血管性认知损害的中医证候特征

Characteristic of Syndrome of Chinese Medicine in Vascular Cognitive Imp airment Patients

目的探讨血管性认知损害(VCI)患者的中医证候特征。方法对774例受试者进行神经心理学检查,结合影像学、生化检查,初步筛选出VCI组和认知功能正常组(NC组)142例,并对患者进行中医证候辨别、中医证候评分以及中医证候对于VCI的危险度研究。结果 VCI组痰浊蒙窍证、瘀阻脑络证、腑滞浊留证出现的比率和证候积分显著高于NC组,热毒内盛证、气血不足证的比率和证候积分低于NC组(P<0.05或P<0.01)。NC组单一证候所占的比例高,VCI组多个证候比例高。中医证候对于VCI的危险度显示,痰浊蒙窍证、瘀阻脑络证、腑滞浊留证回归系数分别为3.472、8.866和3.921(P<0.01)。结论痰浊蒙窍证、瘀阻脑络证、腑滞浊留证在VCI患者中出现频率高、程度严重,其可能是VCI发病的危险因素。

Objective To discuss the characteristic of syndrome o f Chinese medicine in vascular cognitive impairment（VCI） patients. Methods T he patients of VCI group（107 cases） and normal cognition（NC） group（142 cases） were selected among 774 subjects by neuropsychologic,imaging and biochemical e xamination.Syndromes of Chinese medicine were identified and scored.The risk of different syndromes to VCI was researched. Results Comparing with the NC group,the occurrence ra tes and syndrome scores o f phlegm turbidity clouding the orifices syndrome,stasis obstructing the networ k vessels of the brain syndrome,bowels obstruction and turbidity stagnation syn drome were significantly higher（P0.05 or P0.01）,while those of q i and blood deficiency syndrome and exuberant internal heat toxin syndrome were significantly l ower（P0.05 or P0.01）.The proportion of single syndrome was highe r in the NC group,while that of multi-syndrome was higher in the VCI group.Co ncerning the risk of different syndromes to VCI,the regression coefficient was 3.472,8.866 and 3.9 21 in phlegm turbidity clouding the orifices syndrome,stasis obstructing the ne twork vessels of the brain syndrome and bowels obstruction and turbidity stagnat ion syndrome respectively（P0.01）.Conclusion Th e phlegm turbidity clouding the orifices syndrome,stasis obstructing the network vessels of the brain syndrome and bowels obstruction and turbidity stagnation syndrome are more frequent and s evere,which maybe a risk factor to VCI.