轻度认知损害患者中医证型的相关研究

发布时间：2019-01-08 14:20

【摘要】：目的探讨轻度认知损害(Mild Cognitive Impairment,MCI)患者中医证型特点及与神经心理学特征的关系,实现MCI常用神经心理量表的中医辨证应用,为中医早期干预老年痴呆提供辨证依据。方法选择武汉三镇(武昌、汉口和汉阳)中心城区、城郊社区以及城乡结合社区11个具有代表性的社区中符合诊断标准的320例MCI患者为研究对象,应用简易智能状态检查表(Mini-Mental State Examination,MMSE)、蒙特利尔认知评估量表(Montreal Cognitive Assessment Scale,Mo CA)、日常生活功能量表(Activity of Daily Living Scale,ADL)对MCI患者进行认知功能损害评估,参照《轻度认知损害临床指导原则(草案)》中症候诊断标准对MCI患者进行中医辨证。结果 MCI患者的最常见证型是脾肾亏虚型,其次为气血不足型、瘀阻脑络型、阴虚阳亢型、痰浊蒙窍型,且复合证型多见;经相关分析发现:(1)脾肾亏虚型与注意力呈显著正相关,与语言、延迟回忆呈显著负相关;(2)气血不足型与Mo CA得分、MMSE得分呈非常显著负相关;与视空间执行功能、注意力、定向力呈显著负相关;与ADL得分呈非常显著正相关;(3)痰浊蒙窍型与注意力呈显著负相关;(4)腑滞浊留型与ADL得分呈显著正相关。结论在MCI患者中,脾肾亏虚型、气血不足型与多项认知功能损害关系密切。探讨MCI患者的中医证型与神经心理学特征的相关关系,可以博取中西医之所长,细化MCI患者认知减退症状的中医认识,为临床MCI的中医辨证提供客观依据。
[Abstract]:Objective to explore the characteristics of TCM syndromes in patients with mild cognitive impairment (Mild Cognitive Impairment,MCI) and the relationship between TCM syndromes and neuropsychological characteristics, and to realize the application of MCI neuropsychological scale in TCM differentiation, so as to provide evidence for the early intervention of Alzheimer's disease by traditional Chinese medicine (TCM). Methods 320 MCI patients who met the diagnostic criteria in 11 representative communities of three towns (Wuchang, Hankou and Hanyang), suburban communities and urban and rural communities in Wuhan were selected as the study subjects. The cognitive impairment of MCI patients was evaluated with the simple Intelligent State Checklist (Mini-Mental State Examination,MMSE) and the Montreal Cognitive Assessment scale (Montreal Cognitive Assessment Scale,Mo CA),) daily life function scale (Activity of Daily Living Scale,ADL). According to the guidelines for the diagnosis of mild Cognitive impairment (draft), TCM syndrome differentiation of MCI patients was carried out. Results the most common syndromes of MCI patients were deficiency of spleen and kidney, deficiency of qi and blood, stagnation of brain collaterals, hyperactivity of yin deficiency and yang, phlegm and muddy resuscitation. The results of correlation analysis showed that: (1) deficiency of spleen and kidney was positively correlated with attention, negatively correlated with language and delayed recall, (2) deficiency of qi and blood was negatively correlated with Mo CA score and MMSE score; There was a significant negative correlation with visual space executive function, attention and orientation; a very significant positive correlation with ADL score; (3) a significant negative correlation between phlegm turbid orifices and attention; (4) a significant positive correlation between visceral turbid retention and ADL score. Conclusion in patients with MCI, deficiency of spleen and kidney, deficiency of qi and blood are closely related to multiple cognitive impairment. To explore the correlation between TCM syndromes and neuropsychological characteristics of MCI patients can gain the advantages of traditional Chinese and western medicine, refine the TCM cognition of MCI patients with hypocognitive symptoms, and provide an objective basis for TCM differentiation of clinical MCI.
【作者单位】：湖北中医药大学护理学院;
【基金】：国家自然科学基金(No.81473747)
【分类号】：R277.7

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