| ObjectiveBy collecting clinical data of insomnia patients and the information of the fourth diagnosis of traditional Chinese medicine,a comparative study of gastrointestinal symptoms of insomnia patients in the anxiety group and non-anxiety group was carried out to find the correlation between gastrointestinal symptoms and anxiety of insomnnia patients;Summarize the characteristics of TCM syndromes of patients with insomnia and anxiety,and provide reference for clinical syndrome differentiation and treatmentMethods:Cross-sectional study:Insomnia patients who met the inclusion and exclusion criteria in the encephalology clinic of Dongzhimen Hospital from June 2018 to January 2020 were included.The basic clinical data and personality characteristics of the patients were investigated.The questionnaire(self-designed)was used to collect patients The information of the four consultations of traditional Chinese medicine,using the Pittsburgh Sleep Index Scale(PSQI)to assess the sleep quality and sleep disorders of patients;the Hamilton Anxiety Scale(HAMA)and Depression Self-Assessment Scale(SDS)to assess the anxiety and depression;Increase and decrease the symptom entries in the gastrointestinal symptom grading scale to assess the severity of gastrointestinal symptoms in patients with insomnia;use the HXD-1 heart station tester to determine the patient’s heart rate variability and brain function activity;Detection of interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)from fasting blood.Results1 General information about insomnia patients:A total of 134 insomniacs were included in this study,the ratio of male to female is 1:1.73;the maximum age is 79 years,the minimum age is 18 years,and the average age is 45.84±13.18 years.The longest course of insomnia is 30 years and the shortest month is January,with an average course of 57.18 ± 7.16 months.There were 103 mental workers and 31 physical workers.There were 32 cases with hypertension(23.9%),34 cases with cervical spondylosis(25.4%),12 cases with thyroid disease(9.0%),and 11 cases with cerebrovascular disease(8.2%).2 Anxiety and depression of patients with insomnia:Based on the HAMA score of 14 points,134 patients with insomnia were divided into anxiety group(≥14 points)and non-anxiety group(<14 points).89 cases(66.4%)in the anxiety group and 45 cases(33.6%)in the non-anxiety group;there were no significant differences in gender,age distribution,and occupational nature between the anxiety group and the non-anxiety group(P>0.05).The SDS score of the anxiety group was higher than that of the non-anxiety group,and the difference was statistically significant(P<0.05)3 The difference between the anxiety group and the non-anxiety group was statistically significant in terms of work pressure,psychological pressure,staying up late,eating fast,inadequate chewing,and eating meat.There was a statistically significant difference between the anxiety group and the non-anxiety group in terms of too much thought,perfection,timidity,fright,and time urgency(P<0.05).4 Analysis of gastrointestinal symptoms of insomnia patients:The common gastrointestinal symptoms of insomnia patients in this study include uncomfortable stool stickiness(59.0%),unsatisfactory food intake(43.3%),less boring food(40.3%),and sticky mouth.(39.6%),dry stools(37.3%),increased number of bowel movements(35.1%),bloating(32.1%),incomplete bowel movements(32.1%),unshaped stools(28.4%),hiccups(18.7%),Heartburn(14.9%)There was no statistically significant difference in the incidence of gastrointestinal symptoms among insomniacs of different genders(P>0.05);the incidence of gastrointestinal symptoms was high in gastrointestinal symptoms in the anxious group insomnia patients with sticky stools,uncomfortable mouth,unsatisfactory food,and lack of food In the non-anxiety group(P<0.05);and the severity of gastrointestinal symptoms in the anxiety group was higher than that in the non-anxiety group,the difference was statistically significant(P<0.05).5 Analysis of the levels of interleukin-6 and high-sensitivity C-reactive protein in patients with insomnia:There was no statistically significant difference in the levels of interleukin-6 and high-sensitivity C-reactive protein in patients with insomnia of different genders(P>0.05);anxiety group and non-anxiety group The levels of interleukin-6 and high-sensitivity C-reactive protein in insomnia patients were statistically significant(P>0.05).6 Analysis of heart rate variability indicators of insomnia patients:SDNN,rMSSD,PNN50,VLF,LF of insomnia patients of different genders,the difference is statistically significant(P<0.05),SDNN,rMSSD,PNN50,VLF of women is higher than men The LF of men is higher than that of women.Compared with LF and HF in anxiety group and non-anxiety group,the difference was statistically significant(P<0.05).HF and LF in anxiety group were higher than those in non-anxiety group.7 Brain function analysis of patients with insomnia:Comparison of brain function between patients with insomnia of different genders,the difference is not statistically significant(P>0.05).The workload of the anxiety group was higher than that of the non-anxiety group,and the brain vitality of the non-anxiety group was higher than that of the anxiety group;there was a statistically significant difference in the workload and brain vitality of patients with insomnia between the anxiety group and the non-anxiety group(P<0.05)8 TCM syndrome characteristics of patients with insomnia and anxiety:Analysis of symptom frequency of patients with insomnia and anxiety in this study showed that the top ten symptoms were upset and irritable,stool stickiness,forgetfulness,thoughtfulness,palpitations,Stiff shoulders,dry mouth,dizziness,dizziness,poor appetite,and lack of food;preliminary inference from these symptoms is mainly in the liver,heart,and spleen,and is closely related to "qi";cluster analysis shows that insomnia combined The TCM syndromes of patients with anxiety are mainly liver stagnation and spleen deficiency syndrome,heart and spleen deficiency syndrome,liver stagnation and fire syndrome;the total pathogenesis is yang sheng yin decay,yin and yang loss.Conclusion1 Work stress,psychological stress,frequent staying up late,eating fast,inadequate chewing,and eating meat are closely related to the occurrence of insomnia combined with anxiety.Healthy and orderly living habits can avoid the occurrence of insomnia combined with anxiety.2 Patients with insomnia and anxiety are prone to gastrointestinal symptoms.The degree of anxiety is related to the severity of gastrointestinal symptoms.Abnormal mental and psychological factors may play a role in the mechanism of gastrointestinal symptoms in patients with insomnia.3 The dynamic balance between sympathetic and vagal nerves in the autonomic nervous system of patients with insomnia and anxiety is consistent with the basic pathogenesis of yin and yang disharmony in patients with insomnia and anxiety.4 The traditional Chinese medicine syndromes of patients with insomnia and anxiety are mainly liver stagnation and spleen deficiency syndrome,heart and spleen deficiency syndrome,and liver stagnation and fire syndrome. |
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