| 谢明静,许樱楠,方理,裘可怡,李欣儿,王彬彬.基于聚类分析初探恶性肿瘤相关性失眠的中医证候规律[J].浙江中西医结合杂志,2026,36(4): |
| 基于聚类分析初探恶性肿瘤相关性失眠的中医证候规律 |
| Preliminary Exploration of the TCM Syndrome Patterns in Cancer-Related Insomnia Based on Cluster Analysis |
| 投稿时间：2025-06-18 修订日期：2026-02-26 |
| DOI： |
| 中文关键词: 恶性肿瘤相关性失眠 中医证候 聚类分析 |
| 英文关键词:Cancer-related insomnia TCM syndromes Cluster analysis |
| 基金项目:第五批全国中医临床优秀人才研修项目，编号：国中医药人教函[2022]1号；浙江省国医名师传承工作室建设项目吴良村国医名师传承工作室，编号：GZS2021002 |
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| 中文摘要: |
| 目的：基于聚类分析探索恶性肿瘤相关性失眠的中医证候规律。方法：采用回顾性研究，收集225例恶性肿瘤相关性失眠患者的全身症状、舌象、脉象等四诊信息，对四诊信息进行聚类分析。结果：聚类分析显示49条四诊信息共聚为5类。类一：舌红，苔少；类二：入睡困难、头汗出、心烦易怒、便溏、畏寒、夜尿频、手足麻木、腹痛腹胀、大便干结难解、舌紫暗、脉弦；类三：眠浅易醒、纳差、口淡、乏力、动辄汗出、舌淡红、苔白腻、头晕头痛、恶心呕吐、舌淡暗、舌淡紫、脉沉、脉弱、口干口苦、口臭、潮热汗出、脉滑、脉数；类四：早醒、腰背下肢酸痛、耳鸣耳聋、胸闷气短动则气喘、咽干痒咳嗽、痰多、心悸、舌淡、苔薄白、苔黄腻；类五：多梦、便次增多、多思、反酸、头胀、舌暗红、脉细。结论：恶性肿瘤相关性失眠，见入睡困难者可能属心肾寒热错杂、取象太阳寒水，涉及证型为心肾不交；见眠浅易醒者可能属肝与脾胃气滞湿阻、取象少阳相火，涉及证型为肝火扰心、心脾两虚；见早醒者可能属肺肾气阴不足，取象厥阴风木，涉及证型为气阴两虚、痰热扰心；多梦则可能属瘀热内蕴。 |
| 英文摘要: |
| Objective: To preliminarily explore the patterns of traditional Chinese medicine (TCM) syndromes in cancer-related insomnia using cluster analysis. Methods: A retrospective study was conducted, collecting information on the overall symptoms, tongue appearance, pulse characteristics, and other diagnostic data from 225 patients with cancer-related insomnia. Cluster analysis was performed on this diagnostic information. Results: Cluster analysis revealed that 49 diagnostic items were grouped into 5 categories. Category 1: Red tongue, scanty coating. Category 2: Difficulty falling asleep, sweating on the head, irritability, loose stools, aversion to cold, frequent nocturia, numbness in hands and feet, Abdominal pain and distension, hard and difficult-to-pass stools，dark purple tongue, and string-like pulse. Category 3: Light sleep with easy waking, poor appetite, bland taste, fatigue, sweating with slight movement, pale red tongue with white greasy coating, dizziness, headache, nausea, vomiting, pale or dark purple tongue, deep or weak pulse, dry mouth, bitter taste, bad breath, tidal fever with sweating, slippery or rapid pulse. Category 4: Early waking, soreness in the waist, back, and lower limbs, tinnitus, deafness, chest tightness and shortness of breath with exertion, dry and itchy throat with cough, excessive phlegm, palpitations, pale tongue with thin white or yellow greasy coating. Category 5: Frequent dreaming, increased bowel movements, overthinking, acid regurgitation, head congestion, dark red tongue, and thin pulse. Conclusion: In patients with cancer-related insomnia, those with difficulty falling asleep may have a complex pattern of cold and heat in the heart and kidneys, corresponding to the pattern of Taiyang cold water,involving the syndrome of non-intercourse between the heart and kidneys; those with light sleep and easy waking may have stagnation and dampness in the liver and spleen-stomach, corresponding to the pattern of Shaoyang fire,involving the syndromes of liver fire disturbing the heart and deficiency of both heart and spleen; those with early waking may have deficiency of qi and yin in the lungs and kidneys, corresponding to the pattern of Jueyin wind-wood,involving the syndromes of deficiency of both qi and yin and phlegm-heat disturbing the heart; and those with frequent dreaming may have internal heat and stasis. |
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