目的:通过分析失眠伴肠道功能异常患者的临床特点及证候分布特征,研究失眠与肠道功能异常的关系.方法:采用横断面调查方法对238例失眠患者进行包括临床症状、PSQI评分、HAMA评分等系统分析,对肠道功能正常与肠道功能异常2组进行比较分析,其中肠道功能异常主要以排便异常为主.结果:238例失眠患者中,伴有排便异常患者占50.4％,排便异常主要分大便干、大便黏滞不爽、大便泄泻几种类型,失眠患者以中青年女性为多,主要从事脑力劳动,大多数性格急躁易怒、思虑过多.失眠伴有排便异常患者的焦虑程度偏高,临床以心烦、腰膝酸软、畏寒、口燥咽干、五心烦热、脱发、发变白、脘闷食少、腹胀、口黏不爽、纳食不消、咽中异物感、疲乏无力、边有齿痕、舌苔厚等症状为特征性临床表征.通过对失眠伴有肠道功能异常患者的敏感性和特异性临床表征进行聚类分析,发现失眠伴肠道功能异常患者以肝郁脾虚、郁而化火、湿浊困阻为核心证候病机.结论:失眠患者中焦虑程度偏高的容易出现肠道功能异常,失眠伴肠道功能异常患者以肝郁脾虚、郁而化火、湿浊困阻为核心证候病机.且失眠与肠道功能异常存在一定相关性,根据脑肠轴的存在推测脑与肠存在一定的关联,有待进一步临床研究证实.%Object:To study the relationship between Insomnia and intestinal dysfunction by analizing the Clinical characteristics and the TCM syndromes of insomnia patients with and without intestinal dysfunction.Method:Using Cross-sectional survey method to analyzed 238 insomnia patients' clinical symptoms,PSQI scores,HAMA scores,and so on.The insomnia patients were divided into 2 groups normal intestinal function and abnormal intestinal function (the dysfunction of intestinal tract mainly abnormal defecation).Result:Among 238 insomnia patients,the dysfunction of intestinal tract accounted for 50.4％.The majority of insomnia patients is young and middle-aged women,mainly engaged in mental Labour,most irritable character,thinking too much.Insomnia patients associated with abnormal defecation have a higher anxiety level,whose clinical characteristics are:anxiety,soreness and weakness of waist and knees,aversion to cold,dysphoria with feverish sensation in chest,palms soles,dry mouth and dry throat,hair loss,premature graying hair,anorexia,abdominal distension,sticky and greasy in mouth,indigestion,abnormal sensation of throat,tiredness,teethprinted tongue and thick fur.Through the study of the clustering analysis of data found that the central pathogenesis of insomnia patients with intestinal dysfunction is the stagnation of liver qi and spleen deficiency,pathogen accumulation causing fire,damp pathogen obstruction the spleen.Conclusion:Insomnia patients with higher anxiety level is more prone to intestinal dysfunction.The pathogenesis of insomnia patients with intestinal dysfunction is the stagnation of liver qi and spleen deficiency,pathogen accumulation causing fire,damp pathogen obstruction the spleen.There is a certain correlation between insomnia and intestinal dysfunction,and presumably there is a cetain relationship between the brain and the intestine,which needs further clinical study.
展开▼
