不同合并症对血管源性轻度认知障碍证候要素的影响  

Impacts of underlying conditions in patients with vascular mild cognitive impairment

作　　者：陈宝鑫[1] 金香兰[1] 郭蓉娟[1] 陈志刚[1] 高芳[1] 王乐[1] 张艳霞[1] 傅晨[1] 牛焕敏[1] 薛斐然[1] 侯小兵[2] 曹晓岚[3] 黎明全[4] 田军彪[5] 张玉莲[6] 白文[7] 张允岭[1] 

机构地区：[1]北京中医药大学东方医院脑病科,100078 [2]中国中医科学院望京医院针灸科 [3]山东中医药大学附属医院脑病科 [4]长春中医药大学附属医院脑病科 [5]河北医科大学中医院脑病科 [6]天津中医药大学第二附属医院脑病针灸科 [7]北京大学人民医院中医科

出　　处：《环球中医药》2015年第8期926-929,共4页Global Traditional Chinese Medicine

基　　金：国家中医药管局2008年度中医药行业科研专项(200807011);国家中医药管理局2010年度中医药行业科研专项(201007002);北京市新医药学科群建设项目(XK100270569)

摘　　要：目的探讨不同合并症对血管源性轻度认知障碍患者证候要素的影响,为提高临床辨证的准确性提供参考。方法进行多中心合作,纳入血管源性轻度认知障碍患者803例,采用卡方检验、Logistic回归等方法分析不同合并症对证候要素分布的影响。结果合并糖尿病的患者气虚、痰、血瘀、阴虚比例较高,存在火证的风险较低(OR=0.55,95%CI=0.31,0.99);合并冠心病的患者气虚、血瘀、痰、阳虚比例最高,存在气虚的风险高于无冠心病的患者(OR=3.75,95%CI=2.65,5.31),存在阴虚的风险低于无冠心病的患者(OR=0.38,95%CI=0.23,0.65);合并脑血管病的患者气虚比例最高,其次为血瘀,存在阳虚的比例高于无脑血管病的患者(OR=1.90,95%CI=1.23,2.95)。结论不同的合并症影响血管源性轻度认知障碍患者的证候要素分布,在四诊合参的同时,结合合并症综合考虑,有助于提高辨证的准确性。Objective To explore the impacts of underlying conditions in patients with vascular mild cognitive impairment, and provide a reference for improving the accuracy of diagnosis of the syndromes of Traditional Chinese Medicine. Methods 803 cases of mild vascular cognitive impairment were included from multi-centers. Chi-square test and Logistic regression were adopted. Results The most common syndrome factors in patients combined with diabetes were qi deficiency, followed by phlegm, blood stasis, yin deficiency. Patients of vascular mild cognitive impairment combined with diabetes had lower risk of fire syndrome than patients combined without diabetes（OR=0. 55,95%CI=0. 31,0. 99）. The most common syndrome factors in patients combined with coronary heart disease was qi deficiency, followed by blood stasis, phlegm, and yang deficiency. Patients combined with coronary heart disease had higher risk of qi deficiency （OR=3. 75,95%CI=2. 65,5. 31）, lower risk of yin deficiency（OR=0. 38,95%CI=0. 23, 0. 65） than patients combined without coronary heart disease. The most common syndrome factors in patients combined with cerebrovascular disease was qi deficiency, followed by blood stasis. Patients＆amp;nbsp;combined with cerebrovascular disease had higher risk of yang deficiency than patients combined without cerebrovascular disease（OR=1. 90,95%CI=1. 23,2. 95）. Conclusions Underlying conditions affect syndrome factors in patients with vascular mild cognitive impairment. Considering the underlying conditions may help to improve the accuracy of TCM syndrome diagnosis.

关 键 词：合并症 血管源性认知障碍 证候要素 

分 类 号：R749.13[医药卫生—神经病学与精神病学]