Elderly Insomnia Pathogenesis, Clinical Literature, Wuchang District, 913 Cases Epidemiological Survey

Objective:The purpose of this study is to explore the TCM pathogenesis of insomnia in the elderly and try to lay the foundation to the early diagnosis, treatment and further study on elderly insomnia.Methods:Under the guidance of TCM theory,combined with theory of evidence-based medicine,adopt the methods of investigation of literature and epidemiological investigation,though the analysis on formulae literatures and TCM clinical presentations in the elderly insomnia,ascertain the tcm pathogenesis of insomnia in the elderly.1 Investigation of literatureResearch on the formulae literatures and literatures about differentiation of symptoms and signs for classification in the elderly insomnia in the past 10 years,use the methods of "know pathogenesis from symptoms" to infer the TCM pathogenesis of insomnia in the elderly2 Epidemiologieal investigationBased on the literatures mentioned in the clinical treatment and information from differentiation of symptoms and signs for Classification in the elderly insomnia, reference to differentiation of symptoms and signs for classification from tom Internal medicine and tcm diagnosis comprehensively,we make a survey questionnaire of clinical epidemiology on the elderly insomnia,survey in wuchang district of wuhan city,used spss13.0 statistical software for statistical analysis Finally,comprehensive analysis of the findings of the above two parts.Results:1.Investigation of literature1.1 The frequency of using formulae in the literature:①tonifying the kidney and calming the mind:12②tonifying the kidney and promoting blood circulation:5③promoting blood circulation to dissipate blood stasis:6④nourish heart to calm mind:4⑤regulate ying and wei:3⑥harmonizing stomach and gallbladder:1 ⑦nourish spleen:21.2 In the frequency of all the drugs mentioned above,replenishing drug is the highest(29,164 times),then,the mind calming drug(12,115 times);promoting blood circulation drug(12,81times);clearing heat drug(11,67times),they take more than 2/3 of the total drugs.1.3 In the literature of bian zheng lun zhi,the frequency of the symptoms is:disharmony between the heart and kidney:70;weakness of both heart and spleen:55;deficiency of vital energy in heart and gallbladder:26;stagnation of liver-qi turn to heat:21;mental disturbance due to phlegm-fire:20;stagnation of gallbladder and turbid phlegm:9;heart-yin vacuity:9;exuberant heart-fire:6;yin deficiency of liver and kidney:2;without classification:182 Epidemiological investigation913 valid questionnaires of which 333 questionnaires were insomnia,as a positive group,580 papers are sleep in the normal,as a negative group,the morbidit y of the insomnia in the elderly is 36.47%,in Positive group there are 141 male,accounting for 15.4%female 192 cases,accounting for 21%;in negative group,male in 269 cases,accounting for 29.5%female 288 cases, accounting for 31.5%.yin deficiency of liver and kidney:disharmony between the heart and kidney weakness of both heart and spleen,etc are the most important Syndrome forgetful,sore and pain in waist and knees,weak are the most common symptoms,insomnia elderly compared with normal elderly have significant differences,such as:sleep length,sleep maintaining,state of mind in the daytime,different type of insomnia in the elderly sleep on the sleeping structure have no significant difference.Different age groups have significant differences on the character of disease.Conclusions:1 The literatures of clinical studies have no unified standard,the syndrome was not standardized criteria and lack of randomized controll so the study on the elderly insomnia is in urgent need of research methods of evidence-based medicine2 The incidence of elderly insomnia is up to 36.47%,but both of doctors and patients have inadequate understanding of it,need to pay a attention to it and make the special studies.3 The sleep structure and the state of mind in the daytime have differences in elderly insomnia and normal elderly,sleep do have effect on elderly's health and quality of life.4 The TCM pathogenesis on elderly insomnia:it mainly in the kidneys,heart and liver, the characters of it are mostly concern to deficiency or mixed deficiency and excess. the important pathogenic factors are phlegm,heat and blood stasis,the age of the patients have significant impact,with the growth of virtual age,the frequency of asthenia are higher and higher.In short,the main TCM pathogenesis of elderly insomnia are yin deficiency of liver and kidney:disharmony between the heart qi and blood.