Clinical study on traditional Chinese medicine syndrome and anxiety levels in insomnia patients with anxiety
[Objective]To explore how different levels of anxiety affect the heart rate variability and sleep quality of patients with insomnia,so as to prevent,intervene and improve the prognosis of insomnia,and better guide clinical practice.[Methods]General information,clinical symptoms,Pittsburgh sleep index scale,Hamilton anxiety scale(HAMA),Hamilton depression scale and stress perception scale,heart rate variability and other indicators were collected from 282 patients with insomnia admitted to Beijing Dongzhimen Hospital from September 2021 to December 2023.According to the results of hamilton anxiety scale,42 patients with HAMA＜7 were non anxiety group;the 106 patients with 14 to 20 scores were in the mild anxiety group;the 106 patients with 21 to 28 scores were in the moderate anxiety group and 34 patients with＞29 scores were in the severe anxiety group,a total of 282 patients.The differences of anxiety and depression indexes and heart rate variability indexes among different groups were compared.[Results]In terms of the influence of life habit and personality characteristics on anxiety degree,patients with excessive life stress events,frequent staying up late in the past,inadequate fast chewing,sulking,excessive thinking and excessive burden would increase anxiety degree(P＜0.01,P＜0.05);depression and stress would increase with anxiety degree(P＜0.01,P＜0.05);with anxiety degree increasing,standard deviation of NN intervals(SDNN)decreased and sleep quality decreased(P＜0.01,P＜0.05).Through cluster analysis of the common symptoms of insomnia patients with anxiety,such as thinking and caring,fatigue and weakness,and being good at rest,it is preliminarily divided into three syndromes:liver depression and spleen deficiency,heart and liver fire hyperactivity,and heart and gallbladder qi deficiency.[Conclusion]High degree of anxiety,poor sleep quality,"tiredness leads to tension"is the basic cause of the disease,yang qi is not refined,mental loss of nourishment are the pathological results.Insomnia with anxiety can be preliminarily divided into three syndromes:liver depression and spleen deficiency,heart and liver fire,heart and gallbladder qi deficiency.In clinical treatment,yang warming therapy can be appropriately used to treat anxiety and insomnia.
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