血管性认知障碍患者中医证候与认知障碍相关性探讨  

Investigation of the Correlation Between Cognitive Impairment and Syndromes of Traditional Chinese Medicine in Vascular Cognitive Impairment

作　　者：张彦红[1] 梁伟雄[2] 朱磊[3] 

机构地区：[1]广州市第一人民医院,广东广州510180 [2]广东省中医院,广东广州510405 [3]广州中医药大学,广东广州510405

出　　处：《中医学报》2013年第5期725-728,共4页Acta Chinese Medicine

基　　金：国家"十一五"计划科技重大专项(编号:2008ZX09312-021)

摘　　要：目的:探讨血管性认知障碍(VCI)患者的中医证候与认知障碍的相关性,为VCI的中医辨证治疗提供依据。方法:从广东省中医院神经科病房及门诊中招募127例受试者,包括卒中后认知正常的患者26例;VCI患者101例,其中血管性痴呆(VaD)患者55例,非痴呆型血管性认知障碍(VCIND)患者46例。并随机招募35例社区认知正常老年人作为正常对照组。采用MMSE量表及广泛的神经心理学测验评价认知功能,参照血管性痴呆辨证量表拟订VCI的辨证草案对受试者进行辨证。分析中医证候对MMSE评分的影响及与各认知领域受损的关系。结果:由Logistic回归分析可知,腑滞浊留证、气血亏虚证是影响MMSE量表得分的重要影响因素。与记忆力是否受损有关的因素是痰浊阻窍证,执行功能受损与中医证型无明显相关性,与注意力是否受损有关的中医证型是肝阳上亢证,语言功能是否受损与中医证型无明显相关性。视空间是否受损与气血亏虚相关。结论:VCI患者最常见的证候与认知功能损害之间具有密切关系,从这些因素入手发挥中医药优势对VCI患者防治具有重要意义。Objective：To investigate the correlation between cognitive impairments and the Chinese medicine syndrome characteristics of vascular cognitive impairment （VCI）. Methods ： 127 patients came from both neurology clinic and ward of Hospital of traditional Chinese Medicine of Guangdong province with cerebral vascular disease （ CVD ） meeting studying criterion were included, and 35 community cognitively normal elderly as the normal control group were included. The Mini-Mental State Examination （MMSE） and a neuropsycho- logical battery were used to access the cognitive function;the investigation of syndrome manifestations and the syndrome differentiation scale of vascular dementia （SDSVD） were used for diagnosis of syndrome manifestations, the correlation between MMSE score, the im- paired cognitive domains and Chinese medicine syndromes was analyzed. Results：By logistic regression analysis,the syndrome of viscera stagnation and turbid left, the syndrome of deficiency of blood and qi significantly affect the MMSE scores. There was significant rela- tionship between the syndrome of turbid phlegm blocking upper orifices and memory dysfunction, the syndrome of hyperactivity of liver yang due to yin deficiency and attention dysfunction ,the syndrome of deficiency of blood and qi and visual spatial impairment. And there was no significant relationship between executive dysfunction and TCM syndrome,language dysfunction and TCM syndrome. Conclusion： There is close relationship between TCM syndrome of VCI and cognitive impairment. If we start from these factors ,we can take advanta- ges of Traditional Chinese Medicine on the prevention and treatment of VCI.

关 键 词：血管性认知障碍 血管性痴呆 非痴呆型血管性认知障碍 中医证候 

分 类 号：R259.4[医药卫生—中西医结合]