早期术后认知功能障碍老年患者的中医体质研究  

The study of traditional Chinese medical constitutions of elderly patients with early postoperative cognitive dysfunction

作　　者：曾朝坤[1] 张文璇 林明[1] 李德维[1] 熊昕[1] 杨硕 赵高峰[1] ZENG Chao- kun, ZHANG Wen-xuan, LIN Ming, LI De- wei, XIONG Xin, YANG Shuo, ZHAO Gao-feng.(Department of Anesthesiology, Guangzhou University of Chinese Medicine Second Affiliated Hospital, Guangzhou 510120, Guangdong , Chin)

机构地区：[1]广东省中医院麻醉科,广东广州510120 [2]广州市干部疗养院体检中心,广东广州510525

出　　处：《广东医学》2018年第6期931-934,共4页Guangdong Medical Journal

基　　金：广东省中医药局科研课题(编号:20141137)

摘　　要：目的分析早期术后认知功能障碍(POCD)老年患者的中医体质特点,为POCD的防治提供中医药调理的临床依据。方法术前根据《中医体质分类与判定》表判定患者的中医体质类型,并选取需行手术治疗的年龄≥60岁的老年患者为观察对象,术前及术后3 d采用蒙特利尔认知评估量表,进行认知功能的评估,根据2次评估分值的差值决定归入POCD组或对照组。结果 POCD组的瘀血质、气虚质等偏颇体质类型的比例较对照组高,而POCD组平和体质的比例较对照组低,差异有统计学意义(P<0.05)。POCD组患者瘀血质的比例及气虚质的比例均较高,与对照组比较差异有统计学意义(P<0.05)。结论 POCD患者偏颇体质类型的比例较高,气虚质及瘀血质可能是引起老年患者早期的重要因素,可从改善气虚质或瘀血质的角度治疗并预防POCD。Objective To investigated the distribution of Traditional Chinese Medicine （TCM） body constitutions of elderly patients with postoperative cognitive dysfunction （POCD）. Methods Based on the Traditional Chinese Constitution typing and determination, different types of constitutions for patients over 60 - years old before surgery were determined. The cognitive function was assessed based on Montreal Cognitive Assessment 3 days before and after operation. The patients were assigned into POCD group （Group P） and control group （Group C） depend on the differences of twice evaluation. Results There were significantly more patients with constitutions of blood stasis and qi asthenia in Group P than Group C group （ P 〈 0. 05 ）. There was less patients with constitution of yin - yang harmony in Group P than Group C （ P 〈 0. 05 ）. In Group P, there was higher ratio of constitution of blood stasis （40. 0% vs. 9. 9%, P 〈 0. 05 ） and constitution of qi asthenia （ 17.3% vs. 8.8%, P 〈 0.05 ）. Conclusion Biased constitution is risk factor for POCD, suggesting that we could prevent POCD by adjusting the constitutional blood stasis and qi asthenia in elderly patients.

关 键 词：中医体质 老年 术后认知功能障碍 

分 类 号：R614[医药卫生—麻醉学]