血管性认知障碍患者痰、瘀、虚型中医证候与认知功能损害的相关性研究  

Correlation between Cognitive Dysfunction and TCM Syndromes (Phlegm, Stagnation and Deficiency) in Vascular Cognitive Impairment

作　　者：刘立瑾 蔡浩斌 王建军[1] 孔繁鑫[2] 郑浩涛 虢周科[1,2] LIU Lijin;CAI Haobin;WANG Jianjun;KONG Fanxin;ZHENG Haotao;GUO Zhouke(The Fourth Clinical Medicine School,Guangzhou University of Chinese Medicine,Shenzhen 518033,Guangdong,China;Department of Encephalopathy and Psychiatry,Shenzhen TCM Hospital,Shenzhen 518033,Guangdong,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院脑病与心理病科,广东深圳518033

出　　处：《中华中医药学刊》2019年第11期2686-2689,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81804004);中国博士后科学基金项目(2018M643207);广东省中医药建设专项资金立项科研项目(20171243);深圳市卫生系统科研项目(SZBC2018005);深圳市科创委学科布局项目(JCYJ20160428174825490,JCYJ20170307154620600);深圳卫生计生系统科研项目(201604130510)

摘　　要：目的:探讨血管性认知障碍(VCI)患者痰、瘀、虚型中医证候与认知损害的相关性,为VCI的中医微观辨证论治提供科学依据。方法:选取明确诊断为血管性认知障碍的患者,依据纳入标准及排除标准共收集病例163例,采用MoCA量表评价其认知功能,并用血管性痴呆的中医辨证量表(SDSVD)对纳入病例进行中医辨证分型,分析不同中医证候的VCI患者MoCA总分及亚域得分差异,以及VCI患者中医证候积分与MoCA得分的相关性。结果:肾精亏虚证型中,注意亚域得分为3.78±1.51,差异具有统计学意义(P<0.05);瘀血阻络证型中,抽象亚域得分为0.87±0.73,差异具有统计学意义(P<0.05),延迟回忆亚域得分0.67±1.08,差异具有统计学意义(P<0.01)。经Pearson相关发现,MoCA总分与中医证候总分呈负相关(r=-0.157,P<0.05),其中,注意亚域及延迟回忆亚域得分与中医证候总分呈负相关(r=-0.184,r=-0.166,P<0.05);肾精亏虚证得分与注意及延迟回忆亚域得分呈负相关(r=-0.163,r=-0.162,P<0.05);瘀血阻络证得分与执行及延迟回忆亚域得分呈负相关(r=-0.166,r=-0.182,P<0.05),证候得分与命名、语言、抽象、定向亚域无明显相关性。结论:VCI患者常见的肾虚、血瘀证候与认知功能损害之间存在密切关系,而痰浊在研究中显示与VCI患者认知损害关系并不显著。临床上从肾虚血瘀入手治疗VCI可能获得满意疗效。Objective:To investigate the correlation between TCM syndromes and cognitive dysfunction in patients with vascular cognitive impairment(VCI) and provide a scientific basis for VCI syndrome differentiation. Methods:Patients with vascular cognitive impairment diagnosed were selected. According to the inclusion and exclusion criteria, 163 cases were collected. We evaluated its cognitive function and used TCM syndrome differentiation scale(SDSVD) of vascular dementia to carry out TCM syndrome differentiation of the included cases and analyze the difference of MoCA total scores and sub-domain scores and the TCM syndrome scores of VCI patients. Results: In the kidney deficiency syndrome, the attention sub-domain score was(3.78±1.51) and the difference was statistically significant(P<0.05). In the blood stasis syndrome, the abstract sub-domain score was(0.87±0.73) and the difference was statistically significant (P<0.05). The delayed recall sub-domain score was(0.67±1.08) and the difference was statistically significant(P<0.01). According to Pearson correlation, the total score of MoCA was negatively correlated with the total score of TCM syndromes(r=-0.157, P<0.05). Among them, attention sub-domain and delayed recall sub-domain scores were negatively correlated with TCM syndrome scores(r=-0.184, r=-0.166, P<0.05). The score of kidney deficiency syndrome was negatively correlated with attention and delayed recall subdomain scores(r=-0.163, r=-0.162, P<0.05). The scores of blood stasis syndrome were negatively correlated with the scores of execution and delayed recall sub-domains(r=-0.166, r=-0.182, P<0.05). There was no significant correlation between TCM syndrome scores and naming, language, abstraction and orientation sub-domains. Conclusion:There is a close relationship between the syndromes of kidney deficiency and blood stasis and cognitive impairment in patients with VCI, and turbidity in this study shows no significant relationship with cognitive impairment. Clinically, nourishing kidney and activating blood m

关 键 词：血管性认知障碍 中医证候 认知障碍 肾虚 瘀血 

分 类 号：R749.13[医药卫生—神经病学与精神病学]