血管性痴呆的中医证候特点研究

The Characteristics of TCM Syndromes of Vascular Dementia

目的:探索宁夏地区汉族、回族血管性痴呆(VD)患者的中医证候特点。方法:纳入符合诊断标准的患者204例,进行问卷调查及中医证候辨证,分析不同年龄段、不同民族VD的中医证候分布特点及中医证候积分与智力状态检查量表(MMSE)积分关系。结果:肾精亏虚证、痰浊阻窍证、瘀血阻络证为VD患者的前3位证型,分别占总人数的38.7%、19.1%、18.6%;在肾精亏虚证中,50~59岁与60~69岁、70~79岁患者人数比较,差异有统计学意义(P<0.05),60~69岁与70~79岁患病人数比较,差异无统计学意义(P>0.05);在痰浊阻窍证中,3个年龄段患者人数比较,差异均有统计学意义(P<0.05)。在瘀血阻络证中,3个年龄段患者人数相比,差异均无统计学意义(P>0.05)。在痰浊阻窍证中,汉族、回族患者人数比较,差异无统计学意义(P>0.05)。中医证候积分与MMSE积分呈负相关(r=-0.569,P<0.01)。结论:宁夏地区VD患者的中医证候以肾虚、痰浊、瘀血为主;在肾精亏虚证中,随着年龄增长,患者人数逐渐增多;在痰浊阻窍证中,随着年龄增长,患者人数逐渐下降;在瘀血阻络证,虽然不同年龄段比较差异无统计学意义,但患者人数呈上升趋势;在痰浊阻窍证中,汉族患者人数多于回族,但差异无统计学意义,中医证候积分与MMSE积分呈负相关。

Objective: To discuss TCM syndromes characteristics of vascular dementia(VD) of the people from Han and the Hui ethnic groups in Ningxia region. Methods: All 204 patients who met the diagnostic criteria were included, surveyed using questionnaires and differentiated according to TCM syndromes, to analyze the characteristics of TCM syndromes of VD from different ethnic groups at different ages, and the correlation between TCM syndrome scores and MMSE scores. Results: The syndromes of renal essence depletion, phlegm-turbidity blocking the orifices and blood stasis blocking collateral rank the first three syndromes, which held 38.7%, 19.1%and 18.6% of the overall population respectively;regarding the syndrome of renal essence depletion, the difference could be found when the number of the patients aged between 50 and 59 years was compared with that of these between 60 and 69 years, between 70 and 79 years(P <0.05), the difference had no statistical meaning in the comparisons of the number of the patients between 60 and 69 years and these between 70 and 79 years(P>0.05);as for the syndrome of phlegm-turbidity blocking the orifices, the difference could be found in the numbers of the patients at three age groups(P<0.05). The difference had no statistical meaning in the comparisons of the numbers of the patients at three age groups of blood stasis blocking collateral syndrome(P>0.05). The difference showed no statistical meaning in the comparisons of the numbers of the patients of phlegm-turbidity blocking the orifices syndrome between the Han and Hui ethnic groups(P >0.05). TCM syndrome scores was negatively related to MMSE scores(r=-0.569, P <0.01). Conclusion: TCM syndromes of VD in Ningxia region are renal deficiency,phlegm turbidity and blood stasis principally;regarding renal essence depletion syndrome, as the patients grow older,the more the patients become;regarding phlegm-turbidity blocking the orifices syndrome, as the patients become older, the fewer the patients become;as for blood stasis blocking collateral syndrome, the difference has no statistical meaning in the comparisons of different age groups, the number of the patients is on the rise;as for phlegm-turbidity blocking the orifices syndrome, the number of the patients from the Han ethnic group is more than that from the Hui ethnic group, and the difference has no statistical meaning. TCM syndrome scores are negatively related to MMSE scores.