Comparative Study On Syndrome Characteristics Between The Insomnia With Deficiency Of Heart-spleen Syndrome And Liver Depression Transforming Into Fire Syndrome

Objective: Through clinical scale observation and polysomnography,the syndromes and sign,objective sleep characteristics of insomnia patients with deficiency of heart-spleen syndrome,liver depression transforming into fire syndrome were compared,providing research evidence for the differentiation of TCM syndromes of insomnia with deficiency of heart-spleen syndrome and liver depression transforming into fire syndrome.Methods:1.Insomnia patients were recruited according to the diagnostic criteria of insomnia.30 cases of deficiency of heart-spleen syndrome were screened according to the syndrome criteria of insomnia,30 cases of liver depression transforming into fire syndrome were screened by the same way.Collecting demographic data,general data and clinical symptoms,and evaluating PSQI,SDS and SAS scales.2.Fifteen patients were randomly selected from the patients with deficiency of heartspleen syndrome,liver depression transforming into fire syndrome,and 10 healthy patients were recruited according to their baseline conditions for PSG.The parameters of sleep structure,sleep quality,sleep efficiency and breathing were analyzed.Results:1.There are 44 clinical complications in 30 cases of insomnia with deficiency of heartspleen syndrome,and there is no "dizziness" symptom.There are 41 clinical complications in 30 cases of insomnia with liver depression transforming into fire syndrome,and there are no“face red” and “urinary yellow red”symptoms.2.The frequency of insomnia accompanied by deficiency of heart-spleen syndrome are: exhaustion,fatigue,weakness,lusterless complexion,vexation,amnesia,abdominal distension;emotional symptoms are more common in vexation,mental depression;energy symptoms are more common in exhaustion,fatigue;facial color symptoms are more common in lusterless complexion,pale complexion;head and chest flank symptoms are more common in dizziness,palpitations;chest tightness,abdominal and The symptoms of the second stool are more common in abdominal distension,poor appetite,bloating,loss of appetite,and constipation(or constipation).The frequency of insomnia with liver depression transforming into fire syndrome are: amnesia,fatigue,irritability,vexation,headache,exhaustion,dry mouth,dizziness;emotional symptoms are more common vexation,irritability;energy symptoms are more common in amnesia,fatigue;head and chest flank symptoms are more common in headache,dizziness,bulging,hypochondriac pain;the symptoms of fluid are more common in dry mouth and bitterness.3.The total score of PSQI in insomnia group of deficiency of heart-spleen syndrome,insomnia group of liver depression transforming into fire syndrome were more than 7,SAS scores were all less than 50,SDS scores were all greater than 50.There was no statistically significant difference between the two groups in PSQI scores of all dimensions(P > 0.05).4.Comparison of PSG parameters between the three groups of subjects:(1)comparison of SL,the quartile value of the deficiency of heart-spleen syndrome group was significantly higher than that of the healthy group and the liver depression transforming into fire syndrome group,but the Kruskal-Wallis rank sum test showed the difference was not statistically significant(P>0.05).(2)The duration of SWS was significantly shorter than that of the healthy group(P<0.05),and the deficiency of heart-spleen syndrome group.The median value was significantly lower than that of the liver depression transforming into fire syndrome group,but the difference was not statistically significant(P>0.05);(3)WASO comparison,deficiency of heart-spleen syndrome group,the quartile value was significantly higher than that of the liver depression transforming into fire syndrome group and the healthy group,but the difference was not statistically significant(P>0.05);(4)Microawakening index comparison,deficiency of heart-spleen syndrome group,the quartile value of the group was higher than that of the liver depression transforming into fire syndrome group and the healthy group,but the difference was not statistically significant(P>0.05);(5)TST comparison,deficiency of heart-spleen syndrome group was significantly shorter than the healthy group(P<0.05),and the liver depression transforming into fire syndrome group and health group,there was no significant difference(P>0.05).The quartile value of the syndrome of deficiency of heart-spleen syndrome group was significantly lower than that of the liver depression transforming into fire syndrome group,but the difference was not statistically significant(P>0.05);(6)[N1(%TST)],the quartile value of the liver depression transforming into fire syndrome group was significantly higher than the healthy group,and also slightly higher than the h deficiency of heart-spleen syndrome group,but the difference was not statistically significant(P>0.05);(7)The comparison of SE,the heartspleen deficiency syndrome group and the liver-stagnation syndrome group were significantly lower than the healthy group(P<0.05),the heart-spleen deficiency syndrome group,the quartile value of the two deficiency syndrome group was lower than that of the liver depression transforming into fire syndrome group,but the difference was not statistically significant(P>0.05);(8)The CA with the longest time of blood oxygenation decline,the median value of the liver depression transforming into fire syndrome group was significantly higher than the heart-spleen deficiency syndrome group and the healthy group,but the difference was not statistically significant(P>0.05);(9)Total snoring time comparison,the quartile value of the liver depression transforming into fire syndrome group was significantly lower than the healthy group and heart-spleen deficiency syndrome group,but the difference was not statistically significant(P>0.05);(10)Compared with the lying time,the quartile value of the left lateral position of the heart-spleen deficiency syndrome group was significantly higher than that of the healthy group and the liver depression transforming into fire syndrome group.The quartile value of the liver depression transforming into fire syndrome group was significantly lower than that of the healthy group and the heart-spleen deficiency syndrome group.The quartile value of the right lie position time of the heart-spleen deficiency syndrome group and the liver depression transforming into fire syndrome group was significantly higher than that of the health group,but the Kruskal-Wallis rank sum test showed no statistically significant differences between groups(P>0.05).Conclusions:1.When judging the syndrome of deficiency of heart-spleen in insomnia,the symptoms of exhaustion,fatigue,weakness,lusterless complexion,abdominal distension,mental depression,dizziness,loose stool,pale complexion have more discriminant value.When judging the syndrome of liver depression transforming into fire in insomnia,the symptoms of amnesia,irritability,headache,vexation,exhaustion,dry mouth,dizziness,mental depression,bitter mouth are more discriminant value.2.Patients with heart-spleen deficiency syndrome in insomnia and liver depression transforming into fire syndrome have sleep disorders,depression and anxiety tendency,but PSQI total score and its dimension scores,SAS scores,SDS scores can not be used to identify the two syndromes.3.PSG parameters: SL,SWS,WASO,arousal index,TST,[N1(%TST)],SE,total snoring time,and lying time help the identification of of heart-spleen deficiency in insomnia and liver depression transforming into fire.Among them,the syndrome of eart-spleen deficiency mainly showed SL,WASO,prolonged left lateral position,shortened SWS and TST,increased arousal index and decreased SE;liver depression transforming into fire syndrome mainly showed elevated [N1(%TST)],the total snoring time and supine position time are shortened.