基于中医体质辨证的全程分阶健康管理在老年认知障碍治疗中的应用  

Application of Whole-stage Health Management Based on Traditional Chinese Medicine Constitution Differentiation in the Treatment of Senile Cognitive Impairment

作　　者：闫华 杨戈[1] 刘红梅 张润顺[1] 张其慧[3] 李浩 Yan Hua;Yang Ge;Liu Hongmei;Zhang Runshun;Zhang Qihui;Li Hao(Guang anmen Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100053;Chaoyang Fourth Hospital,Chaoyang 122000;Huguo Temple Hospital of Taditional Chinese Medicine affiliated to Beijjing University of Chinese Medicine,Beijing 100035;Wanging Hospital of CACMS,Beijing 100102)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]朝阳市第四医院,朝阳122000 [3]北京中医药大学附属护国寺中医医院,北京100035 [4]中国中医科学院望京医院,北京100102

出　　处：《国际老年医学杂志》2023年第5期543-547,共5页International Journal of Geriatrics

基　　金：北京市西城区财政科技专项项目(XCSTS-SD2021-05);中国中医科学院科技创新工程项目(CI2021A01411)。

摘　　要：目的 研究基于中医体质辨证的全程分阶健康管理在老年认知障碍治疗中的应用价值。方法 选取2021年3月~2022年10月于中国中医科学院广安门医院及北京中医药大学附属护国寺中医医院老年病科门诊或住院的308例认知功能障碍患者作为研究对象,按照随机分组原则分成两组,对照组155例,试验组153例。对照组仅进行常规的病症控制和治疗,试验组采取基于中医体质辨证的全程分阶健康管理,比较两组蒙特利尔认知评估量表(MoCA)、简易精神状态检查表(MMSE)、阿尔茨海默病评定量表-认知分量表(ADAS-Cog)、中医临床证候变化总体印象量表(CGIC-S)、日常生活能力评分量表(ADL)、临床痴呆评定量表(CDR)、韦氏成人智力量表(中国修订版)(WAIS-RC)、基于新版临床医生面试的总体印象量表(CIBIC-plus)、空腹血糖(FBG)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血清胆碱酯酶、同型半胱氨酸之间的差异。结果 治疗前,两组各指标比较差异均无统计学意义(P>0.05)。治疗后,试验组MoCA、MMSE、WAIS-RC高于对照组(P<0.05),ADAS-Cog、CGIC-S、ADL、CDR及CIBIC-plus低于对照组(P<0.05);试验组FBG、TG、LDL-C及同型半胱氨酸低于对照组(P<0.05),HDL-C高于对照组(P<0.05)。结论基于中医体质辨证的全程分阶健康管理使老年认知障碍患者的认知评分显著升高,安全性较高,建议临床推广。Objective To study the application value of whole-stage graded health management based on Traditional Chinese Medicine(TCM)constitution differentiation in the treatment of elderly patients with cognitive impairment.Methods A total of 308 patients with cognitive dysfunction who were admitted to Guang'anmen Hospital of China Academy of Chinese Medical Sciences and Huguosi Hospital of Traditional Chinese Medicine Affiliated to Beijing University of Chinese Medicine from March 2021 to October 2022 were selected as research objects.They were divided into two groups according to the principle of random grouping,with 155 patients in the control group and 153 patients in the test group.The control group only received routine disease control and treatment,while the the test group received whole-stage health management based on TCM constitution differentiation.The differences between Montreal Cognitive Assessment(MoCA),Mini-Mental State Examination(MMSE),Alzheimer's Disease Rating Scale-Cognitive Subscale(ADAS-Cog),Global Impression of Change in TCM Clinical Syndrome(CGIC-S),Activities of Daily Living Scale(ADL),Clinical Dementia Rating(CDR),Wechsler Adult Intelligence Scale(Chinese Revision)(WAIS-RC),Global Impression Scale based on a new version of clinician interview(CIBIC-plus),fasting blood glucose(FBG),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),serum cholinesterase,and homocysteine were compared between the two groups.Results Before treatment,there was no significant difference in each index between the two groups(P>0.05).After treatment,MoCA,MMSE and WAIS-RC in the test group were higher than those in the control group(P<0.05),ADAS-Cog,CGIC-S,ADL,CDR and CIBIC-plus were lower than those in the control group(P<0.05);FBG,TG,LDL-C and homocysteine in the test group were lower than those in the control group(P<0.05),and HDL-C was higher than that in the control group(P<0.05).Conclusion The whole course graded health management based on TCM constitution syndrom

关 键 词：中医体质辨证 认知障碍 全程分阶健康管理 

分 类 号：R277.7[医药卫生—中医学]