基于Logistic回归分析血管性认知障碍中医证型与认知域及危险因素的相关性  

Analysis of the Correlation Among Traditional Chinese Medicine Symptoms of Vascular Cognitive Impairment,Cognitive Domain and Risk Factors Based on Logistic Regression

作　　者：吴宏帅 方小敏 常诚[1] WU Hong-shuai;FANG Xiao-min;CHANG Cheng(The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《南京中医药大学学报》2020年第6期814-819,共6页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：国家自然科学基金(81673759);江苏省科技厅社会发展课题(BE2017770);江苏省自然科学基金(BK2010092);国家中医药管理局中医药循证能力建设项目(2019XZZX-NB007)。

摘　　要：目的探讨血管性认知障碍(VCI)中医证型与认知域及危险因素的相关性。方法将372例VCI患者参考血管性痴呆中医辨证量表(SDSVD)辨证分型,收集患者危险因素资料,采用蒙特利尔认知量表(MoCA)对患者认知功能进行评估,将中医证型与MoCA认知域及危险因素进行相关性分析。结果Exact Logistic回归结果示:肾精亏虚证与视空间(P<0.01,OR=0.305)、注意力(P<0.05 OR=0.469)、延迟回忆(P<0.01,OR=0.380)、定向力(P<0.05,OR=0.447)、年龄(P<0.01,OR=1.141)、体质量指数(BMI)(P<0.01,OR=1.363)相关;痰浊阻窍证与命名能力(P<0.05,OR=0.298)、语言能力(P<0.01,OR=0.336)、延迟回忆(P<0.01,OR=0.498)、定向力(P<0.05,OR=1.887)、BMI(P<0.05,OR=1.267)、高血压病(P<0.01,OR=5.850)、吸烟(P<0.05,OR=5.589)相关;瘀血阻络证与定向力(P<0.05,OR=0.571)、BMI(P<0.05,OR=1.283)、高血压病(P<0.01,OR=19.215)、糖尿病(P<0.01,OR=5.214)、吸烟(P<0.05,OR=6.188)相关;肝阳上亢证与注意力(P<0.05,OR=2.153)、抽象思维(P<0.01,OR=0.042)、定向力(P<0.05,OR=2.432)、年龄(P<0.05,OR=1.116)、高血压(P=0.01,OR=20.787)、吸烟(P<0.01,OR=15.289)、睡眠质量(P<0.05,OR=0.065)相关。结论VCI各中医证型存在不同类型的认知域损害和危险因素特征,可为早期诊断和干预治疗提供依据。OBJECTIVE To discuss the correlation between traditional Chinese medicine(TCM)symptoms of vascular cognitive impairment(VCI),cognitive domain and risk factors.METHODS According to the TCM syndrome differentiation scale for vascular dementia,372 patients were divided into different groups with different symptoms.Patients'risk factors information was collected,and Montreal Cognitive Scale(MoCA)was applied to assess patients'cognitive function and made correlation analysis of TCM symptoms,MoCA cognitive domain and risk factors.RESULTS The result of Exact Logistic Regression showed that kidney essence deficiency symptom was connected with view space(P<0.01,OR=0.305),attention(P<0.05,OR=0.469),delayed recall(P<0.01,OR=0.380),orientation(P<0.05,OR=0.447),age(P<0.01,OR=1.141)and body mass index(BMI)(P<0.01,OR=1.363).Phlegm-turbidity obstructing orifices symptom was relevant to naming ability(P<0.05,OR=0.298),language competence(P<0.01,OR=0.336),delayed recall(P<0.01,OR=0.498),orientation(P<0.05,OR=1.887),BMI(P<0.05,OR=1.267),hypertension(P<0.01,OR=5.850)and smoking(P<0.05,OR=5.589).Blood stasis obstructing collaterals symptom was associated with orientation(P<0.05,OR=0.571),BMI(P<0.05,OR=1.283),hypertension(P<0.01,OR=19.215),diabetes(P<0.01,OR=5.214)and smoking(P<0.05,OR=6.188).Ascendant hyperactivity of liver yang symptom was correlative with attention(P<0.05,OR=2.153),abstract thinking(P<0.01,OR=0.042),orientation(P<0.05,OR=2.432),age(P<0.05,OR=1.116),hypertension(P=0.01,OR=20.787),smoking(P<0.01,OR=15.289)and sleep quality(P<0.05,OR=0.065).CONCLUSION TCM symptoms of VCI have different kinds of damage of cognitive domain and risk factors'characteristics,which can provide a basis for the diagnosis and intervention treatment in the early stage.

关 键 词：血管性认知障碍 中医证型 MOCA量表 认知域 危险因素 

分 类 号：R256.2[医药卫生—中医内科学]