肾阳虚和肾阴虚型绝经期综合征妇女记忆功能损害特征

Characteristics of memory functional impairment in women with menopausal syndrome of kidney yang deficiency and yin deficiency types

目的:分析肾阳虚和肾阴虚型绝经期综合征妇女记忆功能损害特征,论证进行干预的可能性。方法:选择2004-01/2005-10在辽宁省葫芦岛市中心医院妇产科门诊就诊或住院治疗的肾阳虚和肾阴虚型绝经期综合征妇女137例,肾阳虚型组62例,肾阴虚型组75例。均符合《中国精神疾病分类方案与诊断标准》中有关绝经期综合征的诊断标准,肾阳虚或肾阴虚中医辨证标准。对照组选择同期进行健康体检的同龄女性58例。入选对象均在治疗前由资深中医师进行辨证诊断,并接受韦氏记忆量表和临床精神卫生症状自评量表调查及相关血生化实验室检查。结果:①肾阳虚患者平均年龄和平均绝经年限明显高于肾阴虚型和对照组[分别为(59.77±16.24),(54.09±15.49),(55.18±17.65)岁;(8.46±2.55),(5.59±1.64),(6.24±1.57)年,P<0.05～0.01]。②韦氏记忆量表智测成绩比较:肾阳虚组和肾阴虚组长、短时记忆成绩以及记忆商[(11.26±2.85),(11.82±3.21)和(11.13±2.94),(11.95±3.67)和(10.22±2.56),(10.37±3.28)]均明显低于对照组,肾阳虚组长、短时记忆成绩和记忆商也明显低于肾阴虚患者(P<0.05～0.01),3组间瞬间记忆指标差异无显著性意义(P>0.05)。③心理情绪评分比较:肾阳虚组和肾阴虚组症状自评量表总分、阳性总分、阳性项目均数和阳性项目均分均明显高于对照组,肾阳虚组症状自评量表总分、阳性总分和阳性项目均分也明显高于肾阴虚患者(P<0.01～0.05)。④相关血生化指标比较:肾阳虚组和肾阴虚组血浆促卵泡素、促黄体生成素浓度明显高于对照组,而雌二醇、睾酮和去甲肾上腺素浓度明显低于对照组,肾阳虚组雌二醇、睾酮和去甲肾上腺素浓度也明显低于肾阴虚患者(P<0.05～0.01)。结论:肾阳虚和肾阴虚型绝经综合征妇女均有记忆功能损害表现,肾阳虚患者更为严重,还同时伴有较多负性抑郁情绪和低血浆雌、雄激素浓度特征。

AIM： To summarize the characteristics of memory functional impairment in women with menopausal syndrome of kidney yang deficiency and yin deficiency types, and discuss the possibility of interventions. METHODS： Totally 137 female outpatients or inpatients with menopausal syndrome of kidney yang deficiency （n=62） and yin deficiency （n=75） were selected from the Department of Obstetrics and Gynecology, Huludao Central Hospital from January 2004 to October 2005. They all accorded the diagnosis standard of menopausal syndrome in Chinese Classification of Mental Disorders and traditional Chinese medicine （TCM） differentiation for kidney yang deficiency and yin deficiency. Meanwhile, 58 female healthy examinees were selected as control group. All the subjects were diagnosed by senior TCM physicians for differentiation of symptoms and signs before treatment, and assessed with Wechsler memory scale （WMS） and clinical mental health symptom checklist （SCL）. In addition, they received laboratory examinations of related blood biochemical indexes. RESULTS： ①The average age and average menopausal duration in the patients of kidney yang deficiency were obviously higher than those in the patients of kidney yin deficiency and control group [（59.77±16.24）, （54.09 ±15.49）, （55.18±17.65） years old; （8.46±2.55）, （5.59±1.64）, （6.24±1.57） years, P〈0.05-0.01].②Comparison of WMS results： The long and shortterm memory as well as memory quotient in the patients of kidney yin deficiency and yang deficiency types [（11.26±2.85）, （11.82±3.21）; （11.13±2.94）, （11.95±3.67）; （10.22±2.56）, （10.37±3.28）] were obviously lower than those in control group, and the above indexes in the patients of Kidney yang deficiency type were markedly lower than those in the patients of yin deficiency type （P 〈 0.05-0.01）, but the results of transient memory had no significant differences among the three groups （P 〉 0.05）. ③Comparison of SCL scores： The total score of SCL, total score of positive items, average number of positive items and average score of positive items in the patients of kidney yin deficiency and yang deficiency types were all obviously higher than those in the control group; The total score of SCL, total score of positive items and average score of positive items in the patients of kidney yang deficiency type were markedly higher than those in the patients of yin deficiency type （P〈0.05-0.01）.④Comparison of related biochemical indexes： The plasma concentrations of follicle stimulating hormone and interstitial cell stimulating hormone in the patients of kidney yin deficiency and yang deficiency types were obviously higher than those in the control group, but the concentrations of estradiol, testosterone and noradrenaline were obviously lower than those in the control group; The concentrations of estradiol, testosterone and noradrenaline were also significantly lower in the patients of kidney yang deficiency type than in the patients ofyin deficiency type （P 〈 0.05-0.01）. CONCLUSION： Both women with menopausal syndrome of kidney yang deficiency and yin deficiency types have manifestations of memory functional impairment, which is more serious in those of kidney yang deficiency type. Meanwhile, they are accompanied by many negative depressive emotions and low concentrations of hormones and androgens in plasma.