血管性痴呆的诊断标准和评价工具介绍——兼回答《血管性痴呆诊断、辨证及疗效判定标准》一文的读者提问

Introduction to the Diagnostic Criteria and Assessment Scales for Vascular Dementia: to Answer the Questions Raised by the Readers of the Paper Entitled TCM Diagnosis, Differentiation, and Criteria of Clinical Effectiveness in Treating Vascular De

为了更好地理解和使用《血管性痴呆诊断、辨证及疗效判定标准》（下称《VaD标准》,见《北京中医药大学学报》2000年5期）,并回答读者的提问,简要介绍了有关国际公认的痴呆诊断标准和疗效指标及其评定标准,以及常用评价量表的来源、评分标准、基本内容以及选择理由等。这些标准包括DSM-Ⅳ痴呆标准、NINDS-AIREN血管性痴呆标准和显效、有效、无效及恶化标准。评价量表主要有康乃尔痴呆中的抑郁症量表（CSDD）、简易精神状态检查（MMSE）和临床痴呆分级（CDR）、包括躯体性日常生活自理量表（SPMS）在内的工具性日常生活自理能力（IDAL）,以及临床医生对病情变化的总体印象（CGIC）和临床医生的面试印象（CIBIC）等。有些量表等待着在我国试用或验证,以解决因文化交叉带来的差异;对《VaD标准》本身也需要在进一步临床验证基础上进行修改。

This paper briefly introduces some internationally recognized criteria for diagnosis, treatment and treating effectiveness assessment of vascular dementia (VaD), and explains the sources, scoring criteria, essential contents and reasons for the adoption of some oftentimes used VaD assessment scales, in order to help further understand and apply the Criteria for Diagnosis, TCM Differentiation and Clinical Effectiveness Assessment in Treating VaD (see Journal of Beijing University of Traditional Chinese Medicine. 2000, 23(5): 16 - 24), and to answer the readers' relevant questions. The criteria and scales introduced in this paper include DSM-IV criteria for dementia; NINDS-AIREN criteria for VaD; criteria for obvious effectiveness, effectiveness, ineffectiveness and exacerbation in treating VaD; Cornell Scale for Depression in Dementia (CSDD); Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR); Instrumental Activities of Daily living Scale (IDAL) which contains Physical Self-maintenance Scale (PSMS); CGIC; and Clinician Interview-Based Impression of Change (CIBIC). The authors of this paper state that there are still some other criteria and scales waiting for clinical trial in China because there are some cultural differences needing to be dealt with. Too, the Criteria for Diagnosis, TCM Differentiation and Clinical Effectiveness Assessment in Treating VaD need to be revised on the basis of clinical verification.