血管性痴呆肝阳上亢证的危险因素的临床研究

发布时间：2018-02-25 06:14

本文关键词： 血管性痴呆肝阳上亢证危险因素　出处：《广州中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：比较血管性痴呆肝阳上亢证与非肝阳上亢证两者在危险因素方面的不同之处,为血管性痴呆肝阳上亢证——这一高发证型的血管性痴呆的防治提供某些理论参考。方法：研究对象均为2015年9月1日——2015年11月30日在广东省中医院院神经内科门诊部及住院部被诊断为血管性痴呆的患者共131例,其中肝阳上亢证的患者为74例,非肝阳上亢证患者为57例。详细记录两组患者的个人基本信息、梗死次数、既往史、MMSE量表评分、HIS量表评分、HAMD及GYSK量表评分等。结果：1.血管性痴呆肝阳上亢组与非肝阳上亢组之间,在性别和吸烟史方面没有明显差异(P0.05),在年龄、文化程度、饮酒史及家族史方面具有显著差异(P0.05)2.血管性痴呆肝阳上亢组与非肝阳上亢组在卒中次数和卒中类型上存在明显差异(P＜0.05)。3.血管性痴呆肝阳上亢组与非肝阳上亢组在既往病史上的比较,在白内障及高尿酸血症上差异显著(P0.05),但在高血压、糖尿病、心脏疾病等上无明显差异。4.两组在HIS和MMSE量表评分上无统计学差异,而在HAMD及GYSK量表评分存在明显的差异(P0.05)5.血管性痴呆肝阳上亢组在缺血性卒中和出血性卒中两个卒中类型上的比较,在MMSE及GYSK两个量表评分上差异显著(P0.05)。6.血管性痴呆肝阳上亢组内,有白内障病史与无白内障病史二者在年龄及文化程度上存在明显差异(P＜0.05)。结论：1.较小年龄、高文化程度、多次卒中、出血性卒中及具有抑郁倾向可能是血管性痴呆肝阳上亢证的危险因素。2.高血压、糖尿病及心脏疾病为血管性痴呆的危险因素3.年龄较大、具有较高学历的血管性痴呆肝阳上亢证患者可能更易患有白内障等眼疾；白内障病史可能可以作为血管性痴呆肝阳上亢证和其他非肝阳上亢证的一个鉴别点。4.高尿酸血症性血管性痴呆更多为非肝阳上亢证型血管性痴呆,它可能是非肝阳上亢证型血管性痴呆但可能不是肝阳上亢证型血管性的一个危险因素。5. HAMD及GYSK量表评分可能可以作为血管性痴呆肝阳上亢证与其他非肝阳上亢证型血管性痴呆相鉴别时的一个参考。6.卒中性质与血管性痴呆肝阳上亢证认知损害的程度之间存在一定关系,缺血性卒中对认知的损害程度可能要更深。7.血管性痴呆在临床诊治中,特别是早期可能可以参考采用“阴阳类证”的方法。
[Abstract]:Objective: to compare the difference of risk factors between hyperactivity of liver-yang syndrome and non-hyperactivity of liver-yang syndrome in vascular dementia. To provide some theoretical references for the prevention and treatment of vascular dementia with hyperactivity of liver-yang syndrome, a high type of vascular dementia. Methods: the subjects of the study were all from September 1st 2015 to November 30th 2015 in the Department of Neurology, Department of Neurology, Guangdong Provincial Hospital of traditional Chinese Medicine. A total of 131 patients with vascular dementia were diagnosed in the diagnosis department and the hospital department. There were 74 cases of hyperactivity of liver-yang syndrome and 57 cases of non-hyperactivity of liver-yang syndrome. Results: 1. There was no significant difference in sex and smoking history between patients with vascular dementia and those with hyperactivity of liver-yang and non-hyperactivity of liver-yang (P 0.05). There were significant differences in the history of alcohol consumption and family history (P < 0.05). There were significant differences in the number of stroke and the type of stroke between the patients with hyperactivity of liver yang and those without hyperactivity of liver-yang in vascular dementia (P < 0.05). There were significant differences between the patients with hyperactivity of liver-yang and those without hyperactivity of liver-yang in vascular dementia. In the history of the disease, There was significant difference in cataract and hyperuricemia (P 0.05), but there was no significant difference in hypertension, diabetes, heart disease, etc. There was no significant difference between the two groups in the scores of HIS and MMSE. The scores of HAMD and GYSK were significantly different (P 0.05). The types of ischemic stroke and hemorrhagic stroke were compared between the patients with hyperactivity of liver-yang in vascular dementia, and the patients with hyperactivity of liver-yang in vascular dementia. There were significant differences in the scores of MMSE and GYSK scales between the two groups (P < 0.05). There were significant differences in age and education between the two groups (P < 0.05.Conclusion: 1. Younger age, higher education level), there was a significant difference between the two groups in the age and education of the patients with hyperactivity of liver yang in vascular dementia patients (P < 0.05), and there was a significant difference between the two groups in age and education (P < 0.05). Multiple stroke, hemorrhagic stroke and tendency to depression may be risk factors of hyperactivity of liver yang in vascular dementia. Hypertension, diabetes and heart disease are risk factors of vascular dementia. Vascular dementia with higher education may be more likely to suffer from cataract and other eye diseases. The history of cataract may be used as a differentiating point between hyperactivity of liver-yang syndrome and non-hyperactivity of liver-yang syndrome in vascular dementia. Hyperuricemia vascular dementia is more likely to be vascular dementia of non-liver-yang hyperactivity syndrome. It may be a risk factor of vascular dementia without hyperactivity of liver-yang, but it may not be a risk factor of vascular type of hyperactivity of liver-yang. The scores of HAMD and GYSK may be used as the syndrome of hyperactivity of liver-yang and other non-hyperactivity of liver-yang in vascular dementia. There is a certain relationship between the nature of stroke and the degree of cognitive impairment in patients with hyperactivity of liver yang in vascular dementia. The cognitive impairment of ischemic stroke may be more severe. Vascular dementia may be used in clinical diagnosis and treatment, especially in the early stage.
【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】：2016
【分类号】：R277.7

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