Multivariate Correlation Analysis Of Insomnia,Anxiety,Depression And TCM Constitution In Patients After PCI

OBJECTIVE: Based on 86 cases of PCI postoperative patients with insomnia,anxiety,depression,and TCM constitution factor correlation analysis,understand the PCI postoperative patients with insomnia,anxiety,depression,and the correlation of TCM constitution,to provide theoretical basis for the study of sleep,mental and constitution aspects of patients after PCI,and provides ideas for clinical individualized treatment.METHODS: Using epidemiological methods,a total of 86 patients with PCI from the cardiovascular center of gansu university of traditional Chinese medicine were collected(January 2017 to January 2018),all patients were willing to participate in this subject and age range: ?18years.Survey content includes basic informations,Athens insomnia scale(AIS),TCM constitution classification scale,self-evaluation of anxiety scale(SAS),polysomnography and depression self rating scale(SDS)etc.The PCI treatment standard is based on the Chinese percutaneous coronary intervention guidelines published in 2012.The diagnostic criteria for insomnia are referred to in the second edition of ?the international classification of sleep disorders?.The collection of TCM constitution is accomplished through the system of constitution identification system of Shanghai DS01-A.Athens insomnia scale(AIS)?self-evaluation of anxiety scale(SAS)?depression self rating scale(SDS)are International general scale,all the patients were assessed according to the international standard after the 7th day of surgery.All the data are analyzed by SPSS19.0 statistical software,the measured data are described by mean ± standard deviation(x±s),and statistical analysis using Student t test,that do not conform to normal distribution are described in terms of median and quartile.Between the two groups,the mann-whitney U test was used,and kruskal-wallis H was used for comparison between the three groups.The counting data is described by percentage,composition ratio and statistical analysis using ?2 test.The relationship between the constitution of Chinese medicine and insomnia,anxiety,and depression is based on discriminant analysis.All statistical methods used a two-sided test.P<0.05 indicated a statistical difference and the results were significant.RESULT:1.Basic information:Among the 86 patients,65 cases of male,accounting for 75.58%,21 cases of females,accounting for 24.42%.The age range is between 42 and 80 years old,among which the main population is between 56 and 73,accounting for 68.60% of the total patients,and the number of patients between 42 and 55 years old,accounting for 15.12%,the population aged 74 and above accounted for 16.28%.Of the 86 patients after PCI,34 patients were implanted with 1,accounting for 39.53%,and 46 cases of 2~3,accounting for 53.49%,and 6 cases of > 3,accounting for 6.98%.The mean age of patients after PCI was 64.6 ±8.57 years,and the mean body mass index(BMI)was 24.16 ± 2.75.2.The risk factors of the study: the largest number of high blood pressure,accounting for 68.60%,followed by smoking history and hyperlipidemia,accounting for 38.37%,diabetes and family history of coronary heart disease,accounting for 27.91% and 16.28% respectively.3.Scale factor test results: Basic research on insomnia,anxiety and depression after PCI in 86 patients:AIS results showed that there were 13 patients suspected insomniacs,accounting for 15.12%,45 were insomniacs,accounting for 52.33%.The Epworth Sleepiness Scale showed that 37 out of 45 insomniacs were normal no sleepiness,4 had mild sleepiness,3 had moderate sleepiness,1 had severe sleepiness,and 82.22% of patients were within the range of normal no sleepiness.Insomnia had little effect on daytime sleepiness among patients.For a single factor(anxiety,depression,insomnia),or a combination of factors(anxiety with depression,anxiety with insomnia,depression with insomnia),the proportion of females is higher than that of men.After chi-square test,P<0.05,the difference is statistically significant.The significance of the study indicates that women with PCI are more likely than men to suffer from anxiety,depression,and insomnia;among patients with different numbers of stents implanted,regardless of whether one-way factors(anxiety,depression,insomnia)or co-factors(anxiety with depression,anxiety with insomnia,depression with insomnia),the more stents,the higher the positive rate..4.PSG mitoring results: Among the 86 patients who underwent PCI,Relationship between sleep factors in different sex patients of insomnia was analyzed by Mann-Whitney U test,The proportion of N1 in male and female patients with insomnia(U=1.988,P<0.05)was statistically significant,indicating that the proportion of N1 among male insomnia patients after PCI is larger than that of female insomnia patients.The Mann-Whitney U test for sleep factors in patients with insomnia and normal sleep showed that a total sleep time(U=3.818,P<0.001)and sleep latency(U=3.194,P=0.001)between patients with insomnia and those with normal sleep.Sleep efficiency(U=5.855,P<0.001),WAKE duration(U=4.770,P<0.001),N1 proportion(U=5.355,P<0.001),N2 proportion(U=2.778,P=0.005),The N3 proportion(U=4.118,P<0.001)was statistically significant.5.Research on the constitution of TCM: In addition to the female dominated by qi stagnation,other constitutions are mainly male.The number of qi deficiency patients was the highest,accounting for 31.40%,followed by blood stasis,accounted for 26.74%,the rest were yang deficiency,qi stagnation,phlegm,yin deficiency,damp heat,peaceful,special physique,animate each have: 11.63%,10.47%,8.14%,4.65%,8.14%,2.33% and 1.16%,respectively.6.The relationship between the number of different stents and the scores of insomnia,anxiety and depression: The number of implanted stents and patient's anxiety scores,depression scores,and insomnia scores after PCI were all P<0.05,the difference was statistically significant.7.Discriminant analysis of TCM constitution and insomnia,anxiety and depression: Insomnia score may play a major role in the final judgment.After the back substitution method and the cross-validation method,the prediction of special physiques was all correct,and the correct prediction rate of qi stagnation was 77.8%,the correct prediction rate of yin deficiency and yang deficiency were 50.0% and 30.0% respectively.8.Correlation Analysis of Insomnia,Anxiety and Depression Scores: Insomnia and depression,insomnia and anxiety,there are positive correlations between anxiety and depression scores,all P < 0.05,the difference was statistically significant.CONCLUSION:1.The scores of insomnia,anxiety,and depression all increased with the number of stents.2.According to insomnia,anxiety and depression scores,patients were predicted to be which kind of constitution after PCI.If the judgment results are special physique,qi stagnation,yin deficiency and yang deficiency,then the probability that the patient actually suffers from these physiques is very large or large.3.The more severe the insomnia is,the more pronounced is the depression,the more severe the insomnia is,the more obvious the symptoms of anxiety are,and the more serious the degree of anxiety is,the more severe the degree of depression is.