中医不寐五神分型PSG特征及睡眠相关因子分布规律研究

The syndromes standards for Classification of traditional Chinese medicine insomnia is not uniform, which might be one of the reasons that the treatment of traditional Chinese medicine has a good clinical effect on insomnia but low repeatability. After more than 20 years of clinical studies, our group found a new insomnia Classification which is consistent with the theory of Zangxiang, objective and practical, the new insomnia classification is named the traditional Chinese medicine insomnia classification of five-god. In order to find out more sub-clinical evidence of the traditional Chinese medicine insomnia classification of five-god and some of its pathological factors,we plan to collect 480 cases(control group, and Chinese medicine insomnia classification of five-god in each group n = 60 cases) with polysomnogram(PSG) and serum, to explore PSG characteristics of each group and its serum concentration difference of 5-HT, DA, IL-1β, the MT, VIP, NO:On the one hand,we plan to study the PSG characteristics of the traditional Chinese medicine insomnia classification of five-god;on the other hand to use discriminant analysis to discover the correspondence between the traditional Chinese medicine insomnia classification of five-god and the characteristic classifications of PSG;study part of the pathological relationship between the six sleep-related factors (5-HT, DA, IL-1β, the MT, VIP, NO) and the traditional Chinese medicine insomnia, the traditional Chinese medicine insomnia classification of five-god; to the interpretation of the above six kinds of sleep-related factor in traditional Chinese medicine and insomnia disease, Chinese medicine insomnia part in the five-God typedistribution. summing up the serum distribution of the six sleep-related factors (5-HT, DA, IL-1β, the MT, VIP, NO) in Chinese medicine insomnia disease and the traditional Chinese medicine insomnia classification of five-god.

中医不寐辨证分型标准不统一可能是中医不寐治疗疗效高而可重复性低的原因之一，本课题组经二十余年临床研究，发现不寐具有一个既符合中医藏象理论、又方便易行、客观实用的分型方法，我们称之中医不寐五神分型。为丰富中医不寐五神分型的临床证据并探索其部分病理因素，本课题拟临床研究对照组及中医不寐五神分型各组共480例PSG表现特征，及5-HT、DA、IL-1β、MT、VIP、NO的差异；一方面研究归纳中医不寐五神分型各类别PSG表现特征，另一方面采用判别分析法判断中医不寐五神分型与PSG表现特征分类的吻合程度；同时，研究以上六种睡眠相关因子与中医不寐病、中医不寐五神分型之间的部分病理关系；以诠释以上六种睡眠相关因子在中医不寐病、中医不寐五神分型中的部分分布特点。

中医不寐辨证分型标准不统一可能是中医不寐治疗疗效高而可重复性低的原因之一，本课题组经二十余年临床研究，发现不寐病在临床上存在着一个既符合中医藏象理论又方便易行、客观实用的辨病位分型方法，我们称之“中医不寐五神分型”：心不藏神型、肝不藏魂型、脾不藏意型、肺不藏魄型、肾不藏志型。.本课题共纳入研究对象515例，以正常组（n=80）作健康对照，对“中医不寐五神分型”五个病例观察组（n=435）的多导睡眠图（PSG）表现特征、匹兹堡睡眠质量指数（PSQI）表现特征、六种睡眠因子（5-HT、DA、IL-1β、MT、VIP、NO）分布特征展开研究。结果：“中医不寐五神分型”各组的多导睡眠图PSG参数特征、PSQI参数特征、六项睡眠因子含量存在一定的分布规律及差异性。.研究结果表明PSG、PSQI和六种睡眠相关因子可以作为“中医不寐五神分型”的临床证据和部分病理因素，为阐明“中医不寐五神分型”的科学内涵打下一定基础，为中医不寐病“五神分型辨治”提供科学依据，说明“中医不寐五神分型”辨病位分型法是一种有别于辨证分型的新方法，对于中医不寐病的临床诊断有着较高的实用价值，为不寐病的中医临床分型诊断的规范化提供了新的思路。