| OBJECTIVE:Using TCM clinical research information sharing system with a prospective trial design and basing on the data mining technology to explore the treatment of insomnia in patie nts of differentiation of symptoms and signs in clinical experience from the Shen of TCM theory by mentors, excavating the dialectical experience of tutor for the treatment of insomnia, drug characteristics and composing principle, characteristics of the optimum prescription and syndrome and finding who is the suitable crowd,which contributed to a better application in clinic.METHOD:Collecting the mentors March 2015 to 2016 march during the diagnosis and treatment of insomnia clinical cases and using the clinical research of traditional Chinese medicine information sharing system of structural case module to collect clinical data,which includes the case of general information, the treatment information of diagnosis and treatment of insomnia related information and TCM syndrome differentiation.Then we will do some horizontal frequency numberanalysis, clustering analysis, association analysis, to summarize the common symptoms of insomnia induction, main symptom characteristic, commonly used formula and core drug treatment.RESULT:(1) The general information of case There are 62 cases of Male and 84 cases of female, the youngest was 20 years old and the biggest was 78 year old,the average age was 51 years.The degree was different with each other,intermediate culture degree of insomnia in patients with higher incidence.The married patients accounted for insomnia patients with the most,which accounting for 85%and insomnia incidence who lives with others is higher than alone, whose incidence accounted for 97%.The day shift insomnia is the most, accounted for 92% of the total ratio and insomnia in office staff sick is the highest rate of38%.(2) The related information of insomnia About 84% of patients with chronic insomnia, the top three highest frequency of the insomnia is "the shallow depth of sleep" and "easy to wake up" and "difficulty in falling asleep", accounting for 84.93%, 82.88%, 79.45% respectively.The mental factors and body factors is the main causes of insomnia,which account to 60.59% and 48.63%. Nearly half of the population outpatient treatment of insomnia patients have received treatment and taked sleeping pills and had past diseases. Patients with poor sleep quality in the majority, moderate insomnia patients accounted for 1 / 2,among which may be in depression patients accounted for 1 /2 and anxiety patients accounted for 3 / 4, the vast majority of patients people were not satisfied with their sleep quality, the doctor’s evaluation of patients with insomnia were mild, moderate or biased.(3) The information of TCM syndrome differentiation and tre atment There were many typies of hyperactivity of the symptoms,for example, dizziness, headache, irritability, chest tightness, anorexia, lack of strength,whose ratio was 60%above. At the same time, insomnia can also be associated with forgetfulness, Yaoxisuanruan, dry mouth, pale Shaohua, frequency of occurrence,which were more than 35%.The main type of insomnia is hyperactivity of fire due to yin deficiency, blood deficiency, deficiency of both heart and spleen deficiency, phlegm and blood stagnation syndrome, liver qi stagnation syndrome and heart liver fire excess syndrome, which accounted for the case for more than 50%.The insomnia symptoms of elements were Yin and Yang,Shen, the syndrome of higher frequency;gas, vitality, phlegm and blood stasis was also the sleep disorder of common syndromes elements. The disease mainly lies in the heart, the liver and gallblad der, kidney, spleen and stomach.An Shen, Yang Xue, Li Qi,Qing Xin is the commonly used methods of clinical treatment of insomnia,which acounted the highest frequency. In addition, Bu Qi, Zi Yin, resolving phlegm and removing blood stasis, Qing liver, Jian spleen and stomach was also the conventional treatment.Supervisor Wang Ping used to choose the prescriptions of Suanzaoren Decoction, Chaihu Shugan powder, Jin Gui Baihe soup, Sancao Anshen soup, Chaihu Guizhi soup, Tianwang Buxin Dan, Yue Ju pills, Wendan Decoction and Zhizichi soup to treat the insomnia, of which Suanzaoren Decoction, Chaihu Shugan powder were the most commonly, their frequency was 96.58% 40.41%.On clinical medication,there were 50 flavor Chinese Medicine,who had more than 30 frequency, they were Zhigancao,Astragalus,Suanzaoren,Shouwuteng,J iangzhizi,Chuanxiong,Hehuanpi,Baishao,Danggui,Duanlongmu,Daihe,whose medication frequency reached more than 140 times.The key drugs of insomnia were Hehuanpi,Chuanxiong,Shouwuteng,Danggui,Duanlongmu,Huangqi,Zhigancao,Chaosuznaoren,Jian gzhizi. Tutor Wang was good at using the traditional Chinese and Western medicine, both psychological and drug combin ation in the treatment of insomnia, the majority of treatment was the non drug therapy, concurrented with sleeping of Western and Chinese medicine.Conclusion:1.The females were the mojority crowds of clinical insom nia patients, their age was differently from each other, and the elderly was the subject of insomnia patients, the climacteric stage were more likely to suffer from insomnia especially. Insomnia patients with culture degree also had the difference and the secondary education had the higher incidence.The people who had gotten married and lived with others had the higher incidence rate of insomia.It’s had little effect on the insomnia patients with working hours, the office staff of insomnia incidence rate is the highest.2. The chronic insomnia is in the majority in the clinical insomnia,which mainly appeared the shallow depth sleep, easy to wake up, difficulty in sleeping, wake up early,wake up to sleep, wake up after fatigue, dreaminess, Shenpi fatigue, dizziness, headache.The mental factors were the most common cause of insomnia, insomnia patients often accompanied by anxiety, depression, the vast most patients on the quality of their sleep feel dissatisfied or very dissatisfied.. 3. The Chinese medicine had a unique advantage in the treatment of insomnia, data mining is to summarize the TCM experience of effective method for insomnia is common in patients with comorbid symptoms of dizziness, irritability, headache, chest tightness, anorexia, Shenpi fatigue, forget fulness, Yaoxisuanruan, dry mouth, pale Shaohua. Insomnia disease mainly located in the heart, liver, spleen, kidney dirty; the pathological factors often associated with Yin and Yang, Qi and blood, phlegm and blood stasis was also closely related to disease,which had real and false inclusion of the inclusion, as Yinxue deficiency, blood deficiency were the most common, but in reality the phlegm and blood stagnation type, liver qi stagnation type was the most common type. The treatment should be viscera the Qi and blood, Ning Shen firstly,then to adjust the poor mental and emotional, Anshen Ding Zhi, at the same time combined with the other methord to promote the effect of treating the insomia.Suanzaoren Decoction, Chaihu Shugan powder, Golden Lily soup and three grass Anshen Decoction, Radix Bupleuri cassia twig soup, Tianwang Buxin Dan, Yueju pills, Wendan Decoction,zhizichi soup recipe were often used in clinical. The key drugs of insomnia were Hehuanpi,Chuanxiong,Shouwuteng,Danggui,Duanlongmu,Huangqi,Zhigancao,Chaosuznaoren,Jiangzhiziby tutor Wang Ping. |
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