PCI,followed by difficulty in sleep again after PCI.The impact of physical factors in patients with sleep less than the impact of mental factors Sleepers.The most likely cause of the PCI group to affect the patient's sleep was to think about family or work trivia(42.5%).80 patients with insomnia improved in 48 cases,no improvement in 20 cases,improved less in 12 cases;Insomnia improved to take the most effective medication.There were 4 patients(10%)with insomnia in the PCI group,7(17.5%)were more severe after the postoperative insomnia,3(7.5%)were insomnia,and insomnia was no different 26(65%).The changes in insomnia in 65%patients were not associated with PCI.6.Sleep score:To assess the severity of insomnia in patients with PSQI,The differences were not statistically significant.Male patients with PSQI were significantly smaller than women's Pittsburgh score.AIS was used to assess the degree of insomnia in 80 patients,the differences were not statistically significant.ISI score was significantly higher in women than in men.7.Degree of sleepiness and fatigue level:The degree of sleepiness was evaluated by ESS.83.75%patients are within the normal range.FSS evaluation of 80 patients with fatigue,80 patients were in the fatigue range of 68 people,does not belong to the fatigue range of 12 people.8.Anxiety depression:SAS was evaluated for anxiety in patients,with 60 of the 80 patients in the normal range,16 patients with mild anxiety,and 4 patients with moderate anxiety.No patients are severe anxiety.SDS was evaluated for depression in patients.Seven of the 80 patients were in the normal range,12 patients had mild depression,3 patients had moderate depression,and one patient was in severe depression.83.75%patients were not depressed,and 16.25%were in a depressed state.9.TCM syndrome type distribution:The distribution of TCM syndromes in the PCI group and the coronary heart disease group was statistically significant.Stent postoperative patients with qi deficiency and blood stasis type of the most,more than coronary heart disease Qi and blood stasis type patients,stent postoperative patients with syndromes distribution to Qi and blood stasis most,Qi and blood stasis>phlegm heart pulse>blood stasis>Yang Qi and Yin Deficiency>Yin and Yang Deficiency>Qi and blood stasis>Qi and Yin Deficiency>heart and kidney,and coronary heart disease patients with TCM syndromes distribution is significantly different.The symptom score of the PCI group was lower than that of the coronary heart disease group.The symptom score of men in patients with coronary heart disease(regardless of whether or not the stenting)was lower than the females'symptom score.Conclusion:1.The symptom distribution of insomnia in patients with insomnia after PCI was statistically supported by PCI.There were significant differences in the distribution of insomnia between patients with PCI and those with coronary heart disease who did not experience PCI in patients with hypertension or arrhythmia.After PCI patients to sleep the most difficult to sleep,followed by more difficult to sleep again after sleep.2.65%patients with insomnia after PCI no significant changes,PCI caused or increased insomnia 27.5%,PCI after sleep only 7.5%.3.Patients with PSQI,AIS,ESS to assess the severity of insomnia,PCI patients with coronary heart disease,hypertension or arrhythmia patients do not have significant differences.4.PCI patients with postoperative patients with coronary heart disease in the distribution of TCM syndromes have significant differences.Stent postoperative patients with the distribution of syndromes to the largest blood stasis,qi deficiency blood stasis>phlegm obstructed heart>blood stasis>yang deficiency=chill stagnation>Qi stagnation>Qi and Yin Deficiency>heart and kidney,And the distribution of TCM syndromes in patients with coronary heart disease is significantly different. |
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