记忆抱怨主诉与客观认知功能及中医肝郁证的相关性

Correlation between Subjective Memory Complaint, Objective Cognitive Impairment and Chinese Medical Syndrome of Liver Depression

目的探讨中老年人记忆抱怨主诉(SMC)与客观认知损害、抑郁状态及中医肝郁证候因素的关系。方法临床招募SMC受试者102例,分为SMC认知正常组(52例)与SMC认知下降组(50例),并选择无SMC且客观认知功能正常的对照组(20例),分别进行记忆抱怨主诉视觉评价量表(SMC-VAS)自评,简易智能精神状态检查量表(MMSE)、蒙特利尔认知评定量表(MoCA)客观认知功能评价,汉密尔顿抑郁量表(HAMD-17)抑郁状态评价,及中医肝郁相关证候调查。结果 SMC认知正常组HAMD-17平均得分高于SMC认知下降组和对照组(P<0.05和P<0.01);SMC认知正常组中医肝郁相关证候平均得分高于SMC认知下降组(P<0.05);SMC认知正常组SMC-VAS总分与MoCA总分无明显关联,与HAMD-17得分(P<0.01)、中医肝郁相关证候(P<0.05)呈正相关;SMC认知下降组SMC-VAS总分与MoCA总分成负相关(P<0.05),与HAMD-17得分(P<0.01)、中医肝郁相关证候得分(P<0.01)呈正相关。结论并不是所有SMC人群的认知抱怨都与客观认知损害有关;SMC人群无论有无认知下降,都与抑郁状态、中医肝郁证候有关。

Objective To discuss the correlation between subjective memory complaint （SMC）, objective cognitive impairment, depression and Chinese medical syndrome of liver depression in the elderly. Methods Totally 102 participants with SMC and 20 normal cognitive functional controls without SMC were recruited. The 102 SMC patients were divided into SMC with normal cognition （52 cases） and SMC with decreased cognition （50 cases）. Participants were asked to rate the degree of their perceived cognitive decline by Subjective Memory Complaint Visual Rating Scale （SMC-VAS）. The objective cognitive function was examined by using Mini-Mental State Examination （MMSE） and Montreal Cognitive Assessment （MoCA）. De- pression was assessed by using Hamilton Depression Rating Scale （HAMD-17） and Chinese medical syndrome of liver depression was also investigated. Results The HAMD-17 scores in SMC cognitively normal group were significantly higher than those in SMC cognitive decline group and the control group （P〈0.05, P〈0.01）. The average scores of liver depression syn- drome in SMC cognitively normal group were significantly higher than those in SMC cognitive decline group （P〈0.05）. In SMC cognitively normal group, the scores of SMC-VAS had no significant association with MoCA scores, but were positively correlated with the HAMD-17 scores （P〈0.01）. and the scores of liver depression syndrome （P〈0.05）. In SMC cognitively decline group, the scores of SMC-VAS were negatively correlated with MoCA scores （P〈0.05） and were positively correlated with the HAMD-17 scores （P〈0.01） and the scores of liver depression syndrome （P〈0. 01）. Conclusion A considerable part of SMC individuals have no objective cognitive impairment. SMC with or without cognitive impairment is associated with depression and Chinese medical syndrome of liver depression.