卒中后认知功能障碍辨证分型与血脂、P300的相关性研究

发布时间：2018-03-13 05:28

本文选题：卒中后　切入点：认知功能障碍　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过研究卒中后认知功能障碍(PSCI)中医证候的分布情况及PSCI的辨证分型与血脂水平及P300的相关性,为PSCI辨证分型提供客观依据。方法:选择2014年1月到2015年7月在本院治疗的脑卒中患者100例,根据治疗3个月后认知功能评估结果分为认知功能障碍组(PSCI组,30例)和认知功能正常组(PSNCI组,70例),收集研究对象的基本资料(包括发病一般情况、临床表现、舌脉象等),由于病例脱落,共采集30例PSCI患者和65例认知功能正常患者的血脂六项(包括胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、载脂蛋白Al和载脂蛋白B),以及测量各患者的事件相关电位P300,所得数据采用方差分析、t检验等方法进行统计分析。结果:1.PSCI患者的证候中虚实夹杂占83%,6种基本证候中肾虚证比重最大,占80%,其次为血瘀证、痰浊证、脾虚证、心虚证和肝郁证,分别占53%、50%、47%、40%和7%;PSCI组痰浊证和血瘀证明显高于PSN CI组,差异具有显著性意义(P0.05);2.PSCI组患者的总胆固醇、低密度脂蛋白、载脂蛋白A1及载脂蛋白B均高于PSNCI组患者,但经统计学分析,只有总胆固醇、低密度脂蛋白和载脂蛋白B具有显著性意义(P0.05);痰瘀组甘油三酯为1.41±0.63 mmol/L,非痰瘀组甘油三酯为1.19±0.56 mmol/L,两组差异具有统计学意义(P0.05);痰浊证与血瘀证的甘油三酯分别为1.98±0.66m mol/L、1.85±0.56mmol/L,与PSNCI组比较,差异具有统计学意义;痰浊证的低密度脂蛋白为3.52±0.3mmol/L,与PSNCI组比较,差异具有显著性;痰浊证和血瘀证的载脂蛋白B分别为1.52±0.45.1.45±0.41mmo l/L,与PSNCI组比较,差异具有统计学意义;3.PSCI组患者的P300潜伏期为372.8±30.9ms,PSNCI组患者的P300潜伏期为319.1±29.7ms,两组比较,差异有统计学意义(P0.05);PSCI组患者的P300波幅为6.3±0.7m V,而PSNCI组患者的P300波幅为10.8±1.2m V,两组比较有统计学差异(P0.05);PSCI肾虚证的潜伏期为375.3±31.2ms,与PSNCI组比较,差异具有统计学意义;PSCI痰浊证波幅为5.8±0.8m V,与PSNCI组比较,具有显著性差异;PSCI血瘀证潜伏期为392.3±29.6ms,与PSNCI组比较,统计学分析有显著性意义。结论:1.PSCI多表现为虚实夹杂,以肾虚证、痰浊证和血瘀证为主;2.血脂异常多见于PSCI痰瘀证;3.PSCI肾虚证和血瘀证主要表现为P300潜伏期延长,且血瘀证更为明显,而痰浊证主要表现为波幅降低。
[Abstract]:Objective: to study the distribution of TCM syndromes and the correlation between the syndrome differentiation of PSCI and the level of blood lipid and P300 in patients with cognitive dysfunction after stroke. Methods: from January 2014 to July 2015, 100 stroke patients treated in our hospital were selected. According to the results of cognitive function assessment after 3 months of treatment, they were divided into two groups: cognitive dysfunction group (n = 30) and normal cognitive function group (n = 70). As a result of the exfoliation of tongue pulse, six items of blood lipids (including cholesterol, triglyceride, high density lipoprotein, low density lipoprotein) were collected from 30 patients with PSCI and 65 patients with normal cognitive function. Apolipoprotein Al and apolipoprotein BU, as well as measuring the event-related potentials (P300) of each patient, were statistically analyzed by means of ANOVA / t test. Results 1. The syndrome of PSCI was composed of deficiency and solid inclusions, which accounted for 833% of the 6 basic syndromes. Kidney deficiency syndrome has the largest proportion. The proportion of blood stasis syndrome, phlegm turbidity syndrome, spleen deficiency syndrome, heart deficiency syndrome and liver depression syndrome were 53.50% and 4740% respectively, and the phlegm turbid syndrome and blood stasis syndrome were significantly higher in PSCI group than in PSN CI group, the difference was significant (P 0.05) 2.The total cholesterol and low density lipoprotein (LDL) in PSCI group were significantly higher than those in PSN CI group. Apolipoprotein A1 and apolipoprotein B were higher than those in PSNCI group, but only total cholesterol was found by statistical analysis. Low density lipoprotein (LDL-C) and apolipoprotein B (apolipoprotein B) had significant difference (P 0.05), triglyceride in phlegm stasis group (1.41 卤0.63 mmol / L), non-phlegm stasis group (1.19 卤0.56 mmol / L), phlegm turbid syndrome and blood stasis group (1.98 卤0.66 mmol / L, 1.85 卤0.56 mmol / L), respectively. The low density lipoprotein (LDL) of phlegm turbid syndrome was 3.52 卤0.3 mmol / L, which was significantly higher than that of PSNCI group, the apolipoprotein B of phlegm turbid syndrome and blood stasis syndrome was 1.52 卤0.45.1.45 卤0.41 mmo / l / L, respectively, compared with that of PSNCI group. 3. The P300 latency of PSCI group was 372.8 卤30.9 Ms, the P300 latency of PSNCI group was 319.1 卤29.7ms. The P300 amplitude was 6.3 卤0.7mV in P0.05PSCI group and 10.8 卤1.2m V in PSNCI group. The latency of P0.05PSCI was 375.3 卤31.2mscompared with PSNCI group. Compared with PSNCI group, the latency of blood stasis syndrome was 392.3 卤29.6ms. compared with PSNCI group, there was significant difference in the amplitude of phlegm turbid syndrome. Conclusion: 1. PSCI is mainly composed of deficiency and deficiency of kidney, and the latent period of PSCI is 392.3 卤29.6ms.Conclusion: 1. Blood stasis syndrome and phlegm turbid syndrome. 2. Abnormal blood lipid was found in PSCI phlegm stasis syndrome 3.PSCI kidney deficiency syndrome and blood stasis syndrome mainly showed prolonged P300 latency, and blood stasis syndrome was more obvious, while phlegm turbid syndrome mainly showed decreased amplitude.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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