心理健康与轻度认知功能障碍、心脾两虚证的相关性研究

发布时间：2018-02-24 16:11

本文关键词： 轻度认知功能障碍辨证分型主观幸福感社会心理因素　出处：《广州中医药大学》2005年硕士论文　论文类型：学位论文

【摘要】：目的:轻度认知功能障碍(MCI)因为其高度的AD危险性已成痴呆研究领域的的热点课题,研究MCI有助于识别痴呆高危个体并对探索有效干预途径有重要作用。其中有关轻度认知功能损害者心理状况的研究显示:长期的消极情感可加速认知功能的减退,可能是MCI发病的相关因素之一。而中医理论中,七情失度及心脾二脏失调与“忆、意、志、思、虑、智”的意识思维活动功能密切相关,可进一步导致健忘的产生。目前尚无研究涉及MCI、心脾两虚及心理健康(由幸福感指标评价)之间的相关性,本研究初步探讨MCI心脾两虚型与心理健康之间是否存在以下的相关性:1、心理健康水平下降是MCI的相关因素;2、MCI心脾两虚证与心理健康显著相关。方法:本研究为横断面调查。根据国内外有关MCI的研究报道、中医理论,制定中医证候观察表及确定相关神经心理学量表,用之调查广东省中医院门诊就诊、住院及社区中50～80岁人群共89人:MCI组44名,认知功能正常者45名。现场调查收集包括一般人口学资料、中医证候及《纽芬兰纪念大学幸福度量表》、MMSE、ADL等,并用SPSS11.0软件建立数据库。研究:1、社会心理因素对认知功能(MMSE成绩)影响的单因素、多因素分析;2、MCI的中医基本证候初步研究;3、对MCI患者及正常对照组、MCI心脾两虚组及非心脾两虚组分别进行1:1的病例对照研究。分析幸福感(正性情感、负性情感、正性体验、负性体验、总幸福感)与MCI、幸福感与心脾两虚证的相关性,以及不同中医基本证型的幸福感比较。结果:1、影响MCI患者的社会心理因素主要为年龄、教育程度、职业性质、病程。年龄增长、体力劳动、60岁前离退休、病程长是认知功能下降的危险因素,受教育程度高是保护因素。2、70岁以上、初中以下文化程度者MCI检出率显著增加,脑力劳动者与体力劳动者、离退休者之间MCI检出率差异均有显著性意义。3、中医基本证候分析结果提示两组在心血虚证、脾气虚证分布差异有显著性意义。MCI的中医证候以多证兼夹为常见,虚实夹杂者占多数。4、正性体验、总幸福度与认知功能成正相关;负性体验与认知功能呈负相关。其中正性体验得分高是认知功能的保护性因素,而负性体验得分高是认知功能的危险因素。5、MCI心脾两虚组负性体验高于非心脾两虚组,总幸福度低于非心脾两虚组,两组的差异均具有显著性意义。6、中医基本证型中,心血虚组与非心血虚组的负性体验及总幸福度的差异有统计学意义,脾气虚组与非脾气虚组的负性情感、负性体验及总幸福度得分差异均有显著性意义。其余基本证型未见与幸福感的存在相关。
[Abstract]:Objective: mild cognitive impairment (MCI) has become a hot topic in the field of dementia because of its high AD risk. The study of MCI helps to identify individuals at high risk of dementia and play an important role in exploring effective approaches to intervention. It may be one of the related factors in the pathogenesis of MCI. In the theory of TCM, the loss of seven emotions and the disorder of heart and spleen are closely related to the function of mental activities of "memory, will, mind, thought, mind, intelligence". There is no study on the relationship between MCI, deficiency of heart and spleen, and mental health (evaluated by well-being index). This study preliminarily explored whether there was the following correlation between the deficiency of heart and spleen and mental health in MCI. The decrease of mental health level was the related factor of MCI. There was a significant correlation between the deficiency of heart and spleen and mental health. Methods: this study was a cross-sectional investigation. According to the domestic and foreign research reports about MCI, the theory of TCM, the observation list of TCM syndromes and the related neuropsychological scale were made, and the outpatient clinics of Guangdong traditional Chinese Medicine Hospital were investigated. A total of 89 people aged 50 to 80 years old in hospital and community were enrolled in the study, 44 in the MCI group and 45 in the normal cognitive function group. The field investigation included general demographic data, TCM syndromes and MMSE ADL, and so on, and the scale of Happiness of Memorial University of Newfoundland. Using SPSS11.0 software to establish database. To study the single factor of the influence of social and psychological factors on cognitive function and score of MMSE. A preliminary study on the basic syndromes of traditional Chinese Medicine (TCM) in patients with MCI and normal control group was carried out with 1: 1 ratio of 1: 1 in patients with MCI and those with non-deficiency of heart and spleen respectively. The well-being (positive emotion, negative emotion, positive experience) was analyzed. Negative experience, total well-being) and MCI, the relationship between happiness and deficiency of heart and spleen, as well as the comparison of happiness of different TCM basic syndrome types. Results the main psychosocial factors affecting MCI patients were age, education level, occupation nature, course of disease, age increase, physical labor and retirement before 60 years old. The long course of disease was the risk factor of cognitive decline. The high level of education was the protective factor over 70 years old. The positive rate of MCI was significantly increased in those with less than junior middle school education, mental workers and manual workers. There were significant differences in the detection rate of MCI among retirees. The analysis of basic syndromes of TCM indicated that there were significant differences in the distribution of TCM syndromes between the two groups in the deficiency of heart and blood, and the syndrome of multiple syndromes and clippings was common in the two groups. Positive experience, total happiness and cognitive function were positively correlated, negative experience was negatively correlated with cognitive function, and positive experience score was the protective factor of cognitive function. The negative experience score was higher than that in the non-heart and spleen deficiency group, and the total happiness degree was lower than that in the non-heart and spleen deficiency group. The difference between the two groups was significant. 6, in the basic syndrome type of TCM, the negative experience was higher in the MCI group than in the non-heart and spleen deficiency group, and the total happiness degree was lower than that in the non-heart and spleen deficiency group, and the difference between the two groups was significant. There were significant differences in negative experience and total happiness between the heart blood deficiency group and the non-heart blood deficiency group, and the negative emotion between the spleen qi deficiency group and the non-spleen qi deficiency group. There were significant differences in the scores of negative experience and total happiness, and there was no correlation between the other basic syndromes and the existence of happiness.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R395.6

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