| Objective:To investigate the sleep quality and the distribution of thyroid hormone levels in GAD patients with the syndrome liver depression transforming into fire.So as to provide reference data for the diagnosis and treatment of generalized anxiety disorder.Methods:Patients admitted to the department of encephalopathy of the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine from June 2019 to December 2019 due to generalized anxiety and conforming to the syndrome of liver depression and fire were selected as the anxiety group,and healthy volunteers who participated in a physical examination in our hospital during the same period were selected as the control group.The general condition questionnaire,TCM syndrome scale,Hamilton anxiety scale and Pittsburgh sleep quality index scale were used to collect the general condition,TCM syndrome information,anxiety and sleep quality of the subjects.Serum thyroid hormone levels were measured by radioimmunoassay in all subjects.Epidata3.1 was used to establish the database and SPSS 23.0 was used for statistical analysis.For data conforming to normal distribution,independent sample t test was used for comparison between two groups,and one-way analysis of variance was used for comparison between multiple groups.A non-parametric test was used only for data that did not conform to the normal distribution,and the chi-square test was used for multi-group comparison.Pearson correlation analysis was used for the correlation analysis of each factor.Results:1.A total of 89 people were included in this study.There were 57 females,accounting for 64.04%,and 32 males,accounting for 35.96%.The youngest patient was 22 years old and the oldest 75 years old,with an average age of(48.57±14.90)years.Most of the students had a bachelor's degree or above,56 of whom had a bachelor's degree or above,accounting for 62.92%,and 33 with a high school degree or below,accounting for 37.08%.There were 36 people with good economic conditions,accounting for 40.45%,49 people with mediocre economic conditions,accounting for 55.06%,and 4 people with poor economic conditions,accounting for 4.49%.36 people social interaction is widespread,44 people,9 people less social interaction,respectively accounted for 40.45%,49.44%,10.11%.80.90%of the patients lived in urban areas,significantly higher than the townships(12.36%)and suburbs(6.74%).36 people social interaction is widespread,44 people,9 people less social interaction,respectively accounted for 40.45%,49.44%,10.11%.There were 27 people with broad interests,accounting for 30.33%,52 people with general interests,accounting for 58.43%,and 10 people with less interests,accounting for 11.24%.57.30%of the patients had a moderate family relationship,19.10%had a poor family relationship,and only 23.60%had a harmonious family2.Compared with the control group,the overall sleep quality of GAD patients with the syndrome liver depression transforming into fire was worse(p<0.01).Among GAD patients,86.52%were accompanied by sleep disorders of different degrees,moderate insomnia was the most common(53.93%),with mild insomnia and severe insomnia accounting for 12.36%and 20.23%,respectively.Descriptive statistics on the distribution of PSQI factors greater than or equal to 2 in patients in the anxiety group showed that the three most frequent sleep problems were difficulty falling asleep,short sleep time and daytime dysfunction,accounting for 80.90%,82.02%and 78.65%,respectively.The anxiety of different gender in comparison with the sleep quality of patients did not see obvious difference(p>0.05).Compared with the sleep quality of patients in the anxiety group of different age groups,it was found that the elderly group was worse than the young group and the middle-aged group,and the difference was statistically significant(p<0.01).Compared with the patients in the anxiety group with different degrees of anxiety,it was found that the sleep quality of the patients in the moderate anxiety group and the severe anxiety group was worse than that of the patients with mild anxiety,and the difference was statistically significant(p<0.01).3.The T4 level of thyroid hormone in GAD patients was higher than that in the control group,and the difference was statistically significant(p<0.01).At FT4 level,the difference between the female anxiety group and the male anxiety group was statistically significant(p<0.05).The distribution of thyroid hormone levels in T4 was different in the anxiety group of different age groups,and further pair comparison showed that the elderly group was higher than the middle-aged group(p<0.05,p<0.05).The distribution of T4 level in patients with different anxiety levels was different,and further pairings showed that patients with evere anxiety were higher than those with mild anxiety(p<0.05).The distribution of T4 level in patients with different degrees of insomnia was different,and further pairings showed that the group with severe insomnia was higher than the group without insomnia(p<0.01).T4 was positively correlated with sleep efficiency,hypnotic drug use,total PSQI score and total HAMA scoreConclusion:1.GAD patients with syndrome liver depression transforming into fire have different degrees of sleep disorders,most of which are moderate to severe insomnia.Their sleep problems are mainly manifested in difficulty in falling asleep,short sleep duration and daytime dysfunction.Older patients and those with moderate to severe anxiety had worse sleep quality2.Hypothalamus-pituitary-thyroid(HPT)axis dysfunction in GAD patients with syndrome of liver depression transforming into fire and the level of T4 tends to be hyperactive.Advanced age,severe anxiety,and severe insomnia were associated factors for higher T4 levels. |
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