中医药研究论丛

231.1门诊失眠患者中医辨证分型与基本资料之相关性研究
TJ TCM.23(1) : 1-18, 2020 1
门诊失眠患者中医辨证分型与基本资料之相关性研究
Correlation between Traditional Chinese Diagnostic Patterns Identification and Personal Demographics in Outpatient of Insomnia
陈秀美1 王智龙2 翁培元3 李明仪3 康世肇4 曹玄明5 吕万安6*
1 佛光大学生命与宗教学系硕士班生命学组,宜兰,台湾
2 国立阳明大学附设医院中医科,宜兰,台湾
3 国立阳明大学附设医院精神科,宜兰,台湾
4 国立阳明大学附设医院家医科,宜兰,台湾
5 国立阳明大学暨国立阳明大学附设医院心脏内科,宜兰,台湾
6 佛光大学文化资产与创意学系所,宜兰,台湾
【摘要】
目的:全台1/10 人口受慢性失眠症所苦,轮班工作者的慢性失眠为白天班的2.18 倍,失眠是中医门诊常见的主诉,许多疾病常伴随着失眠的出现,加上失眠的成因与种类复杂,容易造成临床辨证上的困难,本研究目的为失眠症进行中医辨证分型评量,分析是否与个案之人口学资料、疾病状况、家族病史、疾病治疗等有所关联。
方法:本研究采取横断式问卷调查法,以方便取样为原则,选取宜兰县某一区域教学医院精神科门诊,根据失眠症之诊断标准,筛选失眠症患者,进行问卷调查。
结果:180 位失眠症个案,女性118 人,男性62 人,年龄22-80 岁,平均年龄51.6±13.4 岁,中医辨证分型以阴虚火旺型70 人(38.9%)最多,依序为肝郁化火型60 人(33.3%)、痰热内扰型26 人(14.4%)、心胆气虚型10人(5.6%)、心脾两虚型8 人(4.4%)、其他证型6 人(3.3%)。个案之性别、年龄、婚姻状况、BMI、腰围、教育程度、职业、轮班、抽烟、喝酒、病程、接受西医治疗、是否曾接受或合并其他疗法等与中医辨证分型均无显着相关,但家族史与中医辨证分型之间则具有显着相关(P<0.05)。
结论:中医辨证分型与家族史之间具有显着相关性,换言之中医辨证分型可能与遗传性体质有关联,显示中医辨证分型是客观的、事实的。因此,本研究可作为失眠症整合医学发展时的叁考。
【关键词】失眠症、中医辨证分型、原发性失眠、次发性失眠
Hsiu-Mei Chen1 Zhi-Long Wang2 Pei-Yuan Weng3 Ming-Yih Lee3
Shih-Checo Kang4 Xuan-Ming Cao5 Wan-An Lu6*
1Life Study Group for Graduate Institute of Life and Religions Studies, Fo Guang
University,Yilan, Taiwan
2Division of Traditional Chinese Medicine, National Yang Ming University Hospital, Yilan, Taiwan
3Division of Psychiatry, National Yang Ming University Hospital, Yilan, Taiwan
4Division of Family Medicine, National Yang-Ming University Hospital, Yilan, Taiwan
5Division of Cardiology, National Yang Ming University Hospital and National Yang
MingUniversity, Yilan, Taiwan
6Department of Cultural Assets and Reinvention, Fo Guang University, Yilan, Taiwan
【Summary】
Purpose: The 1/10 population of the whole station suffers from chronic insomnia in Taiwan. The chronic insomnia of shift workers is 2.18 times that of the day shift. Insomnia is a common complaint in traditional Chinese medicine (TCM)clinics. Many diseases are often accompanied by the occurrence of insomnia, plus complex of the causes and types of insomnia, so easy to cause clinical difficult in syndrome differentiation. The purpose of this study was investigated the
correlation among the demographic data, disease status, family history, treatment and the classification of TCM syndromes for insomnia assessment.
Methods: This study used the cross-sectional questionnaire survey with the convenience sampling method. Screened patients according to the diagnostic criteria for insomnia and conducted a survey from the psychiatric outpatient department of regional teaching hospital in Yilan y.
Results: There were 180 cases of insomnia, 118 females and 62 males, aged 22-80 years old, with an average age of 51.6±13.4 years old. TCM syndrome differentiation was performed by 70 cases (38.9%) with the most type of Yinxuhuowang, and followed in descending order were 60 cases (33.3%) of Ganyuhuahuo type, 26 cases (14.4%) of Tanreneirao type, 10 cases (5.6%) of Xindanqixuxing type, 8 cases (4.4%) of Xinbiliangxu type, and 6 cases (3.3%) of Other type. The gender, age, marital status, BMI, waist circumference, education level, occupation, shift, smoking, drinking, duration of illness, treatment with Western medicine, whether or not received or combined with other treatments were not significantly related to TCM syndrome differentiation. There is a significant correlation with p< .05 between family history and TCM syndrome differentiation.
Conclusion: There was significant correlation between the classification of TCM and family history in insomnia. In other words, TCM syndrome differentiation might be related to hereditary constitution. This indicated that the classification of TCM was evidence on actuality. This study will provide health care workers and people on insomnia, and as a modern reference in integrative medicine.
Keywordsinsomnia, traditional Chinese diagnostic patterns identification, primary insomnia, secondary insomnia