失眠患者证候分布特点及影响因素分析OA

Objective:To analyze the distribution characteristics of TCM syndromes and related influencing factors in patients with insomnia based on a cross-sectional survey.Methods:Patients with insomnia who visited the General Internal Medicine Outpatient Department of Xiyuan Hospital,China Academy of Chinese Medical Sciences from January 2023 to January 2025 were enrolled.Demographic data,medical records and Pittsburgh Sleep Quality Index(PSQI)scores were collected.Statistical description,cluster analysis and linear regression were performed using SPSS 27.0.Results:A total of 456 insomnia patients were included,with 72.6%being female.The mean age was(42.6±13.4)years,and the mean PSQI score was(12.62±3.37).A total of 85 common symptoms,signs,tongue and pulse variables were collected,including 56 TCM symptom variables,19 tongue variables and 10 pulse variables.The TCM syndromes in descending order of frequency were liver fire disturbing heart syndrome,stomach qi disharmony syndrome,liver stagnation with spleen deficiency syndrome,heart-spleen deficiency syndrome and heart-kidney disconnection syndrome.Influencing factor analysis showed that age was a significant positive predictor of total PSQI score(P<0.001);age(P<0.001),stomach qi disharmony syndrome(P=0.038),liver stagnation with spleen deficiency(P=0.007)and heart-spleen deficiency(P=0.003)were significant negative predictors of daytime dysfunction score.Conclusion:Insomnia is becoming younger and more chronic,with liver fire disturbing heart syndrome as the main TCM type.Older age is associated with higher total PSQI score,while younger age and heart-kidney disconnection syndrome are related to more severe day-time dysfunction.Diagnosis and treatment should focus on the heart and liver,pay attention to daytime func-tion,and provide early intervention to prevent excessive syndromes from transforming into deficiency syndromes.