CAJ | 학술논문

目的：观察慢性肝胆病失眠多梦的临床特征，分析多梦的发生频率和中医证型分布情况，试图发现慢性肝胆病患者中失眠与多梦的相关性，从中医经典理论“肝藏血，血舍魂”引发出对梦诊的进一步思考。方法采用睡眠基本情况调查表、 PSQI、 SRSS、 SAS和SDS量表问卷方式，归纳慢性肝胆病失眠多梦患者临床特征，借助统计软件对数据分析总结，并探讨其机理。结果慢性肝胆病合并失眠的患者中出现多梦占54.4％（135／248）、出现恶梦占13.3％（18／135）；从性别分布看，慢性肝胆病失眠中多梦的男性占45.9％（62／135）、女性占54.1％（73／135）；从中医证型分布看，男性多发于肝郁气滞型29.0％（18／62）和肝郁血瘀证型21.0％（13／62），女性多发于心胆不宁型28.8％（21／73）、肝血亏虚型19.2％（14／73）、肝郁气滞证型16.4％（12／73）；慢性肝胆病单纯失眠与失眠多梦者在PSQI和SRSS评分比较方面差异无统计学意义；在SAS评分比较，男性高于同组女性（ P＜0.05）； SDS评分比较，女性高于同组男性（P＜0.05）； SDS评分比较，失眠多梦组女性高于单纯失眠组女性（P＜0.05）。结论失眠多梦是慢性肝胆病常见伴随症状，中医证型蕴涵了不同性别患者特定的失眠特征。
목적：관찰만성간담병실면다몽적림상특정，분석다몽적발생빈솔화중의증형분포정황，시도발현만성간담병환자중실면여다몽적상관성，종중의경전이론“간장혈，혈사혼”인발출대몽진적진일보사고。방법채용수면기본정황조사표、 PSQI、 SRSS、 SAS화SDS량표문권방식，귀납만성간담병실면다몽환자림상특정，차조통계연건대수거분석총결，병탐토기궤리。결과만성간담병합병실면적환자중출현다몽점54.4％（135／248）、출현악몽점13.3％（18／135）；종성별분포간，만성간담병실면중다몽적남성점45.9％（62／135）、녀성점54.1％（73／135）；종중의증형분포간，남성다발우간욱기체형29.0％（18／62）화간욱혈어증형21.0％（13／62），녀성다발우심담불저형28.8％（21／73）、간혈우허형19.2％（14／73）、간욱기체증형16.4％（12／73）；만성간담병단순실면여실면다몽자재PSQI화SRSS평분비교방면차이무통계학의의；재SAS평분비교，남성고우동조녀성（ P＜0.05）； SDS평분비교，녀성고우동조남성（P＜0.05）； SDS평분비교，실면다몽조녀성고우단순실면조녀성（P＜0.05）。결론실면다몽시만성간담병상견반수증상，중의증형온함료불동성별환자특정적실면특정。
To explore the correlation between chronic liver and gallbladder diseases with insomnia and dreaminess by observing the clinical features of chronic liver and gallbladder diseases with insomnia and dreaminess,analysing the frequency of dreaminess and distribution of TCM syndrome.To reflect further on dream diagnosis based on the classical theory of traditional Chinese medicine “liver storing blood,blood storing soul”.Methods To summarize the clinical features of patients with chron-ic liver and gallbladder diseases with insomnia and dreaminess by sleep basic questionnaire, PSQI、SRSS、SAS and SDS scale questionnaire,to analyze and summarize the data by using statistical software,and explore its mechanism.Results In total chro-nic liver and gallbladder diseases patients with insomnia and dreaminess,the dreaminess accounted for 54.4%(135/248),the e-mergence of a nightmare accounted for 13.3%(18/135).On the gender distribution of chronic liver and gallbladder diseases and insomnia and dreaminess,males accounts for 45.9%(62/135),female accounts for 54.1%(73/135).On the distribution of TCM syndrome,in the total dreaminess patients,male trends to liver-Qi stagnation type 32.1%(18/62) and stagnation of blood stasis 23.2%( 13/62 ) , female trends to the heart and gallbladder restless type 28.8%( 21/73 ) , the deficiency of hepatic blood type19.2%( 14/73 ) and liver-Qi stagnation type 16.4%( 12/73 ) .There is no significant difference between chronic liver and gallbladder diseases patients with insomnia and with both insomnia and dreaminess.In comparison of SAS score,male is higher than female from the same group (P<0.05).In comparison of SDS score,female is higher than male from the same group (P<0.05),and female in the group of both insomnia and dreaminess is more than only insomnia(P<0.05).Conclusion The in-somnia and deaminess are the common associated symptoms of chronic liver and gallbladder diseases,TCM syndrome implies in-somnia characteristics of patients with different gender-specific.