NIHSS评分为0分的脑卒中患者认知功能变化特点及中医证候要素分析  

Characteristic of change in cognitive function of stroke patients with NIHSS of 0 point and analysis on TCM syndrome element

作　　者：姬少珍 金香兰[2] 郝颖[1] 申伟[1] 梁晓[1] 王建伟[1] 赵珈艺[1] 赵建军[3] 曹晓岚[4] 张宪忠 侯小兵[6] 王少杰[7] 张虎 杨健[9] 王玲玲 胡皓 林安基[12] 田军彪[13] 吴业清 吴浩[15] 张允岭[2] 

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078 [3]长春中医药大学附属医院,长春130021 [4]山东中医药大学附属医院,济南250011 [5]山东省日照市中医院,日照276800 [6]中国中医科学院望京医院,北京100102 [7]北京大学人民医院,北京100044 [8]北京中医医院顺义医院,北京101300 [9]重庆市中医院,重庆400011 [10]北京市丰台区右安门社区卫生服务中心,北京100069 [11]北京市丰台区蒲黄榆社区卫生服务中心,北京100075 [12]厦门市中医院,厦门361009 [13]河北医科大学中医院,石家庄050011 [14]北京市丰台区兴隆中医医院,北京100141 [15]北京市丰台区方庄社区卫生服务中心,北京100078

出　　处：《中华中医药杂志》2016年第5期1812-1815,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家中医药管理局2010年度中医药行业科研专项(No.201007002);国家中医药管理局2014年度中医药行业科研专项(No.201407001);2011年北京市科技计划项目(No.Z111107056811040);2013年首都临床特色应用研究(No.Z131107002213151)~~

摘　　要：目的:分析NIHSS评分为0分的脑卒中患者认知功能损害特点、危险因素及中医证候要素特点,为脑卒中后认知障碍防治提供依据。方法:选择NIHSS评分为0分的脑卒中患者816例,观察其认知水平,采集基本资料、中医症状、舌象、脉象等信息,6个月后进行随访,观察认知功能变化,分析认知功能损害特点。根据认知功能下降与否分为认知功能下降组和非认知功能下降组,比较两组人群认知功能损害危险因素及中医症状、舌象、脉象及证候要素。结果:NIHSS评分为0分的脑卒中患者认知功能下降涉及视空间与执行能力、记忆力、计算力、语言等多方面,表现为大脑高级智能的全面下降。两组冠状动脉粥样硬化性心脏病史、脑卒中类型差异显著(P<0.01),证候要素分布呈现显著差异(P<0.01)。结论:冠状动脉粥样硬化性心脏病史、腔隙性脑梗死与NIHSS评分为0分的脑卒中患者认知功能下降相关,患者证候要素复杂多样,特别是认知功能下降的患者多以复合证候要素为主,症状表现形式多样。Objective： To investigate the characteristic of cognitive impairments, risk factors and TCM syndrome element of stroke patients with a National Institute of Health stroke scale score（NIHSS） of 0 point, and to provide a basis for prevention and treatment of cognitive impairment after stroke. Methods： Eight hundred and sixteen cases of stroke patients with NIHSS of 0 point were recruited to observe cognitive level, collect basic information, TCM symptom, tongue manifestation and pulse manifestation, and follow these patients up after 6 months to observe the change of cognitive level and analyze the characteristic of cognitive impairments. The patients were divided into 2 groups： the cognitive impairments group and the no-cognitive impairments group, risk factors of cognitive impairments, TCM symptoms, tongue manifestation, pulse manifestation and syndrome element were compared. Results： The cognitive decline of patients with NIHSS of 0 point inloved view space with various aspects such as executive capacity, memory, calculation and language. There was significant difference in Mo CA scores, MMSE scores, coronary heart disease history and cerebral stroke type（P〈0.05）. The two groups had a significant difference in the rate of TCM syndrome elements（P〈0.05）. Conclusion： There was a positive relationship between cognitive decline and coronary heart disease history and cerebral infarction. TCM syndrome elements of stroke patients with NIHSS of 0 point were complex and diverse, especially for cognitive decline patients with more complex TCM symptoms.

关 键 词：NIHSS 认知功能损害 危险因素 中医证候要素 

分 类 号：R277.7[医药卫生—中医学]