不同阶段、不同类型血管性认知障碍的中医证候分布及差异研究  

Study on the Distribution and Difference of Traditional Chinese Medicine Syndromes of Different Stages and Different Types of Vascular Cognitive Impairmentt

作　　者：王炳权[1] 曹璐璐 谢美雯 张炳立[1] 常淑枫[1] 丁慧芬[1] 尚懿纯[1] WANG Bingquan;CAO Lulu;XIE Meiwen;ZHANG Bingli;CHANG Shufeng;DING Huifen;SHANG Yichun(Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China)

机构地区：[1]天津中医药大学

出　　处：《吉林中医药》2019年第9期1173-1175,共3页Jilin Journal of Chinese Medicine

基　　金：国家自然和科学基金资助项目(81703968);天津市卫生和计划项目(2017098)

摘　　要：目的探讨血管性认知障碍在不同类型、不同阶段的中医证候分布及其差异。方法将本院2016年1月-2017年12月收治的143例缺血性卒中作为研究对象,通过简易精神状态量表(MMSE)对患者进行评分后分组,其中MMSE≥27分的患者为对照组(53例),MMSE <27分的患者为观察组(90例),并根据临床诊断与临床痴呆评定量表(CDR)评分结果,观察组患者中诊断为血管性痴呆为痴呆组(41例),非痴呆血管性认知障碍为非痴呆组(49例)。通过阿尔茨海默病评定量表-认知部分(ADAS-Cog)、画钟试验(Clox)、血管性痴呆证候量表、日常生活能力(ADL)量表对所有研究对象进行评分。结果非痴呆组瘀阻脑络18例(36.73%)、脾肾亏虚证型30例(61.22%);痴呆组瘀阻脑络16例(39.02%)、脾肾亏虚证型20例(48.78%);各组患者中医证候分布情况的比较,并无明显差异(P> 0.05)。在观察组中,瘀阻脑络型的患者ADL量表评分较脾肾亏虚患者显著降低,Clox 2和MMSE量表评分较脾肾亏虚者均显著升高(均P <0.05);而Clox 1和ADAS-Cog量表评分的比较,均无明显差异(均P> 0.05)。结论血管性认知障碍的患者中医证候以瘀阻脑络、脾肾亏虚为多见,且脾肾亏虚型者认知功能障碍的程度高于瘀阻脑络者,日常生活能力低于瘀阻脑络者。Objective To explore the distribution and difference of traditional Chinese medicine syndromes in different types and stages of vascular cognitive impairment. Methods 143 cases of ischemic stroke in our hospital during January 2016 to December 2017 were selected as the object of study. The mini-mental state examination(MMSE) were scored after grouping, patients with MMSE≥ 27 scores as control group(53 cases), with MMSE < scores as the observation group(90 cases). According to the clinical diagnosis and Clinical Dementia Rating(CDR) Scale scores of the patients in the observation group, the diagnosis of vascular dementia as dementia group(41 cases) and non-dementia vascular cognitive impairment as non-dementia group(49 cases). All subjects were scored by Alzheimer’s Disease Assessment Scale-Cognitivesection(ADAS-Cog), clock drawing test(Clox), vascular dementia syndrome scale, and Activity of Daily Living Scale(ADL). Results There were 18 cases(36.73%) of blood stagnant in cerebral venation syndrome in the non-dementia group, deficiency of spleen and kidney syndrome in 30 cases(61.22%);16 cases(39.02%) of blood stagnant in cerebral venation syndrome in dementia group, 20 cases(48.78%) of deficiency o spleen and kidney syndrome;the distribution of traditional Chinese medicine syndromes among those group showed no significant difference(P > 0.05). In the observation group, the ADL scale score in patients with blood stagnant in cerebral venation syndrome was significantly lower than patients with deficiency of spleen and kidney, the Clox 2 and MMSE scale scores were significantly higher than patients with deficiency of spleen and kidney(P < 0.05);and the Clox 1 test score and ADAS-Cog showed no significant difference(P > 0.05). Conclusion The blood stagnant in cerebral venation syndrome and deficiency of spleen and kidney syndrome are mainly common in patients with vascular cognitive impairment, and the degree of cognitive impairment in patients with deficiency of spleen and kidney are higher than that of blood s

关 键 词：血管性认知障碍 中医证候 缺血性卒中 认知功能 日常生活能力 

分 类 号：R749.1[医药卫生—神经病学与精神病学]