Study On The Relationship Between Sleep Disorders And TCM Syndromes And Symptoms In Maintenance Hemodialysis Patients

Objective:To evaluate the quality of sleep and symptom distress of patients with maintenance hemodialysis(MHD)in Guang' anmen Hospital and the distribution characteristics of TCM Syndromes in patients with MHD and sleep disorders,analyze the related factors affecting sleep in MHD patients and the relationship between sleep disorders and TCM syndromes and symptom distress,and to provide a basis for the clinical studies in sleep disorder and TCM syndromes in maintenance hemodialysis.Method:Using cross-sectional epidemiological survey methods investigate general situation,Pittsburgh sleep quality index(PSQI),dialysis symptom index and TCM syndromes differentiation scale to obtain sleep quality index,symptom distress and symptoms of TCM,collecting clinical and biochemical indexes.Using SPSS20.0 statistical analysis the correlation between the quality of sleep in MHD patients with TCM syndrome and symptom distress.Results:The total score of PSQI in 201 patients with maintenance hemodialysis in Guang'anmen Hospital was 0?21 points,the mean value was 9.23±4.88 points,and the incidence of sleep disorder was 47.26%.The score of PSQI and the scores of each factor were significantly higher than that of domestic norm,and there were statistical differences(P<0.01).The distribution of TCM syndromes in MHD patients with deficiency syndromes are:Qi-Yin deficiency syndrome(77 cases,38.3%),Yang deficiency of spleen and kidney(55 cases,27.4%),Deficiency of spleen and kidney(37 cases,18.4%),Syndrome of liver and kidney Yin deficiency(23 cases,11.4%),Yin and yang deficiency syndrome(9 cases,4.5%);The distribution of the empirical syndrome types are:dampness syndrome(74 cases,36.8%),damp-heat syndrome(69 cases,34.3%),blood stasis syndrome(33 cases,16.4%),wind-induced syndrome(19 cases,9.5%),Water vapor syndrome in 6 cases(3.0%).The scores of PSQI have statistically significant difference between each syndrome of deficiency syndromes(P<0.05),with the same statistical significance in each syndrome of deficiency syndromes.According to the analysis of the influence factors of sleep disorders in MHD patients,there are statistical differences in age,age stratification,occupation,dialysis age,and whether sleeping pills were used(P<0.05),and no statistical differences in sex,educational level,marital status,family income,dialysis frequency,medical payment methods and primary diseases(P>0.05).According to multivariate analysis,there are statistical differences in age(P<0.05).Biochemical indicators in the calcium-phosphorus product,SF,Hb are statistical differences(P<0.05)and biochemical indicators in Ca,P,ALP,TP,ALB,CRP,Fe,PTH are not statistical differences(P>0.05).Distribution of TCM syndromes:the distribution of deficiency syndromes in patients with sleep disorders and without sleep disorders was statistical difference(P<0.05);the distribution of empirical syndrome types was statistically significant between the two groups(P<0.05).The PSQI score between the different syndromes of deficiency syndromes is statistically different(P<0.05)whlie the PSQI score is no significant difference between empirical syndromes(P>0.05).In the investigation of hemodialysis symptom distress,the incidence of 30 kinds of symptoms is 9.95%to 82.59%,with the average number of symptoms of 11,of which five of the highest incidence of symptoms are dry skin(82.59%),fatigue(66.67%),pruritus(66.67%),dry mouth(64.18%),(61.69%),easy to wake up.The above five symptoms in the symptom distress score,symptom frequency score,severity score are the highest.Spearman correlation analysis showed that the difference between the PSQI of factors and total scores in MHD patients and symptom severity,symptom severity symptom frequency,symptom distress are statistically significant(P<0.05).The investigation of hemodialysis MHD patients with sleep disorders shows that the incidence of 30 kinds of symptoms is 15%to 87.37%,the average number of symptoms is 14.The scores in symptoms score,symptom distress score,symptom frequency score,symptom severity scores about symptoms of dry skin,sleep difficulties,fatigue,easy to wake up,dry mouth are the highest.Comparison results of the incidence of symptoms in the two groups of patients indicate that the average number of symptoms of sleep disorders in patients isl4 while the other group is 9.The incidences of 24 symptoms are statistical differences(P<0.05),with significant differences in the 13 symptoms of difficulty in sleep,easy to wake up,fatigue,constipation,loss of appetite,dry mouth,restless legs,muscle soreness,dizziness,cough,chest pain,feeling anxious,sad(P<0.01).Conclusion:1.Sleep disorders are prevalent in MHD patients in Guang'anmen Hospital,with high incidence,affecting the quality of life of patients.Medical staff should pay more attention to the problems of sleep disorders.2.The occurrence of sleep disorders in MHD patients is affected by multiple factors,age is one of risk factors for sleep disorders.The calcium-phosphorus product,serum ferritin and hemoglobin were related factors of sleep quality.Clinical workers should more concern about the elderly patients,and strengthen the clinical monitoring of calcium,phosphorus,serum ferritin,hemoglobin in order to take appropriate interventions to improve the sleep quality of MHD patients.3.In this research patients with Qi and yin deficiency syndrome on MHD are more likely to suffer from sleep disorders and patients with amp-heat syndrome syndrome and water vapor syndrome on MHD are more easy to suffer from sleep disorders.Patients with Yin and Yang deficiency syndrome in the group of sleep disorders patients suffer from more severe sleep disorders.4.The more kinds of symptoms,more severe of symptom distress types,the higher frequency of symptoms,the more serious of symptoms,the poorer sleep quality in MHD patients with sleep disorders.Patients with sleep disorders on MHD suffer from a variety of symptoms,and symptoms are very difference with patients without sleep disorders.The clinical medical staff should pay attention to the occurrence of the overall symptoms and the difference in the incidence of symptoms to take appropriate intervention measures to improve patients' sleep disorders.