【作者】 孟迎春；

【导师】 乔明琦；

【作者基本信息】 山东中医药大学 ， 中医基础理论， 2008， 博士

【副题名】睡眠和疲劳状况与愤怒郁怒产生及致病的相关性研究

【摘要】 目的:探讨机体睡眠疲劳状况与怒产生及致病的相关性。为进一步探索怒诱发疾病的致病条件奠定基础。方法:运用人群流行病学研究方法对工人、农民、护士群体共601人进行问卷调查。使用斯皮尔伯格状态-特质怒表达量表(STAXI-2)对个体进行易怒、愤怒(anger-out)、郁怒(anger-in)的特质判别,同时采用匹兹堡睡眠质量指数量表(PSQI)和疲劳评定量表(FAI)评价个体睡眠和疲劳状况,探索易怒及易愤怒易郁怒与个体睡眠疲劳状况的相关性。在人群流调基础上,对94例怒致病门诊患者机体睡眠和疲劳状况进行评价。结果:601人中,易怒特质群体102人,非易怒特质群体499人。易怒特质群体与非易怒特质群体在睡眠、疲劳状况方面存在显著性差异,前者睡眠质量显著低于后者(P﹤0.001),主要体现在主观睡眠质量、睡眠紊乱和日间功能几个方面,易怒特质群体对睡眠质量主观评价较低、存在睡眠紊乱、日间精力不足;其机体疲劳程度显著高于非易怒群体(P﹤0.001),而且在因疲劳可能导致的心理后果方面差异明显(P﹤0.01),易怒特质群体更易因为身体疲劳而出现心理问题,如缺乏耐心、欲望降低、不能集中注意力等。单因素非条件logistic回归分析结果显示,疲劳可能导致的心理后果因子对易怒特质有显著影响(P﹤0.05)。疲劳可能导致的心理后果因子对愤怒有显著影响(P﹤0.05),睡眠效率因子对郁怒有显著影响(P﹤0.05)。94例怒致病患者中,42例(44.7%)睡眠质量差,58例(61.7%)存在疲劳状态,26例(27.7%)睡眠质量差与疲劳状态并存,总计74例(78.7%)存在眠差和(或)疲劳状态。结论:个体睡眠疲劳状况与易怒密切相关,疲劳可能带来心理后果因素对怒的产生影响较大,睡眠疲劳状况对怒的不同表达方式(愤怒、郁怒)亦有影响;怒致病患者多有睡眠质量差、疲劳情况,机体状态欠佳。该结论为深入探索怒致病条件奠定基础。本研究以机体状态对怒致病影响为切入点,增添情志致病理论新认识,使中医学“正气不足”发病观在情志致病中得到深化和体现,对完善情志致病理论具有重要意义。更多还原

【Abstract】 Objective: Aimed at exploring the relationship between somni-fatigued condition and the form and pathogenesis of anger-in or anger-out expression,in order to clarify furtherly emotional relative pathogenesis machanism.Method:Investigated different colony, totle 601 persons,including workers,farmers and nurses by epidemic questionnaire method. To distinguish trait anger person by using Spielberger state-trait anger expression index-2(STAXI-2).Trait Anger(T-Ang) subscales , Anger Expression-In(AX-I) subscales and Anger Expression-Out(AX-O) subscales were used.To evaluate body condition by using Pittsburg Sleep Quality Index(PSQI) and Fatigue Assessment Index(FAI).We studyed the relationship between trait anger, including anger-in,anger-out and individual sleep or fatigue condition by analysing these index data.Based on these works,we observed 94 cases which caused disease by anger, evaluating their body condition,i.e sleep quality and fatigue state by PSQI and FAI.Result:102 high trait anger person were distinguished.Other 499 were low trait anger person.There were marked difference between the two group in sleep quality and fatigue assessment. Sleep quality in high trait anger group were worse than that in low trait anger group(P﹤0.001),mainly embodied in sleep quality subjectivly evaluation, sleep disorder, and daily energy. Persons in high trait anger group believe they have bad sleep ,have difficalty in maintaining commen sleep.they feel sleepy and fatigue in daytime.There were magnificent difference in fatigue severity and fatigue consequence between two groups.Persons in high trait anger group have high fatigue condition(P﹤0.001),and they have more fatigue consequence(P﹤0.01)such as low endurance,low appetite,consentration difficalty.Logistic statis conclusions show that fatigue consequence factor has magnificent meaning on high trait anger(P﹤0.05).As the same, sleep efficiency factor on anger-in expression(P﹤0.05), fatigue consequence factor on anger-out expression(P﹤0.05). 94 cases observation:42 cases(44.7%) have low sleep quality,58 cases (61.7%)have fatigue body condition,26 cases (27.7%)have both states mentioned above,totlely,74 cases (78.7%)have bad sleep or fatigue body condition.Conclusion:High trait anger have close relationship with body sleep quality and fatigue state. The somni-fatigued condition affect not only form of anger especially but also anger expression style.Pations whose disease caused by anger mostly have low sleep quality and high fatigue body condition.These conclusions can guide us to study and clarify condition for anger inducing disease.This study add new opinions on pathopoiesis of emotion,deepen“zheng Qi”inadequate thory in TCM.It has important meanings in consummating emotion pathogenesis.更多还原