马琼　牛阳

【摘 要】 目的：探討舌脉诊数据在失眠不同证型中分布规律，为同病异治提供临床数据支持。方法：搜集失眠为主症的398例医案中患者的一般资料、舌象脉象信息和证候诊断等。运用频数分析、R×C卡方检验和关联规则分析等统计方法分析失眠高频证候舌脉数据。结果：选取以失眠症为主症的医案中出现频数较高且典型的三种证候进行，证候类型分别为：肝郁气滞型、心脾两虚型和痰瘀互结型。其中78例肝郁气滞型高频舌脉诊数据为：淡红舌、舌胖大、苔薄白或薄黄、脉弦；65例心脾两虚型高频舌脉诊数据为：淡白舌、舌胖或带有齿痕、苔白或薄白、脉沉或脉虚无力；49例痰瘀互结型高频舌脉诊数据为：舌质暗或紫、舌胖大、苔白或黄腻、脉弦滑。经关联规则分析得出肝郁气滞型失眠常见的舌脉组合为：舌淡红、苔白、脉弦；心脾两虚型失眠常见的舌脉组合为：舌淡白、苔薄白、脉沉或脉虚无力；痰瘀互结型失眠常见的舌脉组合为：舌暗紫、苔白腻、脉弦滑。结论：在失眠症医案中，失眠症的三类典型临床常见证候的舌质、舌苔、脉象数据客观地反映了三种不同证型的病理特征，为临床辨证疾病证候提供辨识度高且行之有效的方法。

【关键词】 失眠；证型；舌脉象；分布规律

【中图分类号】R241 【文献标志码】 A 【文章编号】1007-8517（2018）08-0010-04

Abstract：Objective In order to discuss the lingual and pulse distribution of different syndrome in the insomnia medical record.Methods To select 398 cases insomnia in medical basis to do the research the general information， the lingual and pulse information， and syndrome information，usingfrequency analysis， R×C chi-square test analysis and association rules analysis statistical methods to analyze. Results The high-frequency and typical three syndromes are the liver depression and qi stagnation syndrome， the heart and spleen two deficiency syndrome、the phlegm and stasis in resistance. The high-frequencylingual and pulse data of 78 liver depression and qi stagnation syndrome are reddish tongue， corpulent tongue， thin-white or thin-yellow moss， taut pulse. The high-frequencylingual and pulse data of 65 heart and spleen two deficiency syndrome are light white tongue， corpulent and indentation tongue， thin-white or white moss， deep or weak pulse. The high-frequencylingual and pulse data of 49 phlegm and stasis in resistance are dark purple tongue， corpulent tongue， white or yellow greasy moss， taut and rolling pulse. Through association rules analysis statistical methods to analyze， The common lingual and pulsecombinations of liver depression and qi stagnation syndrome are reddish tongue， white moss， taut pulse. The common lingual and pulse combinations of heart and spleen two deficiency syndrome are light white tongue， thin-white moss， deep or weak pulse. The common lingual and pulse combinations of phlegm and stasis in resistance are dark purple tongue， white and greasy moss， taut and rolling pulse. Conclusion In the insomnia medical record， The lingual and pulse information of the three typical and common syndrome reflects the pathological characteristics objective， and provides a better and more effective method for the identification of clinical syndromes.

Keywords：Insomnia；Syndromes；The Lingual And Pulse；Distribution Regularly

失眠，又称“不寐”，是以经常性不能获得正常睡眠为主症的一种疾病，临床表现为睡眠时间和深度的不够，轻者入睡困难，或寐而易醒，或醒后不能再寐，重则彻夜不寐，常影响人们正常的工作、生活、学习和健康[1]。……