門診失眠患者中醫辨證分型與基本資料之相關性研究

Correlation between Traditional Chinese Diagnostic Patterns Identification and Personal Demographics in Outpatient of Insomnia

陳秀美(Hsiu-Mei Chen) ； 王智龍(Zhi-Long Wang) ； 翁培元(Pei-Yuan Weng) ； 李明儀(Ming-Yih Lee) ； 康世肇(Shih-Checo Kang) ； 曹玄明(Xuan-Ming Cao) ； 呂萬安(Wan-An Lu)

《中醫藥研究論叢》 23卷1期 (2020/03) Pp. 1-18

https://doi.org/10.6516/TJTCM.202003_23(1).0001

摘要

目的：全台1/10人口受慢性失眠症所苦，輪班工作者的慢性失眠為白天班的2.18倍，失眠是中醫門診常見的主訴，許多疾病常伴隨著失眠的出現，加上失眠的成因與種類複雜，容易造成臨床辨證上的困難，本研究目的為失眠症進行中醫辨證分型評量，分析是否與個案之人口學資料、疾病狀況、家族病史、疾病治療等有所關聯。方法：本研究採取橫斷式問卷調查法，以方便取樣為原則，選取宜蘭縣某一區域教學醫院精神科門診，根據失眠症之診斷標準，篩選失眠症患者，進行問卷調查。結果：180位失眠症個案，女性118人，男性62人，年齡22-80歲，平均年齡51.6±13.4歲，中醫辨證分型以陰虛火旺型70人（38.9%）最多，依序為肝鬱化火型60人（33.3%）、痰熱內擾型26人（14.4%）、心膽氣虛型10人（5.6%）、心脾兩虛型8人（4.4%）、其他證型6人（3.3%）。個案之性別、年齡、婚姻狀況、BMI、腰圍、教育程度、職業、輪班、抽煙、喝酒、病程、接受西醫治療、是否曾接受或合併其他療法等與中醫辨證分型均無顯著相關，但家族史與中醫辨證分型之間則具有顯著相關（P＜0.05）。結論：中醫辨證分型與家族史之間具有顯著相關性，換言之中醫辨證分型可能與遺傳性體質有關聯，顯示中醫辨證分型是客觀的、事實的。因此，本研究可作為失眠症整合醫學發展時的參考。

關鍵字

失眠症 ； 中醫辨證分型 ； 原發性失眠 ； 次發性失眠

並列摘要

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 County. 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.

並列關鍵字

insomnia ； traditional Chinese diagnostic patterns identification ； primary insomnia ； secondary insomnia

參考文獻

台灣睡眠醫學學會第十三屆學術研討會：臺灣睡眠醫學會第 13 屆學術研討會－大眾教育記者會。http://www.tssm.org.tw/resource_03.php。引用015/03/28。

台灣睡眠醫學學會第十七屆學術研討會：2019 年台灣睡眠醫學學會年度調查。http://www.tssm.org.tw/resource_03.php。引用 2019/03/30。

林惠珠：淺談失眠問題之心理暨社會處遇。醫療品質雜誌 2009；3：36-38。

王俐潔、王桂芸：失眠的臨床評估及護理處置。護理雜誌 2010；57：105-110。

Billiard M, Bentley A. Is insomnia best categorized as a symptom or a disease? Sleep Med. 2004; 5(1): S35-40.