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1、北京中醫(yī)藥大學學報（中醫(yī)臨床版）2009年5月，16（3）·5·神經(jīng)內(nèi)科失眠患者中醫(yī)辨證要素調(diào)查*邢佳1郭蓉娟1王嘉麟2張允嶺1姜思源1陳志剛1（1北京中醫(yī)藥大學東方醫(yī)院神經(jīng)內(nèi)科北京100078；2北京中醫(yī)藥大學）摘要：目的探討失眠患者中醫(yī)辨證要素的分布、組合情況。方法對100例失眠患者的中醫(yī)辨證要素進行判斷，比較單純失眠患者與失眠伴情緒障礙患者辨證要素分布的差異。結果100例失眠患者中火熱證占92%，血虛證占79%，氣郁證占78%，氣虛證占74%，這4個辨證要素的出現(xiàn)率均在70%以上；4、5、
2、6個辨證要素組合共占62%；失眠伴情緒障礙較單純失眠與氣虛證關系更密切。結論火熱證、血虛證、氣郁證和氣虛證是失眠常見的辨證要素；失眠病機復雜，虛實夾雜者多見；失眠伴有情緒障礙在一定程度與氣虛證相關。關鍵詞：失眠；中醫(yī)辨證要素；火熱證；血虛證；氣郁證；氣虛證中圖分類號：R256.23FactorsofTCMsyndromedifferentiationinpatientswithinsomniaXINGJia1,GUORong-juan1,WANGJia-lin2,ZHANGYun-ling1,J
3、IANGSi-yuan1,CHENZhi-gang1(1DepartmentofNeurology,DongfangHospital,BeijingUniversityofChineseMedicine,Beijing100078;2BeijingUniversityofChineseMedicine)Abstract:ObjectiveTodiscussthedistributionandcombinationofTCMsyndromedifferentiationfactorsinpatie
4、ntswithinsomnia.MethodThefactorsofTCMsyndromedifferentiationin100patientswithinsomniawereestimated,andthedifferenceofTCMsyndromedifferentiationfactorsbetweenthepatientswithsimpleinsomniaandthosewithinsomniaaccompaniedbyemotionaldisorderwascompared.Re
5、sultIn100patientsthosewithfire-heatsyndromeaccountedfor92%,blood-deficiencysyndrome,for79%,qi-stagnationsyndrome,for78%,andqi-deficiencysyndrome,for74%.Theoccurrencerateofabove4syndromedifferentiationfactorswasallhigherthan70%.Thecombinationof4,5and6
6、factorsofsyndromedifferentiationaccountedfor62%.Theinsomniaaccompaniedbyemotionaldisorderwasrelatedtoqi-deficiencysyndromemorecloselythansimpleinsomniawas.ConclusionThefire-heatsyndrome,blood-deficiencysyndrome,qi-stagnationsyndromeandqi-deficiencysy
7、ndromearecommonsyndromedifferentiationfactorsofinsomnia.Insomniahascomplicatedpathogenesis,andthesyndromeofdeficiencycombinedwithexcessivenessismorecommon.Theinsomniaaccompaniedbyemotionaldisorderiscorrelatedtoqi-deficiencysyndrome.Keywords:insomnia;
8、TCMsyndromedifferentiationfactors;fire-heatsyndrome;blood-deficiencysyndrome;qi-stagnationsyndrome;qi-deficiencysyndrome中醫(yī)治療遵循辨證論治原則，但是我們在臨床年齡18~78歲，平均（41.2±11.64）歲。文化程度：文實踐中發(fā)現(xiàn)失眠患者的臨床表現(xiàn)很難與教科書中盲1例、小學8例、中學58例、大專21例、本科10的某一典型證型相對應，而常表現(xiàn)為多個證型相兼例、碩士1例、博士1例
