Research On The Distribution Of TCM Syndromes And Characteristics Of Insomnia In Middle-aged And Elderly People

ObjectiveBy comparing the TCM syndromes,insomnia types,and sleep quality between middle-aged insomnia patients and elderly insomnia patients,as well as the correlation among TCM syndromes,insomnia types and sleep quality in the two groups of patients,this study explored the distribution rules of TCM syndromes and clinical characteristics of middle-aged and elderly insomnia,so as to provide some reference for the theoretical system of clinical prevention and treatment of elderly insomnia.MethodsThis study adopted the method of cross-sectional study,and selected 264 patients with insomnia in the outpatient clinic or ward of Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2019 to December 2019.They were divided into middle-aged group(n=132)and elderly group(n=132).The general data and TCM four diagnostic information of the two groups were collected.The sleep quality was evaluated by Pittsburgh Sleep Index scale(PSQI),and the daytime sleepiness was measured by Epworth sleepiness scale(ESS).The TCM syndromes and insomnia types of the two groups of insomnia patients were determined through the above information.SPSS 20.0 statistical an alysis software was used to perform statistical analysis on all data.The methods used included descriptive analysis,chi-square test,nonparametric test,and so on.Results1.The difference of TCM syndrome:there were significant differences between the two groups in syndrome of stagnation of liver into fire,incompatibility of heart and kidney and deficiency of yang-qi(P<0.05),but there was no significant difference in phlegm-heat internal disturbance syndrome and heart-spleen deficiency syndrome(P>0.05).The middle-aged group was more likely to have liver-stagnation fire syndrome(26.5%),while the elderly group was more likely to have heart-kidney disharmony syndrome(28.8%)and yang-qi deficiency syndrome(24.2%).2.The difference in insomnia types:the difference between the two groups was statistically significant(P<0.05)in the types of difficulty in falling asleep,easy-wake,early-wake and dreamy,but not statistically significant in the types of sleepless and mixed sleep(P>0.05).The middle-aged group was more likely to have difficulty falling asleep(28.1%)and dreamy(22.7%).The elderly group was more likely to easy-wake(24.2%)and early-wake(16.7%).3.The difference in sleep quality and daytime arousal:there was significant difference between the two groups(P<0.05).The mean value of PSQI score in the elderly group was higher than that in the middle-aged group.And the mean value of ESS score in the middle-aged group was higher than that in the elderly group.4.The distribution of PSQI score in TCM syndrome:the distribution of PSQI score in TCM syndrome has significant difference in the middle-aged and elderly group(P<0.05).From high to low,the average value of PSQI of the middle-aged group score was heart-kidney disharmony syndrome,phlegm-heat internal disturbance syndrome,yang-qi deficiency syndrome,liver depression and fire resolving syndrome,and heart-spleen deficiency syndrome,while the elderly group was liver depression and fire resolving syndrome,heart-kidney disharmony syndrome,yang-qi deficiency syndrome,heart-spleen deficiency syndrome andphlegm-heat internal disturbance syndrome.5.The distribution of PSQI score in insomnia type:the distribution of PSQI in insomnia type in the middle-aged and elderly group was significantly different(P<0.05).The average value of PSQI score of the middle-aged group from high to low was sleepless type,dreamy type,early-wake type,difficult to fall asleep type,easy-wake type and mixed type,while the elderly group was sleepless type,mixed type,early-wake type,easy-wake type,dreamy type and difficult to fall asleep type.6.The comparison of TCM syndrome distribution of different types of insomnia:In middle-aged gr oup,ther e were differences in the distribution of TCM syndromes of sleepless night type(P<0,05).There was no significant di.fference in the distribution of TCM syndromes of sleep difficulty type,easy-wake type,early-wake type,dreamy type and mixed type(P<0.05).The heart-kidney disharmony syndrome was the main type of sleepless night type.While in the elderly group,there were differences in the distribution of TCM syndromes of sleep difficulty type,early-wake type and mixed type(P<0.05),There was no significant difference in the distribution of TCM syndromes of easy-wake type,dreamy type and sleepless night type(P>0.05).The heart-kidney disharmony syndrome was the main type of difficulty in falling asleep and the mixed type,and the early-wake type was dominated by yang-qi deficiency syndrome.Conclusion1.There are differences in the distribution of TCM syndromes in middle-aged and elderly patients with insomnia.The middle-aged patients are mainly positive,mainly liver-stagnation fire syndrome,and elderly patients are mainly kidney deficiency syndrome,mainly heart-kidney disharmony syndrome and yang-qi deficiency syndrome.2.There are differences in the distribution of insomnia types in middle-aged and elderly patients with insomnia.The middle-aged patients are mainly falling asleep type and d'reamy type.The elderly patients are mainly early-wake type and easy-wake type.3.The daytime awakening of middle-aged patients with insomnia is lower than that of elderly patients,and the sleep quality of elderly patients with insomnia is worse than that of middle-aged patients.4.The TCM syndromes of middle-aged and elderly patients with insomnia are related to sleep quality.The sleep quality of middle-aged patients with heart-kidney disharmony syndrome and phlegm-heat internal disturbance syndrome is the worst,while the sleep quality of elderly patients with liver-stagnation fire syndrome and heart-kidney disharmony syndrome is the worst.5.The type of insomnia in middle-aged and elderly patients with insomnia is related to sleep quality.The quality of sleepless and dreamy type in middle-aged patients is the worst,while the quality of sleepless and mixed type in elderly patients is the worst.6.There is a certain correlation between insomnia types and TCM syndromes in middle-aged and elderly patients with insomnia.Middle-aged patients with sleepless type often have heart-kidney disharmony syndrome,while elderly patients have difficulty in falling asleep and mixed type,often have heart-kidney disharmony syndrome,and early awakening type often see yang-qi deficiency syndrome.