Study On The Treatment Of Insomnia From Spleen And Stomach By Professor Lizhong Guo

[Objective]The object of study is tutor Lizhong Guo’s outpatient cases which about the treatments of insomnia from spleen and stomach in these three years.By using data mining method and curative effect evaluation to summarize the academic thoughts and clinical experience of treating insomnia,in order to improve the clinical efficacy of Chinese medicine in the treatment of insomnia.[Method]On the basis of outpatient service learning and learning insomnia theoretical knowledge and research dynamic through the literature,we collected the outpatient cases which treat from the spleen and stomach during October 2014 to December 2016.According to the inclusion criteria and exclusion criteria,we selected 158 patients,each taking two medical records,a total of 316 clinical cases to establish a database.By means of data mining,such as frequency distribution and association rule sets,analysising the inner link between clinical manifestation,pathogenesis and formulas.Further to summarize the experience.And analysising curative effect evaluation through the Pittsburgh sleep quality index scale scores after the treatment of statistical calculation.[Results]In the 158 cases of 316 clinical times,male petients are 40 cases,and women are 118 cases.Obviously,female patients are more than male patients.Each age stage is different.The oldest patient is 81 years old,and the youngest is 18 years old,the largest number of patients aged 40 to 49.There are 73 clinical symptoms at the first visit,as follows whose frequency above 10%:poor sleep,easy to wake,difficulty sleeping,much dream,fatigue,epigastric distension and fullness,sensation of chill,anorexia,four limbs cold,mouth dryness,dizziness,lumbar acid,sweat more,loose stools,sleepless after wake up,hypohidrosis,heart palpitations,constipation,stomachache,belching,stiff neck,tinnitus,acid regurgitation.There are 49 positive symptoms of the last visit,whose frequency above 10%are fatigue,easy to wake,sweat more.In the negative symptoms of the last visit,insomnia primary symptoms(poor sleep,easy to wake,difficulty sleeping,much dream,sleepless after wake up)improve most obviously,and in the minor symptoms of insomnia,the symptoms associated with spleen and stomach(epigastric distension and fullness,constipation,stomachache,acid regurgitation,nausea vomiting)improve most obviously.There are 18 different tongue pictures at the first visit,there are eight tongue pictures’frequency above 10%:light redness tongue(40.51%),greasy white fur(34.18%),thin white fur(27.85%),dark redness tongue(25.32%),tooth traces on tongue sides(20.25%),greasy yellow fur(13.29%),thin dark(11.39%),baby fat Tongue(10.13%).In terms of pulse’s conditions,there are ten pulses occurs in first visits,which frequency above 20%is as follows:thready(51.90%),tense(45.57%),feeble(26.58%),sunken(22.78%).There are 14 different pathogenesis in total,the frequency above 10%is as follows:cold-dampness retention of the middle-jiao,Yang deficiency of spleen and kidney,Yang deficiency of spleen and heart,blood deficiency,upward perversion of stomach qi,stagnation of cold-dampness.The aspect of related pathogenesis,the supports of Yang deficiency of spleen and heart and blood deficiency,heart and blood deficiency and Yang deficiency of spleen are33.544%,the confidences are 100%.the supports of cold-dampness retention of the middle-jiao and Yang deficiency of spleen and kidney,Yang deficiency of spleen and kidney and cold-dampness retention of the middle-jiao are33.544%,43.671%,the confidences are100%,76.812%.Other pathogenesis are most related to upward perversion of stomach qi.In aspect of the association of pathogenesis and symptoms,these symptoms are most related to Yang deficiency of spleen and heart and blood deficiency:poor sleep,difficulty sleeping,much dream,easy to wake,sleepless after wake up fatigue,lumbar acid,hypohidrosis,heart palpitations,sweat more,fatigue.These symptoms are most related to Yang deficiency of spleen and kidney and cold-dampness retention of the middle-jiao:poor sleep,difficulty sleeping,much dream,easy to wake,sensation of chill,epigastric distension and fullness,fatigue,loose stools,four limbs cold.These symptoms are most related to stagnation of cold-dampness and upward perversion of stomach qi:poor sleep,easy to wake,stomachache,epigastric distension and fullness,acid regurgitation,hypohidrosis,stiff neck,four limbs cold.In regard to the medication,there are 27 chinese herbs in the cases of Yang deficiency of spleen and heart and blood deficiency.The frequency above 80%is as follows:Zhifupian,Shengbaizhu,Zhufushen,Suanzaoren,Zhigancao,Jiang(Shengjiang,Ganjiang,W eijiang),Shen(Renshen,Dangshen),Yuanzhi,Danggui,Sharen.There are 24 chinese herbs in the cases of Yang deficiency of spleen and kidney and cold-dampness retention of the middle-jiao.The frequency above 80%is as follows:Zhifupian,Gongdingxiang,Sharen,Zhigancao,Jiang(Shengjiang,Ganjiang,Weijiang),Shen(Renshen,Dangshen),Fabanxia,Shengbaizh u,Baidoukou,Guizhi.There are 48 chinese herbs in the cases of stagnation of cold-dampness and upward perversion of stomach qi.The frequency above 80%is as follows:Zhufushen,Zhifupian,Zhigancao,Houpu,Sharen,Jiang(Shengjiang,Ganjiang,Weijiang).In the curative effect evaluation research,only selecting 75 cases whose course of treatment is 28 days,and with effective Pittsburgh sleep quality scale before and after the treatment.By the integral statistics for the first time and at the end of the time,according to the curative effect evaluation standard,clinical recovery in 18 cases,41 cases are markedly effective,effective in 10 cases,ineffective in 6 cases,the total markedly effective rate is 78.67%and total effective rate is 92%.Not only the scale total score but also each component score of Pittsburgh sleep quality index of three groups have significant differences after treatment(P<0.01).[Conclusion]1.The main symptoms of insomnia treated from spleen and stomach are poor sleep,easy to wake,difficulty sleeping,much dream,sleepless after wake up,even stay up all night and are commonly coupled with such symptoms as fatigue,epigastric distension and fullness,sensation of chill,anorexia,mouth dryness,dizziness.As for the tongue quality,light redness,greasy white fur,thin white fur are common.For the pulse conditions,thready,tense,feeble,sunken are common.2.The most common pathogenesis of treating insomnia by professor Lizhong Guo from spleen and stomach are Yang deficiency of spleen and heart and blood deficiency,Yang deficiency of spleen and kidney and cold-dampness retention of the middle-jiao,stagnation of cold-dampness and upward perversion of stomach qi.Respectively use siniguipi decoction(which composition is sini decoction and guipi decoction),fuzilizhong decoction and zhenba decoction to add and subtract.3.Through the comparative analysis before and after treatment of Pittsburgh sleep quality scale,the effect of treating insomnia from spleen and stomach is curative and significantly.The overall improvement and each ingredient are all have statistical significance,which deserves further investigation.