Research On The Characteristics And Quantitative Discrimination Of Phlegm Syndrome Of Insomnia

Objective:To investigate the distribution of "Diagnostic Criteria for TCM Syndrome" in patients with insomnia.To compare the differential distribution of clinical manifestations between insomnia patients with sputum syndrome and non-sputum syndrome.To study the general syndrome characteristics of patients with insomnia.To explore the quantitative identification points of the diagnosis of phlegm insomnia.To provide a certain reference for the diagnosis and treatment of clinical syndrome differentiation and subsequent scientific research for insomnia with sputum syndrome.Methods:Taking patients who came to the outpatient in Oriental Hospital of Beijing University of Traditional Chinese Medicine with sleep disorder from May 2018 to March 2019 as the main research object.The questionnaire was used to collect information from the first-time patients.The meaningful factors were selected by single factor analysis and binary logistic stepwise regression method.The conditional probability conversion method was used to assign relevant factors,and the maximum likelihood discrimination method was used to determine quantitative diagnostic threshold of the insomnia sputum syndrome.At the same time,with reference to the evaluation principle of diagnostic tests,the established quantitative criteria were retrospectively tested for sensitivity and specificity.Results:1.The literature review finds that using quantitative opinion to explore the quantitative diagnostic criteria of TCM syndromes with modern computer technology is a hot topic in today's syndrome research.The current diagnostic criteria for phlegm syndrome of insomnia mainly focus on the pathological factors of phlegm and heat.But sputum can also be combined with qi stagnation,blood stasis,etc.There are relatively few studies on the general syndrome characteristics of sputum syndrome in patients with insomnia.2.A total of 162 patients with insomnia were included in the study,including 100 patients in the phlegm syndrome group and 62 patients in the non-sputum syndrome group;52 males and 110 females.There was no significant difference in age between the phlegm syndrome group and the non-sputum group.The patients under 65 years old accounted for 89%and 87.1%,respectively.There was no statistical difference in gender between the phlegm syndrome group and the non-sputum group.Among the male patients,the youth group(aged 18-45)accounted for 61.5%,and 52.7%of the female patients were 45-65 years old.The most common type of insomnia in the phlegm syndrome group were difficulty falling asleep(73.3%),while the most frequent type of insomnia in the non-sputum group were wake up early(60%).3.The chi-square test showed that the distribution of the following eight factors was statistically different between the two groups:dizziness,chest tightness,abdominal cramps,anorexia,mouth stick,viscous stool,greasy tongue,and slippery pulse.Further Logistic Regression analysis obtained 5 meaningful indicators:head dizziness,abdominal cramps,viscous stool,greasy tongue and slippery pulse.After the assignment and calculation of the diagnostic threshold,we concluded the diagnostic points of sputum syndrome of insomnia:1.Head dizziness(13 points)2.Abdominal cramps(8 points)3.Slippery pulse(8 points)4.greasy tongue(5 points)5.viscous stool(4 points).As long as the score is>19 points,the phlegm syndrome can be diagnosed.The diagnostic test results in a sensitivity of 88%and a specificity of 80.6%.4.Among all the objects,56 patients underwent biochemical examination.Chi-square test found that elevation of low-density lipoprotein(LDL)and Hyperhomocysteinemia were significantly different between the two groups(P<0.01).Conclusion:1.It is difficult for the sputum syndrome group to fall asleep,while the non-phlegm syndrome group is more likely to wake up early.2.Head dizziness,abdomen suffocation,slippery pulse,greasy tongue and stool stagnation are meaningful for the diagnosis of phlegm syndrome.3.Elevation of low-density lipoprotein(LDL)and homocysteine may be meaningful for the diagnosis of sputum syndrome in insomnia patients.It can not be considered that elevation of total cholesterol(TC),triglyceride(TG)and small-density low-density lipoprotein(sdLDL)are abnormal for the diagnosis of sputum syndrome in insomnia patients.