| Background:Diabetes, belong to the "wasting-thirst" in traditional Chinese medicine which is a kind of endocrine metabolism diseases characterized by glucose metabolic disorder. Because of the development of the economy, the improvement of material life level, and the changes in our lifestyle and eating habits, the incidence of diabetes is increasing year by year. It has become a household name in China. Insomnia, which is the most common type of sleep disorder, equals to the "inability to sleep" in TCM. It manifests itself in falling asleep difficult, being easily wakened, early awakening, profuse dreaming and so on. It can adversely affect the living quality of patients. Insomnia is one of the most common comorbidity of diabetes. Studies have found that Diabetes is closely associated with insomnia. Diabetic patients are prone to mental problems and insomnia. Lack of sleep can affect patients’confidence to fight with diabetes resulting in a serious decline in the quality of life, affecting the physical and mental health of patients.Objective:The insomnia of diabetics is often stubborn to be cured. Modern medical treat the disease with sleeping pill, which has curative effect, but also has intolerable side-effects. On the contrary, the traditional Chinese medicine not only can make the patients sleep better, but also has no toxic and side effect. Therefore, the traditional Chinese medicine has obvious advantage in the treatment of diabetic insomnia. In order to provide more basis for the clinic treatment of diabetic insomnia, to improve the level of syndrome differentiation and the curative effect of traditional Chinese medicine, it is necessary to do a research of etiology, TCM symptoms characteristics and pathogenesis of diabetic insomnia.Methods:This study of diabetic insomnia is carried out from the TCM syndrome distribution characteristics by the way of clinical survey, using the method of evidence-based medicine. Pittsburgh sleep quality index scale was used to survey the patients of diabetic insomnia to evaluate their sleep quality. The related symptoms were record in a chart. At the last, effective factors and TCM symptoms characteristics of diabetic insomnia was analyzed by statistical software.Results:The study includes 107 cases of diabetic patients with insomnia. Men account for 53.37% while women account for 46.73%.①There is no obvious difference between the incidence of women and men compared with the overall diabetics.②The average age of the patients surveyed is 56.67±8.537 years. What is more, it is found that the older, the bigger the percentage is. Among them, the group of 60-70 years accounts for 42.2%. It points out that age maybe one of the important factors of the diabetic insomnia. ③The diabetes duration of the patients investigated is 11.02±7.04 years on average. The group of patients who have 5 to 10 years duration accounts 31.7%, more than all the other groups. ④In the study of the correlation between the sleep quality and glycosylated hemoglobin, fasting blood sugar and diabetes duration, it tells that there is no obvious correlation between them. The study of TCM syndrome characteristics shows that the depressed liver qi transforming into fire pattern and yin deficiency with effulgent fire pattern are the most common patterns among the patients of diabetic insomnia, accounts for 51.4% and 42.1% respectively, while the pattern of heart-gallbladder qi deficiency is the least common, accounting for 16.8%, and just one patient of the pattern of blood stasis harassing the heart spirit was found among the 107 diabetic insomnia. The result tells that the occurrence of the disease may be associated with poor emotions. In addition, insomnia type has no specificity for judging syndrome types and there is no obvious correlation between the syndrome type and glycosylated hemoglobin and fasting blood sugar. But the syndrome type has correlation with the course of the disease. Among the patients with the disease duration of more than 10 years, the depressed liver qi transforming into fire pattern, yin deficiency with effulgent fire pattern and heart and spleen deficiency pattern are more common than the patterns among patients with the disease duration of less than 10 years. ⑤In study about correlation of the sleep quality and syndrome type, no linear correlation was found, but the sleep quality score of each type has significant difference. The sleep quality of the patients diagnosed heart-gallbladder qi deficiency pattern score 14.88±2.826 on average, while the heart and spleen deficiency pattern and internal harassment of phlegm-heat pattern scorel2.93±3.552 and 12.53±3.579 respectively, and the pattern of depressed liver qi transforming into fire and the pattern of yin deficiency with effulgent fire score 11.80±3.969 and 11.64±3.675 respectively. In the research on relationship between the mental state during the day and syndrome type,17 patients with heart-gallbladder qi deficiency pattern have poor status during the day.Conclusion:This study reveals that the occurrence of diabetic insomnia may have a close relationship with age, poor emotion. The depressed liver qi transforming into fire pattern and yin deficiency with effulgent fire pattern are the most common patterns among the patients of diabetic insomnia, while the depressed liver qi transforming into fire pattern, yin deficiency with effulgent fire pattern and heart and spleen deficiency pattern among patients with longer duration of diabetes are more common than those among patients with short duration of diabetes. The patients’sleep quality of each syndrome type exists difference, the heart and spleen deficiency pattern is common in the insomnia, but not in the diabetic insomnia. Patients of heart-gallbladder qi deficiency syndrome have the worst sleep quality, while patients of the heart and spleen deficiency pattern and internal harassment of phlegm-heat pattern have a better sleep quality. Relatively, patients of depressed liver qi transforming into fire pattern and yin deficiency with effulgent fire pattern have the best sleep quality, the patient with heart- gallbladder qi deficiency pattern generally has poor status during the day.
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