阻塞性睡眠呼吸中止症患者之中醫體質與生活品質相關性分析

The Correlation between the Constitution in Traditional Chinese Medicine and the Quality of Life in Patients with Obstructive Sleep Apnea Syndrome

阻塞性睡眠呼吸中止症患者因呼吸暫停或通氣量低下而影響睡眠品質，造成疲勞、嗜睡、注意力不集中、記憶力下降等症，並會增加心腦血管疾病的發生率及死亡率。本病直接肇因於上呼吸道狹窄，但其根本原因與肥胖及多種代謝性疾病相關，需從改變體質與生活型態著手。近年的研究報告指出，本病與痰、瘀及氣虛等中醫之證相關，但尚須客觀調查及量化評估。本研究使用中醫體質分類及判定表、Epworth 嗜睡量表及SF-36 健康量表對101 名阻塞性睡眠呼吸中止症患者進行評估，結果顯示：患者之中醫體質以痰濕質（79.2%）及氣虛質（75.2%）最常見。SF-36 健康量表中，具氣虛質、氣鬱質、陽虛質者其生理層面分數較低， 具氣虛質、氣鬱質者，其心理層面分數較低。Epworth 嗜睡量表中，具濕熱質者其分數較低。Obstructive sleep apnea syndrome (OSAS) is characterized by transient upper airway obstruction resulting in breathing pause and/or flow reduction during sleep. The patients with OSAS are ordinarily accompanied with daytime sleepiness, fatigue as well as decrease of attention and memory. In addition, the prevalence of OSAS is closely associated with obesity-mediated metabolic syndrome and has also contributed to high incidence and mortality of cardio- and cerebrovascular diseases. Previous studies indicated that OSAS had been response to patterns of phlegm, stasis and qi vacuity in traditional Chinese medicine (TCM), therefore the therapeutic strategies should aim to change the individual constitution and lifestyle. However, the epidemiological study and quantifying analysis are still in need. One hundred and one patients with OSAS were evaluated with Constitution in Chinese Medicine Questionnaire (CCMQ), Epworth Sleepiness Scale (ESS) and 36-item Short Form Healthy Survey (SF-36). Our results revealed that Phlegm-dampness (79.2%) and Qi-deficiency (75.2%) were the most common constitutions. The data from SF-36 showed patients with Qi-deficient, Stagnant Qi and/ or Yang-deficient constitutions had lower scores in Physical Component Summary, and patients with Qi-deficient and/or Stagnant Qi constitutions had lower scores in Mental Component Summary. On the other hand, patients with Damp-heat constitution had lower scores in ESS.