Phân loại chứng mất ngủ sử dụng hệ thống y học cổ truyền Trung Quốc: Bài báo đánh giá có hệ thống trong thuốc thay thế và bổ sung dựa trên bằng chứng · Tháng 7 năm 2012 DOI: 10.1155 / 2012/735078 · Nguồn: PubMed CITATIONS READS 14 2.479 tác giả, bao gồm: Maggie MK Poon Wing Fai Yeung Đại học Hồng Kông Đại học Bách khoa Hồng Kông CÔNG TÁC 185 CÔNG TÁC 105 CÔNG TÁC 1.962 CÔNG TÁC XEM HỒ SƠ XEM HỒ SƠ Verdi HK Yau Shi Ping Zhang Đại học Hồng Kông Đại học Baptist Hồng Kông XUẤT BẢN 14 CÔNG TÁC 53 CÔNG KHAI 1.808 CÔNG TÁC XEM HỒ SƠ XEM HỒ SƠ Một số tác giả của ấn phẩm này cũng đang thực hiện các dự án liên quan này: Châm cứu để giảm đau do dùng Benzodiazepine dài hạn: A Dự án xem thử có đối chứng ngẫu nhiên Tất cả nội dung sau trang này được tải lên bởi Wing Fai Yeung vào ngày 30 tháng 6 năm 2014 Người dùng đã yêu cầu nâng cao tệp tải xuống Tiêu đề Tác giả (Các) Phân loại chứng mất ngủ sử dụng hệ thống chẩn đoán y học cổ truyền Trung Quốc: đánh giá có hệ thống Poon, Man -ki; Trích dẫn Ngày phát hành URL Quyền 2010 http://hdl.handle.net/10722/57704 Không hạn chế Phân loại chứng mất ngủ sử dụng hệ thống chẩn đoán Y học cổ truyền Trung Quốc: Một đánh giá có hệ thống của POON Man Ki (潘敏琪) BCM, HKU Một luận án được đệ trình hoàn thành một phần Các yêu cầu đối với Bằng Thạc sĩ Khoa học Y tế tại Đại học Hồng Kông Tháng 12 năm 2009 Mục tiêu Tóm tắt: Các đánh giá trước đây về chẩn đoán bệnh mất ngủ của Y học Cổ truyền Trung Quốc (TCM) bị giới hạn trong việc tìm kiếm không có hệ thống các tài liệu tiếng Trung hoặc một hội chứng TCM cụ thể mẫu Do đó, một đánh giá toàn diện về văn học tiếng Trung và tiếng Anh đã được tiến hành để xem xét việc phân loại chứng mất ngủ bằng hệ thống chẩn đoán TCM Phương pháp: Chúng tôi thực hiện đánh giá có hệ thống tất cả các nghiên cứu về chứng mất ngủ sử dụng hệ thống chẩn đoán TCM Hai nhà nghiên cứu độc lập chịu trách nhiệm thu hồi giấy tờ giai đoạn, dữ liệu từ tập hợp các giấy tờ liên quan cuối cùng được trích xuất bằng cách sử dụng standa Biểu mẫu trích xuất dữ liệu rdized Kết quả: Tìm kiếm mang lại 4795 tiêu đề bài báo tiềm năng; Sau khi xem xét các tiêu chí đưa vào và loại trừ của chúng tôi để lựa chọn giấy, tổng số 103 nghiên cứu và 9499 đối tượng mất ngủ đã được đưa vào đánh giá giai đoạn hai Chúng tôi tìm thấy tổng cộng 69 dạng hội chứng TCM khác nhau đối với chứng mất ngủ. Dạng phổ biến nhất là Thiếu cả tim tỳ vị hư nhược được nói đến trong 93,2% số bài, tiếp theo là Chứng hư hỏa do âm hư (63,1%), Gan khí ngưng trệ chuyển hóa thành hỏa khí (42,7%), Nội nhiệt đờm nhiệt (34,0%), Suy tim - thận (30,1%) và thiếu hụt Qi của tim và túi mật (29,1%) Mặc dù chỉ có các mẫu chẩn đoán TCM được liệt kê trong sách giáo khoa tiêu chuẩn về TCM, đánh giá của chúng tôi cho rằng không có tim - thận, không được liệt kê trong sách tiêu chuẩn , được xếp hạng giữa các mẫu chẩn đoán TCM phổ biến thứ hai đến thứ sáu theo các tiêu chí lựa chọn khác nhau Chúng tôi đã tìm thấy 23 thuật ngữ khác nhau cho các triệu chứng liên quan đến giấc ngủ và 89 các triệu chứng không liên quan đến giấc ngủ khác nhau liên quan đến wi Các mô hình hội chứng TCM đối với chứng mất ngủ Các triệu chứng liên quan đến giấc ngủ phổ biến nhất trong các tài liệu về bệnh TCM là giấc ngủ bị rối loạn giấc mơ, dễ thức giấc và ngủ không yên giấc Các triệu chứng không liên quan đến giấc ngủ phổ biến nhất là chóng mặt, hồi hộp và trí nhớ kém Ngoài ra còn có Các đặc điểm về lưỡi và mạch được đề cập trong tài liệu về bệnh TCM Chúng tôi nhận thấy một số điểm trùng lặp về triệu chứng và dấu hiệu giữa các mô hình TCM phổ biến đối với chứng mất ngủ Ví dụ, giấc ngủ bị rối loạn giấc mơ và chóng mặt có trong các mô hình phổ biến nhất So sánh các mẫu TCM với chẩn đoán mất ngủ theo phân loại của phương Tây hệ thống, chúng tôi phát hiện ra rằng chứng mất ngủ nguyên phát có thể kết hợp với chứng Thiếu cả tim và lá lách và chứng Tâm hỏa do thiếu âm; mất ngủ liên quan đến rối loạn lo âu tương thích với thiếu khí của tim và túi mật và gan-khí ngưng trệ chuyển hóa thành hỏa; mất ngủ liên quan đến rối loạn trầm cảm có thể giống như thiếu Qi của tim và túi mật; trong khi mất ngủ do tắc nghẽn hội chứng ngưng thở khi ngủ có một số điểm tương đồng với Thiếu cả tim Kết luận: Chúng tôi đã xác định được một số dạng hội chứng TCM phổ biến liên quan đến chứng mất ngủ đáng được nghiên cứu thêm, đặc biệt, chứng tim-thận không được liệt kê trong Sách giáo khoa về bệnh TCM Một số triệu chứng liên quan đến giấc ngủ bao gồm giấc ngủ bị rối loạn giấc mơ và giấc ngủ không yên không được sử dụng thường xuyên trong các hệ thống chẩn đoán phương Tây, nhưng thường được đề cập trong hệ thống bệnh TCM. Cần phải xem xét thêm tầm quan trọng lâm sàng của các triệu chứng liên quan đến giấc ngủ. Đánh giá của chúng tôi cho thấy rằng nhiều thuật ngữ Trung Quốc khác nhau đã được sử dụng trong tài liệu về TCM để mô tả hiện tượng tương tự
See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/230686374 Classification of Insomnia Using the Traditional Chinese Medicine System: A Systematic Review Article in Evidence-based Complementary and Alternative Medicine · July 2012 DOI: 10.1155/2012/735078 · Source: PubMed CITATIONS READS 14 2,479 authors, including: Maggie MK Poon Wing Fai Yeung The University of Hong Kong The Hong Kong Polytechnic University PUBLICATIONS 185 CITATIONS 105 PUBLICATIONS 1,962 CITATIONS SEE PROFILE SEE PROFILE Verdi HK Yau Shi Ping Zhang The University of Hong Kong Hong Kong Baptist University PUBLICATION 14 CITATIONS 53 PUBLICATIONS 1,808 CITATIONS SEE PROFILE SEE PROFILE Some of the authors of this publication are also working on these related projects: Electroacupuncture for Tapering off Long-Term Benzodiazepine Use: A Randomized Controlled Trial View project All content following this page was uploaded by Wing Fai Yeung on 30 June 2014 The user has requested enhancement of the downloaded file Title Author(s) Classification of insomnia using traditional Chinese medicine diagnostic system : a systematic review Poon, Man-ki; Citation Issue Date URL Rights 2010 http://hdl.handle.net/10722/57704 unrestricted Classification of insomnia using Traditional Chinese Medicine diagnostic system: A systematic review by POON Man Ki (潘敏琪) BCM, HKU A thesis submitted in partial fulfillment of the requirements for the Degree of Master of Medical Sciences at The University of Hong Kong December 2009 Abstract Objective: Previous reviews regarding Traditional Chinese Medicine (TCM) diagnosis for insomnia were either limited to non-systematic search of Chinese language literature or a particular TCM syndrome pattern A comprehensive review of Chinese and English language literatures was therefore conducted to review the classification of insomnia using TCM diagnostic system Methods: We performed systematic review of all studies on insomnia that used TCM diagnostic system Two independent researchers were responsible for paper retrieval At the second phase, data from the final set of relevant papers was extracted using a standardized data extraction form Results: The search yielded 4795 potential articles titles; after going through our inclusion and exclusion criteria for paper selection, a total of 103 studies and 9499 insomniac subjects were included in the second phase review We found a total of 69 different TCM syndrome patterns for insomnia The most common pattern was Deficiency of both the heart and spleen, which was mentioned in 93.2% of the articles, followed by Hyperactivity of fire due to yin deficiency (63.1%), Liver-qi stagnation transforming into fire (42.7%), Internal disturbance of phlegm-heat (34.0%), Heart-kidney noninteraction (30.1%) and Qi deficiency of the heart and gallbladder (29.1%) Although only TCM diagnostic patterns are listed in the standard TCM textbook, our review suggested that Heart-Kidney noninteraction, which was not listed in the standard textbook, was ranked between second to sixth commonest TCM diagnostic patterns by different selection criteria We found 23 different terms for sleep-related symptoms and 89 different non-sleep-related symptoms associated with the TCM syndrome patterns for insomnia The most common sleep-related symptoms in the TCM literature were dream-disturbed sleep, easy awakening from sleep and restless sleep The most common non-sleep-related symptoms were dizziness, palpitation and poor memory There were also tongue and pulse features mentioned in the TCM literature We found some overlaps in symptom and sign among the common TCM patterns for insomnia For example, dream disturbed sleep and dizziness were present in of the most common patterns Comparing TCM patterns with insomnia diagnoses in the Western classification systems, we found that primary insomnia can probably be matched with Deficiency of both the heart and spleen and Hyperactivity of fire due to yin deficiency; insomnia related to anxiety disorders is compatible with Qi deficiency of the heart and gallbladder and Liver-qi stagnation transforming into fire; insomnia related to depressive disorder may resemble Qi deficiency of the heart and gallbladder; while insomnia due to obstructive sleep apnea syndrome has some similarities with Deficiency of both the heart Conclusion: We identified some common TCM syndrome patterns related to insomnia that were worthy of further studies, in particular, Heart-Kidney noninteraction, which was not listed in the TCM textbook Some sleep-related symptoms including dream disturbed sleep and restless sleep are not frequently used in the Western diagnostic systems, but are commonly mentioned in the TCM system It is worthwhile to further examine the clinical importance of those sleep-related symptoms Our review showed that many different Chinese terms were used in the TCM literature to describe similar phenomenon This lack of standardization in the terminology can definitely affect the scientific studies of TCM Lastly, we found some similarities between the TCM and Western classification for insomnia Further studies are needed to examine the integration of TCM and Western classification systems in the diagnosis of insomnia disorder Declaration I declare that the thesis hereby submitted for the Degree of Master of Medical Sciences at the University of Hong Kong is my own work and has not been previously submitted by me at another University for any degree I cede copyright of the thesis in favor of the University of Hong Kong Acknowledgements I would like to gratefully acknowledge the enthusiastic supervision of Prof KF Chung during my research I thank Mr Jerry Yeung for the technical discussions and advice on data retrieval methodology In particular, I would like to acknowledge the help of Mr Verdi Yau for data extraction and database analysis model I am grateful to all my friends at the Faculty of Medicine, University of Hong Kong, for being my surrogate family during the many years I stayed there and for their continuous moral support thereafter Finally, I am forever indebted to my family for their understanding, endless patience and encouragement when it was most required Contents Abstract Declaration Acknowledgements Contents List of Figures and Tables Chapter Introduction 1.1 Definition of insomnia 1.2 Epidemiology of insomnia 1.3 Traditional Chinese Medicine (TCM) theory of insomnia 1.4 TCM diagnostic approach 11 1.5 Syndrome differentiation 12 1.6 Qi, Blood and Body-fluid Differentiation 12 1.7 Zang Fu Organs Differentiation 13 1.8 Classification of insomnia using TCM diagnostic system 15 1.9 Aim of study 18 Methods 19 2.1 Databases searched 19 2.2 Paper selection process 20 2.3 Data extraction process 21 Results 22 3.1 Excluded papers 22 3.2 Description of the included studies 22 Chapter Chapter 3.3 Types of study 23 3.4 Types of journal 23 3.5 Diagnosis of insomnia disorders 23 25 Chapter 3.6 TCM syndrome diagnostic patterns mentioned in the reviewed papers 3.7 TCM syndrome diagnostic patterns in RCT study design papers and papers published in high impact factor 3.8 TCM syndrome diagnostic patterns in subjects with insomnia 3.9 Clinical features of the TCM syndrome diagnostic patterns 3.10 Clinical features of TCM syndrome patterns based on our review vs TCM textbook description 3.11Comparing the clinical features among the top TCM diagnostic patterns 3.12 Comparing TCM syndrome diagnostic patterns with insomnia diagnoses in the Western Classification Discussion 41 Chapter Reference 47 25 27 28 29 33 36 List of Figures and Tables Figure Selection of trials for inclusion in the review 59 Table Studies reviewed for TCM diagnostic pattern of insomnia 60 Table Diagnostic criteria for insomnia used in the 103 included studies 66 Table 3.1 The top 10 TCM syndrome diagnostic patterns used in the 103 reviewed papers (Total N = 103) 67 The top 12 TCM syndrome diagnostic patterns in subjects with insomnia in the 26 reviewed RCT paper (Total N = 26) The top 11 TCM syndrome diagnostic patterns in subjects with insomnia in the 46 reviewed paper with impact factor above 0.5 (Total N = 17) The top 10 most common TCM syndrome diagnostic patterns in subjects with insomnia (Total N = 9499) 69 Table Summary of the TCM syndrome diagnostic patterns in Table 3.1-3.4 71 Table Sleep-related symptoms in the top TCM syndrome diagnostic patterns for insomnia (Total N = 37) 72 Table Non-sleep-related symptoms in the top TCM syndrome diagnostic patterns for insomnia (Total N = 37) 74 Table Tongue features in the top TCM syndrome diagnostic patterns for insomnia (Total N = 37) 79 Table Pulse features in the top TCM syndrome diagnostic patterns for insomnia (Total no of paper = 37) 80 Table TCM syndrome diagnostic patterns according to “Traditional Chinese Internal Medicine” recommended by the Ministry of Health of China 81 Table 10 The top TCM syndrome diagnostic patterns found in this review 82 Appendix A Data Extraction Form 83 Table 3.2 Table 3.3 Table 3.4 68 70 70 Table 3.4 The top 10 most common TCM syndrome diagnostic patterns in subjects with insomnia (Total N = 9499) TCM Syndrome Diagnostic Pattern Chinese name N (%) * Deficiency of both the heart and spleen 心脾兩虛 2378 (25.0) Hyperactivity of fire due to yin deficiency 陰虛火旺 1622 (17.1) Liver-qi stagnation transforming into fire 肝鬱化火 921 (9.7) Heart-kidney noninteraction 心腎不交 767 (8.1) Qi deficiency of the heart and gallbladder 心膽氣虛 544 (5.7) Internal disturbance of phlegm-heat 痰熱內擾 466 (4.9) Liver fire flaming upward 肝火上擾 285 (3.0) Overexertion and fatigue damage to Qi 勞倦傷氣 262 (2.8) Heart deficiency with timidity 心虛膽怯 202 (2.1) Spleen-stomach disharmony 脾胃不和 162 (1.7) 71 Table Summary of the TCM syndrome diagnostic patterns in different types of paper Rank All reviewed papers ( N = 103) RCT papers ( N=26) Papers published in journals with impact factor above 0.5 (N=17) Papers with subjects’ clinical features (N = 37) Deficiency of both the heart and spleen Deficiency of both the heart and spleen Deficiency of both the heart and spleen Deficiency of both the heart and spleen Hyperactivity of fire due to yin deficiency Hyperactivity of fire due to yin deficiency Heart-kidney noninteraction Hyperactivity of fire due to yin deficiency Liver-qi stagnation transforming into fire Liver-qi stagnation transforming into fire Hyperactivity of fire due to yin deficiency Liver-qi stagnation transforming into fire Internal disturbance of phlegm-heat Heart-kidney noninteraction Liver-qi stagnation transforming into fire Heart-kidney noninteraction Heart-kidney noninteraction Internal disturbance of phlegm-heat Qi deficiency of the heart and gallbladder Qi deficiency of the heart and gallbladder Qi deficiency of the heart and gallbladder Heart deficiency with timidity Internal disturbance of phlegm-heat Internal disturbance of phlegm-heat Liver fire flaming upward Qi deficiency of the heart and gallbladder Spleen-stomach disharmony Liver fire flaming upward Heart deficiency with timidity Spleen-stomach disharmony Stomach disharmony 10 Stomach Qi disharmony Effulgent Heart-Liver fire/ Liver fire flaming upward/ Liver yang flaming upward/ Disturbance of Heart by phlegm-heat Effulgent Heart-liver fire/ Heart deficiency with timidity/ Liver fire flaming upward/ Stomach Qi disharmony Overexertion and fatigue damage to Qi Heart deficiency with timidity Spleen-stomach disharmony 72 Table Sleep-related symptoms in the top TCM syndrome diagnostic patterns for insomnia (Total N = 37) Total no of paper Deficiency of both the heart and spleen Heart-kidney noninteraction Qi deficiency of the heart and gallbladder 心脾兩虛 心腎不交 35 Hyperactivity of fire due to yin deficiency Internal disturbance of phlegm-heat 心膽氣虛 Liver-qi stagnation transforming into fire 肝鬱化火 陰虛火旺 痰熱內擾 10 19 24 13 108 Symptoms related to Insomnia Chinese Name N (%) N (%) N (%) N (%) N (%) N (%) Total (%) Daytime sleepiness 白天昏沉欲睡 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Difficulty falling asleep 入睡困難 (2.9) (0.0) (0.0) (5.3) (4.2) (0.0) ( 2.8 ) Difficulty falling asleep 不易入寐 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Difficulty falling asleep 不易入睡 (5.7) (0.0) (0.0) (0.0) (8.3) (0.0) ( 3.7 ) Difficulty falling asleep 難以入眠 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Difficulty falling asleep 難以入睡 (2.9) (10.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Difficulty falling asleep 難寐 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Difficulty falling asleep 不能入眠 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Difficulty falling asleep 不能入睡 (0.0) (0.0) (0.0) (26.3) (0.0) (0.0) ( 4.6 ) Difficulty falling asleep alone 不能獨自安臥 (0.0) (0.0) (14.3) (0.0) (0.0) (0.0) ( 0.9 ) Dream-disturbed sleep 夢多 (5.7) (0.0) (0.0) (5.3) (0.0) (0.0) ( 2.8 ) Dream-disturbed sleep 入寐多夢 (0.0) (0.0) (0.0) (0.0) (8.3) (0.0) ( 1.9 ) Dream-disturbed sleep 多夢 26 (74.3) (20.0) (100.0) (10.5) (20.8) (0.0) 42 ( 38.9 ) Early awaking 早醒 (5.7) (0.0) (0.0) (0.0) (8.3) (0.0) ( 3.7 ) Easy awakening from sleep 易醒 26 (74.3) (10.0) (14.3) (5.3) (16.7) (0.0) 33 ( 30.6 ) Easy awakening from sleep Easy awakening from sleep and difficulty falling asleep again Easy awakening from sleep and difficulty falling asleep again Frequent awakening with a start 稍寐即醒 (0.0) (0.0) (0.0) (0.0) (16.7) (0.0) ( 3.7 ) 醒後不易再寐 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) 醒後再難入睡 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) 易於驚醒 (0.0) (0.0) (14.3) (0.0) (0.0) (0.0) ( 0.9 ) Frequent awakening with a start 易驚醒 (0.0) (0.0) (42.9) (0.0) (0.0) (0.0) ( 2.8 ) Frequent awakening with a start 寐易驚醒 (0.0) (0.0) (14.3) (0.0) (0.0) (0.0) ( 0.9 ) Half asleep 朦朧不實 (14.3) (0.0) (0.0) (0.0) (0.0) (0.0) ( 4.6 ) Half asleep and restless 朦朧不安 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Inability to sleep whole night 徹夜不眠 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Inability to sleep whole night 徹夜難寐 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) 73 Deficiency of both the heart and spleen Heart-kidney noninteraction Qi deficiency of the heart and gallbladder Symptoms related to Insomnia Chinese Name N (%) N (%) N (%) Liver-qi stagnation transforming into fire N (%) Insomnia 不眠 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Insomnia 不寐 (2.9) (30.0) (28.6) (21.1) (37.5) (15.4) 21 ( 19.4 ) Insomnia 失眠 (14.3) (10.0) (28.6) (26.3) (20.8) (7.7) 19 ( 17.6 ) Insomnia 夜間失眠 (0.0) (0.0) (0.0) (5.3) (4.2) (7.7) ( 2.8 ) Late night difficulty falling asleep 夜來不易入寐 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Late night falling asleep 夜寐 (0.0) (0.0) (28.6) (0.0) (0.0) (0.0) ( 1.9 ) Little sleep 少寐 (0.0) (0.0) (14.3) (0.0) (0.0) (0.0) ( 0.9 ) Nightmare 惡夢紛紜 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Restless sleep 心煩不寐 (2.9) (10.0) (0.0) (5.3) (25.0) (0.0) ( 8.3 ) Restless sleep 心煩失眠 (0.0) (0.0) (0.0) (0.0) (4.2) (7.7) ( 1.9 ) Restless sleep 虛煩不寐 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Restless sleep 睡眠不安 (0.0) (0.0) (0.0) (0.0) (0.0) (46.2) ( 5.6 ) Restless sleep 心煩難以入睡 (0.0) (10.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Restless sleep 夜寐不安 (0.0) (0.0) (0.0) (0.0) (8.3) (0.0) ( 1.9 ) Restless sleep 臥寐不安 (0.0) (0.0) (0.0) (0.0) (0.0) (7.7) ( 0.9 ) Restless sleep 寐不得安 (0.0) (10.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Shallow sleep 夜寐短暫 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Shallow sleep 寐而不酣 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Shallow sleep 睡而不實 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Shallow sleep 睡眠不實 (0.0) (0.0) (0.0) (0.0) (0.0) (7.7) ( 0.9 ) Sometimes shallow sleep 時寐時醒 (2.9) (0.0) (0.0) (0.0) (8.3) (0.0) ( 2.8 ) Sometimes shallow sleep 時寐醒 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Sometimes wakes up with a start 時易驚醒 (0.0) (0.0) (14.3) (0.0) (0.0) (0.0) ( 0.9 ) Tiredness after sleep 醒後困倦 (5.7) (0.0) (0.0) (0.0) (8.3) (0.0) ( 3.7 ) Hyperactivity of fire due to yin deficiency Internal disturbance of phlegm-heat N (%) N (%) Total 74 Table Non-sleep-related symptoms in the top TCM syndrome diagnostic patterns for insomnia (Total N = 37) Deficiency of both the heart and spleen Heart-kidney noninteraction Qi deficiency of the heart and gallbladder Hyperactivity of fire due to yin deficiency Internal disturbance of phlegm-heat 心膽氣虛 Liver-qi stagnation transforming into fire 肝鬱化火 心脾兩虛 心腎不交 陰虛火旺 痰熱內擾 35 10 19 24 13 Total no of paper Chinese Name N (%) N (%) N (%) N (%) N (%) N (%) Total 食後腹脹 (5.7) (0.0) (0.0) (0.0) (4.2) (0.0) ( 2.8 ) Acid regurgitation 反酸 (0.0) (0.0) (0.0) (0.0) (0.0) (7.7) ( 0.9 ) Acid regurgitation 吞酸 (0.0) (0.0) (0.0) (0.0) (16.7) (15.4) ( 5.6 ) Agitation 心情煩躁 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Agitation 煩躁 (0.0) (0.0) (0.0) (47.4) (0.0) (0.0) ( 8.3 ) Anguish in the heart 懊惱 (0.0) (0.0) (0.0) (0.0) (0.0) (46.2) ( 5.6 ) Anorexia 惡食 (0.0) (0.0) (0.0) (0.0) (0.0) (15.4) ( 1.9 ) Anorexia 厭食 (0.0) (0.0) (0.0) (0.0) (0.0) (7.7) ( 0.9 ) Belching 噯氣 (0.0) (0.0) (0.0) (0.0) (8.3) (23.1) ( 4.6 ) Bitter taste 口苦 (0.0) (0.0) (0.0) 16 (84.2) (12.5) 12 (92.3) 31 ( 28.7 ) Blurred vision 目眩 15 (42.9) (0.0) (0.0) (5.3) (0.0) 13 (100.0) 29 ( 26.9 ) Body weight loss 身體消瘦 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Constipation 大便秘結 (0.0) (0.0) (0.0) (21.1) (0.0) (0.0) ( 3.7 ) Constipation 大便結 (0.0) (0.0) (0.0) (10.5) (0.0) (0.0) ( 1.9 ) Constipation 便秘 (0.0) (0.0) (0.0) (42.1) (0.0) (0.0) ( 7.4 ) Cowardly 怯弱 (0.0) (0.0) (14.3) (0.0) (0.0) (0.0) ( 0.9 ) Depression 抑鬱 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Discomfort in abdomen 腹中不舒 (0.0) (0.0) (0.0) (0.0) (0.0) (7.7) ( 0.9 ) Distending pain of stomach 胃脘脹痛 (0.0) (0.0) (0.0) (0.0) (8.3) (0.0) ( 1.9 ) Distention of head 頭脹 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Dizziness 眩暈 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Dizziness 頭昏 (8.6) (0.0) (0.0) (0.0) (0.0) (0.0) ( 2.8 ) Dizziness 頭暈 18 (51.4) (50.0) (0.0) (26.3) 18 (75.0) (61.5) 54 ( 50 ) Dizziness and headache 頭暈而痛 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Dizzy due to Meniere's disease 耳眩 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Dry mouth 口乾 (2.9) (20.0) (0.0) (5.3) 17 (70.8) (0.0) 21 ( 19.4 ) Dry stool 大便乾 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Dry stool 大便乾結 (0.0) (0.0) (0.0) (0.0) (0.0) (7.7) ( 0.9 ) Dry throat 咽乾 (0.0) (10.0) (0.0) (5.3) (0.0) (0.0) ( 1.9 ) Symptoms related to Insomnia Abdomen distention after meals 108 75 Deficiency of both the heart and spleen Heart-kidney noninteraction Qi deficiency of the heart and gallbladder Symptoms related to Insomnia Chinese Name N (%) N (%) N (%) Liver-qi stagnation transforming into fire N (%) N (%) N (%) Total Dry throat 咽燥 (2.9) (0.0) (0.0) (0.0) (16.7) (0.0) ( 4.6 ) Easy sweating 易汗出 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Easy sweating 容易出汗 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Easy to get flu 易感冒 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Easy to Sighing 善太息 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Emission of semen 遺精 (2.9) (30.0) (0.0) (0.0) (12.5) (0.0) ( 6.5 ) Emission of semen during dreaming Emission of semen during dreaming and spermatorrhea Encumbering lower limbs 夢遺 (0.0) (10.0) (0.0) (0.0) (20.8) (0.0) ( 5.6 ) 夢遺滑泄 (0.0) (10.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) 腿困 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Fatigue of muscles 肌肉酸痛 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Fatigue of the limbs 四肢困倦 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Fatigue of the limbs 四肢倦怠 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Fatigue of the limbs 肢倦 (14.3) (0.0) (0.0) (0.0) (0.0) (0.0) ( 4.6 ) Favour in cold drink 喜飲冷 (0.0) (0.0) (0.0) (0.0) (8.3) (0.0) ( 1.9 ) Favour in drink a lot 喜飲 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Favour in sighing 喜歎息 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Feeling cold of the limbs 四肢發涼 (0.0) (10.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Fever 發熱 (0.0) (0.0) (0.0) (0.0) (8.3) (0.0) ( 1.9 ) Feverish sensations in the palms, soles and chest 手足心發熱 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Feverish sensations in the palms, soles and chest 手足心熱 (0.0) (0.0) (0.0) (0.0) (25.0) (0.0) ( 5.6 ) Feverish sensations in the palms, soles and chest 五心煩熱 (2.9) (40.0) (0.0) (0.0) 11 (45.8) (0.0) 16 ( 14.8 ) Flusteredness 心慌 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Fright palpitation 驚悸 (0.0) (10.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Headache 頭痛 (0.0) (0.0) (0.0) (42.1) (0.0) (15.4) 10 ( 9.3 ) Heat in the heart 心熱 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Heavy sensation in the head 頭沉 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Heavy sensation in the head 頭重 (0.0) (0.0) (0.0) (0.0) (0.0) (30.8) ( 3.7 ) Hydrostomia 流涎 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Hypochondriac distension 兩脇肋脹痛 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Hypochondriac distension 兩脇脹痛 (0.0) (0.0) (0.0) (10.5) (0.0) (0.0) ( 1.9 ) Hypochondriac pain 脇痛 (0.0) (0.0) (0.0) (31.6) (8.3) (0.0) ( 7.4 ) Idle for words 懶言 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Hyperactivity of fire due to yin deficiency Internal disturbance of phlegm-heat 76 Deficiency of both the heart and spleen Heart-kidney noninteraction Qi deficiency of the heart and gallbladder Symptoms related to Insomnia Chinese Name N (%) N (%) N (%) Liver-qi stagnation transforming into fire N (%) Impatience 性急 (0.0) (0.0) (0.0) (5.3) Impatience 性情急躁 (0.0) (10.0) (0.0) (21.1) (0.0) (0.0) ( 4.6 ) Impatience 急躁 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Irritability 易怒 (0.0) (10.0) (0.0) 16 (84.2) (0.0) (0.0) 17 ( 15.7 ) Irritability 易激怒 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Lack of strength 少力 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Lack of strength 乏力 12 (34.4) (0.0) (0.0) (0.0) (0.0) (0.0) 12 ( 11.1 ) Lack of strength 無力 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Lassitude of spirit 神疲 25 (71.4) (0.0) (0.0) (0.0) (4.2) (0.0) 26 ( 24.1 ) Lassitude of spirit 精神疲憊 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Lassitude of spirit 精神萎靡 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Less intake 食少 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Less intake 納少 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Less intake 納食減少 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Little saliva 唾液少 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Lower of sporting ability 運動能力下降 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Lumbago 腰痛 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Lusterless complexion 面色不華 (8.6) (0.0) (0.0) (0.0) (0.0) (0.0) ( 2.8 ) Lusterless complexion 面色無華 (14.3) (0.0) (0.0) (0.0) (0.0) (0.0) ( 4.6 ) Lusterless complexion 顏面無華 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Menstrual irregularities 月經不調 (5.7) (0.0) (0.0) (0.0) (8.3) (0.0) ( 3.7 ) Menstruation at irregular intervals 月經紊亂 (0.0) (10.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Nauseating (0.0) (0.0) (0.0) (0.0) (0.0) (15.4) ( 1.9 ) Night sweating 噁心 盜汗 (0.0) (30.0) (0.0) (0.0) (4.2) (0.0) ( 3.7 ) Oppression in the chest 胸悶 (0.0) (0.0) (0.0) (21.1) (0.0) (61.5) 12 ( 11.1 ) Oppression in the chest Oppression in the chest and stuffiness in the stomach Pain in sinews, bones, joints 胸膈滿悶 (0.0) (0.0) (0.0) (0.0) (4.2) (7.7) ( 1.9 ) 胸悶脘痞 (0.0) (0.0) (0.0) (0.0) (0.0) (15.4) ( 1.9 ) 筋骨關節疼痛 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Pain in the chest and hypochondrium 胸脅痛 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Pain in the chest and hypochondrium 胸脇疼痛不適 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Pale white complexion 面色蒼白 Palpitation 心悸 Hyperactivity of fire due to yin deficiency N (%) N (%) Total (0.0) (0.0) ( 0.9 ) Internal disturbance of phlegm-heat (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) 29 (82.9) (30.0) (100.0) (0.0) (37.5) (0.0) 48 ( 44.4 ) 77 Deficiency of both the heart and spleen Heart-kidney noninteraction Qi deficiency of the heart and gallbladder Symptoms related to Insomnia Chinese Name N (%) N (%) N (%) Liver-qi stagnation transforming into fire N (%) Palpitation and restless 心悸不安 (0.0) (10.0) (0.0) (0.0) Poor appetite 不思飲食 (0.0) (0.0) (0.0) (21.1) (0.0) (0.0) ( 3.7 ) Poor appetite 納差 (8.6) (0.0) (0.0) (0.0) (8.3) (0.0) ( 4.6 ) Poor memory 健忘 26 (74.3) (10.0) (0.0) (0.0) 19 (79.2) (0.0) 46 ( 42.6 ) Profuse sputum 痰多 (0.0) (0.0) (0.0) (0.0) (0.0) 10 (76.9) 10 ( 9.3 ) Prolonged and clear urine 小便清長 (0.0) (0.0) (42.9) (0.0) (0.0) (0.0) ( 2.8 ) Red face Red face 面赤 面紅 (0.0) (0.0) (0.0) (10.0) (0.0) (0.0) (5.3) (26.3) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) ( 5.6 ) Red zygomatic 顴紅 (0.0) (0.0) (0.0) (0.0) (12.5) (0.0) ( 2.8 ) Reddish and yellow urine 小便黃赤 (0.0) (0.0) (0.0) (10.5) (0.0) (0.0) ( 1.9 ) Reddish eyes 目赤 (0.0) (10.0) (0.0) 13 (68.4) (0.0) (0.0) 14 ( 13 ) Reddish urine 小便赤 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Reddish urine 尿赤 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Reddish urine 溲赤 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Reduction in luster complexion 面色少華 13 (37.1) (0.0) (0.0) (0.0) (4.2) (0.0) 14 ( 13 ) Restless of sit and lie down 坐臥不安 (0.0) (0.0) (14.3) (0.0) (0.0) (0.0) ( 0.9 ) Restlessness 心煩 (0.0) (20.0) (0.0) (36.8) 12 (50.0) 13 (100.0) 34 ( 31.5 ) Restlessness 多煩 (0.0) (0.0) (0.0) (5.3) (0.0) (0.0) ( 0.9 ) Restlessness of deficiency type 虛煩 (0.0) (20.0) (0.0) (0.0) (4.2) (0.0) ( 2.8 ) Sallow complexion 面色萎黃 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Sallow lusterless complexion 面黃無華 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Scant fluid 少津 (0.0) (0.0) (0.0) (0.0) (20.8) (0.0) ( 4.6 ) Scant fluid 津少 (0.0) (10.0) (0.0) (0.0) (20.8) (0.0) ( 5.6 ) Scant fluid in mouth 口中津少 (0.0) (10.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Shortened and little urine 小便短小 (0.0) (0.0) (0.0) (0.0) (0.0) (7.7) ( 0.9 ) Shortness of breath 氣短 (5.7) (0.0) (57.1) (0.0) (0.0) (0.0) ( 5.6 ) Sloppy stool 大便稀溏 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Sloppy stool 大便溏稀 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Sloppy stool 便溏 (8.6) (0.0) (0.0) (0.0) (0.0) (0.0) ( 2.8 ) Sore in mouth and tongue 口舌生瘡 (0.0) (10.0) (0.0) (0.0) (4.2) (0.0) ( 1.9 ) Sore lower limbs 腿軟 (0.0) (10.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Sore waist 腰酸 (0.0) (40.0) (0.0) (0.0) (37.5) (0.0) 13 ( 12 ) Sore waist 腰酸 (0.0) (40.0) (0.0) (0.0) (37.5) (0.0) 13 ( 12 ) Hyperactivity of fire due to yin deficiency Internal disturbance of phlegm-heat N (%) N (%) Total 10 (41.7) (0.0) 11 ( 10.2 ) 78 Deficiency of both the heart and spleen Heart-kidney noninteraction Qi deficiency of the heart and gallbladder Symptoms related to Insomnia Chinese Name N (%) N (%) N (%) Liver-qi stagnation transforming into fire N (%) N (%) N (%) Total Sore waist and knee 腰膝酸軟 (2.9) (20.0) (0.0) (5.3) (16.7) (0.0) ( 7.4 ) Spermatorrhea 滑精 (0.0) (10.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Spirit failing to keep to its abode Stuffiness and oppression in the chest and stomach Stuffiness in the stomach 神不守舍 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) 胸脘痞悶 (0.0) (0.0) (0.0) (0.0) (0.0) (15.4) ( 1.9 ) 脘痞 (5.7) (0.0) (0.0) (0.0) (0.0) (30.8) ( 5.6 ) Susceptibility to fright 易驚 (0.0) (10.0) (14.3) (0.0) (4.2) (0.0) ( 2.8 ) Susceptibility to fright 善驚 (0.0) (10.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Susceptibility to fright 遇事易驚 (0.0) (0.0) (14.3) (0.0) (0.0) (0.0) ( 0.9 ) Susceptibility to fright 遇事善驚 (0.0) (0.0) (57.1) (0.0) (0.0) (0.0) ( 3.7 ) Sweating 出汗 (2.9) (0.0) (0.0) (0.0) (8.3) (0.0) ( 2.8 ) Sweating 汗出 (2.9) (0.0) (0.0) (0.0) (8.3) (0.0) ( 2.8 ) Tasteless 乏味 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Tasteless 食納無味 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Tasteless 納食無味 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Tasteless 納穀無味 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Tasteless 飲食乏味 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Tasteless 飲食無味 (14.3) (0.0) (0.0) (0.0) (0.0) (0.0) ( 4.6 ) Thirsty 口渴 (0.0) (0.0) (0.0) (26.3) (0.0) (0.0) ( 4.6 ) Thirsty and drink a lot 口渴喜飲 (0.0) (0.0) (0.0) (10.5) (0.0) (0.0) ( 1.9 ) Thoughtful 多慮 (0.0) (0.0) (14.3) (0.0) (0.0) (0.0) ( 0.9 ) Tidal fever 潮熱 (0.0) (10.0) (0.0) (0.0) (12.5) (0.0) ( 3.7 ) Timidity 膽怯 (0.0) (10.0) (85.7) (0.0) (0.0) (0.0) ( 6.5 ) Tinnitus 耳鳴 (2.9) (60.0) (0.0) (21.1) 20 (83.3) (0.0) 31 ( 28.7 ) Tired and loss of strength 倦怠無力 (0.0) (0.0) (14.3) (0.0) (0.0) (0.0) ( 0.9 ) Tiredness (5.7) (0.0) (0.0) (0.0) (4.2) (0.0) ( 2.8 ) Tiredness 體倦 倦怠 (5.7) (0.0) (57.1) (0.0) (0.0) (0.0) ( 5.6 ) Tiredness 疲乏 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Torpid intake 納呆 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Weak 體虛 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) White complexion 面色白 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Yellow urine 小便黃 (0.0) (0.0) (0.0) (21.1) (0.0) (0.0) ( 3.7 ) Yellow urine 尿黃 (0.0) (0.0) (0.0) (31.6) (0.0) (0.0) ( 5.6 ) Hyperactivity of fire due to yin deficiency Internal disturbance of phlegm-heat 79 Table Tongue features in the top TCM syndrome diagnostic patterns for insomnia (Total N = 37) Total no of paper Deficiency of both the heart and spleen Heart-kidney noninteraction Liver-qi stagnation transforming into fire 肝鬱化火 Hyperactivity of fire due to yin deficiency Internal disturbance of phlegm-heat 心腎不交 Qi deficiency of the heart and gallbladder 心膽氣虛 心脾兩虛 陰虛火旺 痰熱內擾 35 10 19 24 13 108 Tongue Chinese Name Pale Tongue 舌淡 N (%) N (%) N (%) N (%) N (%) N (%) Total 28 (80.0) (10.0) (100.0) (0.0) (4.2) (0.0) 37 ( 34.3 ) Pale Tongue 舌質淡 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Plump tongue 舌胖 (5.7) (0.0) (0.0) (0.0) (0.0) (0.0) ( 1.9 ) Plump tongue 舌體胖 (2.9) (0.0) (0.0) (0.0) (4.2) (0.0) ( 1.9 ) Red tip Tongue 舌尖紅 (0.0) (10.0) (0.0) (0.0) (4.2) (0.0) ( 1.9 ) Red tip Tongue 舌尖紅赤 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) Red Tongue 舌紅 (2.9) (50.0) (0.0) 13 (68.4) 14 (58.3) (53.8) 40 ( 37 ) 14 ( 13 ) Red Tongue 舌質紅 (0.0) (20.0) (0.0) (21.1) (25.0) (15.4) Scanty Coating 苔少 (0.0) (10.0) (0.0) (0.0) (16.7) (0.0) ( 4.6 ) Scanty Coating 少苔 (0.0) (20.0) (0.0) (5.3) (16.7) (0.0) ( 6.5 ) 15 ( 13.9 ) Slimy Coating 苔膩 (0.0) (0.0) (0.0) (0.0) (12.5) 12 (92.3) Teeth-printed tongue 有齒印 (2.9) (0.0) (0.0) (0.0) (0.0) (0.0) ( 0.9 ) Thin Coating 苔薄 23 (65.7) (20.0) (14.3) (5.3) (8.3) (0.0) 29 ( 26.9 ) Thin tongue 舌薄 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) White Coating 苔白 (22.9) (0.0) (0.0) (0.0) (12.5) (0.0) 11 ( 10.2 ) Yellow Coating 苔黃 (0.0) (10.0) (0.0) 16 (84.2) (12.5) 12 (92.3) 32 ( 29.6 ) Dry Coating 苔燥 (0.0) (0.0) (0.0) (5.3) (4.2) (0.0) ( 1.9 ) No Coating 無苔 (0.0) (0.0) (0.0) (0.0) (4.2) (0.0) ( 0.9 ) 80 Table Pulse features in the top TCM syndrome diagnostic patterns for insomnia (Total no of paper = 37) Total no of paper Pulse Deep pulse Thready pulse Rapid pulse Slippery pulse Wiry pulse Swift Pulse Weak pulse Chinese Name 脈沉 脈細 脈數 脈滑 脈弦 脈速 脈弱 Deficiency of both the heart and spleen Heart-kidney noninteraction 心脾兩虛 心腎不交 Qi deficiency of the heart and gallbladder 心膽氣虛 Liver-qi stagnation transforming into fire 肝鬱化火 Hyperactivity of fire due to yin deficiency Internal disturbance of phlegm-heat 陰虛火旺 痰熱內擾 35 10 19 24 13 108 N (%) N (%) N (%) N (%) N (%) N (%) Total (2.9) 30 (85.7) (2.9) (0.0) (2.9) (0.0) 29 (82.9) (0.0) 10 (100.0) (70.0) (0.0) (10.0) (0.0) (10.0) (0.0) (100.0) (0.0) (0.0) (85.7) (0.0) (0.0) (5.3) (15.8) 18 (94.7) (0.0) 17 (89.5) (5.3) (0.0) (0.0) 21 (87.5) 20 (83.3) (12.5) (8.3) (4.2) (4.2) (0.0) (7.7) 11 (84.6) 13 (100.0) (0.0) (7.7) (0.0) ( 1.9 ) 72 ( 66.7 ) 57 ( 52.8 ) 16 ( 14.8 ) 27 ( 25 ) ( 2.8 ) 31 ( 28.7 ) 81 Table The TCM syndrome diagnostic patterns adopted by the textbook Traditional Chinese Internal Medicine recommended by the Ministry of Health of China for TCM classification of insomnia TCM syndrome diagnostic pattern Common sleep problems Common clinical symptoms and signs Sleeplessness and dream-disturbed sleep Irritability, thirst with desire to drink water, hypochondriac distension, a poor appetite, a red face, a bitter taste in the month, constipation, bloody urine Tongue Pulse Red tongue with a yellow coating Wiry and rapid pulse Red tongue with a yellow and greasy coating Slippery and rapid pulse Excess Liver-qi stagnation transforming into fire Profuse sputum, chest stuffiness, nausea, belching, restlessness, a bitter tasted in the mouth, blurred vision, a heavy sensation in the head Deficiency Internal disturbance of phlegm-heat Sleeplessness Deficiency of both the heart and spleen Dream-disturbed sleep Palpitation, poor memory, dizziness, blurred vision, weakness of the limbs, lassitude, a poor appetite, a lusterless complexion Pale tongue with a thin and white coating Thready and weak pulse Hyperactivity of fire due to yin deficiency Restlessness, sleeplessness Palpitation, uneasiness, dizziness, tinnitus, poor memory, soreness and weakness in the lumbar region and knee joints, feverish sensations in the palms, soles and chest, a dry mouth Red tongue with a scanty coating Thready and rapid pulse Qi deficiency of the heart and gallbladder Sleeplessness, dream-disturbed sleep, Frequent awakening with a start Timidity, palpitation, susceptibility to fright, shortness of breath, lassitude, clear and profuse urine Pale tongue Wiry and thready pulse 82 Table 10 The top TCM syndrome diagnostic patterns found in this review TCM syndrome diagnostic pattern Liver-qi stagnation transforming into fire Common sleep problems Difficulty falling asleep, dream-disturbed sleep Internal disturbance of phlegm-heat Restless sleep Deficiency of both the heart and spleen Easy awakening from sleep and dream-disturbed sleep Hyperactivity of fire due to yin deficiency Qi deficiency of the heart and gallbladder Heart-kidney noninteraction Restless sleep, easy awakening from sleep, dream-disturbed sleep, sometimes shallow sleep Dream-disturbed sleep, Frequent awakening with a start Restless sleep, dream-disturbed sleep Common clinical symptoms and signs Tongue Pulse Red tongue with yellow coating Wiry and rapid pulse Red tongue with yellow and slimy coating Slippery and rapid pulse Pale tongue with thin and white coating Thready and weak pulse Red tongue with scanty coating Thready and rapid pulse Palpitation, susceptibility to fright, timidity, shortness of breath, tiredness, prolonged and clear urine Pale tongue Thready and wiry pulse Tinnitus, dizziness, feverish sensations in the palms, soles and chest, palpitation, night sweating, emission of semen, restlessness Red tongue Thready and rapid pulse Excess Irritability, bitter taste, constipation, reddish eyes, yellow urine, agitation, hypochondriac distension, headache, thirst, restlessness, dizziness, impatience, red face, poor appetite, oppression in the chest, tinnitus Restlessness, blurred vision, oppression in the chest, profuse sputum, bitter taste, dizziness, stuffiness in the stomach, anguish in the heart, heavy sensation in the head, acid regurgitation, anorexia, belching Deficiency Palpitation, lassitude, poor memory, reduction in luster complexion or lusterless complexion, dizziness, blurred vision, lack of strength, tasteless and fatigue of the limbs Tinnitus, poor memory, palpitation, dizziness, dry mouth, sore waist, restlessness, feverish sensations in the palms, soles and chest, scant fluid, emission of semen during dreaming, acid regurgitation, dry throat, sweating 83 Appendix A: Data Extraction Form Research ID: Title: Authors: Journal: Year/ Volume/ Pages: Language: Does it fall into our exclusion criteria? Should this study be Not related to insomnia included in our Not related to TCM research? Duplicate article Discussion paper Magazine article Focus on elderly or childhood Focus on one gender only Specific medical & psychiatric condition Particular development or life transition period Focus on a specific TCM diagnostic pattern Study cases less than 30 Without TCM diagnostic pattern No specific number of cases Type of study Randomized controlled studies Controlled non-randomized study Case studies Uncontrolled trials Epidemiological study Cross-sectional studies Cohort studies Case-control studies Other/ Specify: Intervention Number of cases Total Woman Man % Female Age Range: Duration of insomnia (Range) Impact Factor Diagnostic criteria for insomnia used / Book for inclusion: Inclusion Criteria of List additional inclusion criteria here: the article i) ii) iii) Exclusion Criteria of List additional exclusion criteria here: the article i) ii) iii) Study Setting Sleep Disorders Center/ Clinic Medical Center Nursing Home Mental Health Center Private Medical Clinic University Psychology Clinic Other/specify: Not specify Types of Subjects Inpatients Outpatients Long-Term Care Research Volunteers Other/specify: Not specify Mean: 84 Sample Selection Diagnosis of insomnia disorder Symptoms of TCM Diagnostic patterns (List all Symptoms and all TCM Diagnostic pattern mentioned in the article) In a few sentences, please provide a brief narrative summary of the study findings here View publication stats Check the method(s) used in the column to the right Randomly selected community sample (e.g random digit dialing method) Series of consecutive clinic patients Prospectively selected clinic patients (not necessary all consecutive) Physician (or other health provider) Referrals Archival data such as a clinic data base Solicited research volunteers Polysomnography Pittsburgh Sleep Quality Index (PSQI) Spiegel Sleep Questionnaire Actigraphy Sleep Logs MSLT Latencies Other/specify: Measures not specify in the article TCM No of patient Sleep related Other Tongue diagnostic symptoms complaints pattern Pulse