非痴呆型血管性认知功能障碍（VCIND）中医证候与MoCA量表认知域的相关性研究

发布时间：2018-01-21 00:55

本文关键词： 非痴呆型血管性认知功能障碍中医证候 MoCA 认知域相关性　出处：《长春中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:探讨非痴呆型血管性认知功能障碍(vascular cognitive impairment no dementia,VCIND)的中医证候与MoCA量表间认知功能损害领域的相关性,为患者相应的认知功能损伤领域进行针对性干预治疗奠定基础。方法:本研究采用横断面调查的研究方法,病例收集来源于六个分中心单位(长春中医药大学附属医院、黑龙江中医药大学附属第二医院、辽宁中医药大学附属医院、辽宁中医药大学附属第二医院、陕西中医学院附属医院、山东中医药大学附属医院)2012年11月-2013年12月期间神经内科门诊及住院的中风后轻度认知障碍患者。填写患者一般信息、MoCA等神经心理学评估量表及轻度认知障碍中医辨证量表,基于信息采集资料进行描述性及相关性分析,对VCIND的神经心理学损伤特征、中医证候分布特征及VCIND中医证候与MoCA量表各认知域评分的相关性进行探讨。结果:1.VCIND患者抽象思维、延迟回忆、视空间与执行能力、语言流畅、注意力、命名及定向力各项认知域得分占其项目满分的百分比由低到高排序,依次为27.40%、55.40%、60.60%、62.67%、73.67%、83.67%、90.00%。2.VCIND两种证型兼见的复合证型中脾肾亏虚、痰浊蒙窍复合证型占44.15%。其次是热毒内盛、阴虚阳亢复合证型占10.28%。3.脾肾亏虚证、痰浊蒙窍证在所有单一独立证型中出现比率分别为24.27%和25.66%。其次是气血不足(13.11%)、瘀阻脑络(12.69%)、热毒内盛(11.58%)、阴虚阳亢(10.88%)、腑滞浊留(1.81%)。4.脾肾亏虚、痰浊蒙窍两种证型在多种证型组合中总出现比率分别为51.35%,43.57%。其次是阴虚阳亢(30.01%)、热毒内盛(25.98%)、气血不足(22.61%)、瘀阻脑络(21.67%)、腑滞浊留(15.89%)。5.VCIND患者热毒内盛证积分与定向力得分呈负相关(P0.05);痰浊蒙窍证积分与命名得分呈负相关(P0.05)、与语言流畅得分呈显著负相关(P0.01);气血不足证积分与注意力得分呈负相关(P0.05)、与定向力得分呈显著负相关(P0.01);瘀阻脑络证积分与定向力得分呈负相关(P0.05);腑滞浊留证积分与命名得分呈负相关(P0.05)。结论:1.VCIND患者可能在抽象思维、延迟回忆、视空间与执行能力、语言流畅四项认知功能受损较重。2.VCIND中医证候以脾肾亏虚、痰浊蒙窍为主。3.VCIND患者的中医证候积分与MoCA部分认知域得分存在负相关。
[Abstract]:Objective: to investigate the vascular cognitive impairment no dementia in patients with vascular cognitive impairment of non-dementia type. The correlation between the TCM syndromes of VCIND and the field of cognitive impairment in MoCA scale. Methods: a cross-sectional investigation method was used in this study. Cases were collected from six sub-central units (affiliated Hospital of Changchun University of traditional Chinese Medicine, second affiliated Hospital of Heilongjiang University of traditional Chinese Medicine, affiliated Hospital of Liaoning University of traditional Chinese Medicine, second affiliated Hospital of Liaoning University of traditional Chinese Medicine). Affiliated Hospital of Shaanxi College of traditional Chinese Medicine. From November 2012 to December 2013, patients with mild cognitive impairment after stroke in outpatient and inpatient department of neurology. Fill in general information of patients. The neuropsychological assessment scale such as MoCA and TCM syndrome differentiation scale for mild cognitive impairment were used to analyze the characteristics of VCIND neuropsychological injury based on the information collection data. The distribution characteristics of TCM syndromes and the correlation between TCM syndromes of VCIND and the scores of cognitive domains of MoCA scale were discussed. Results 1. Abstract thinking and delayed recall of VCIND patients. The scores of visual space and executive ability, language fluency, attention, naming and orientation were ranked from low to high (27.4055.40%). 60.60 and 62.67, including 83.67 and 90.00. VCIND, the deficiency of spleen and kidney was found in both the two types of syndromes of VCIND and VCIND, and the deficiency of spleen and kidney was also found in the two syndromes of VCIND and VCIND. The syndrome of phlegm turbid and resuscitation accounted for 44.15%, followed by heat and toxin, Yin deficiency and yang hyperactivity, 10.28.3.Spleen-kidney deficiency syndrome. The occurrence rates of phlegm turbid and resuscitation syndrome were 24.27% and 25.66respectively in all the single independent syndrome types, followed by Qi and blood deficiency 13.111a, stasis of brain collaterals 12.69cm). Heat toxin in the Sheng Li 11.58U, Yin deficiency Yang hyperactivity Li 10.88U, Fu stagnation left turbid 1.81C. 4. deficiency of spleen and kidney. The total occurrence rate of phlegm turbid and resuscitation in various syndromes was 51.35 and 43.57 respectively, followed by Yin deficiency and Yang hyperactivity in 30.01D, heat toxin in Neijiao 25.98). (2) the total occurrence rate of phlegm turbid and resuscitated resuscitation was 51.35 and 43.57 respectively. Qi and blood deficiency of 22.61D, stasis of cerebral collaterals 21.67m). There was a negative correlation between the score of heat toxin and internal heat toxin syndrome and the score of directional force in patients with VCIND (P 0.05). The score of phlegm turbid and resuscitation was negatively correlated with the nomenclature score (P 0.05) and with the score of language fluency (P 0.01). There was a negative correlation between the score of qi and blood deficiency and the attention score (P 0.05), and a significant negative correlation between the score of qi and blood deficiency and the score of orientation (P 0.01). There was a negative correlation between the score of blood stasis and the score of directional force (P 0.05). Conclusion: 1. VCIND patients may be in abstract thinking, delayed recall, visual space and executive ability. The four cognitive impairment of language fluency is more serious. 2. VCIND TCM syndromes are deficiency of spleen and kidney. The scores of TCM syndromes in patients with phlegm turbid and resuscitation were negatively correlated with the scores of partial cognitive domain of MoCA.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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