记忆抱怨主诉人群的认知功能检测及肝郁证候调查

Relationship between objective cognitive impairment and liver depression syndrome in patients with subjective memory complaints: a crosssectional study

目的探讨记忆抱怨主诉(SMC)与客观认知功能、抑郁和肝郁证候的关系。方法临床招募SMC组受试者95例,无SMC的对照组19例。计算简易智能精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表北京版(Mo CA)评分、汉密尔顿抑郁量表(HAMD)评分和肝郁证候评分。然后分别以SMC及记忆力自评得分(SMC-VAS)为因变量,回归分析影响记忆抱怨主诉的因素。结果 SMC组的MMSE和Mo CA得分明显低于对照组(P<0.05),HAMD得分明显高于对照组(P<0.05)。Logistic回归显示,MMSE分值越低,HAMD分值越高,SMC的可能性越大。线性回归显示,更低的MMSE得分、更高的HAMD得分、直系家属痴呆和独居预示着更差的记忆力自评。SMC组肝郁证相关症状积分、肝郁证诊断积分明显高于对照组(P<0.05)。结论 SMC与客观认知水平和抑郁关系密切。肝郁症状与主观认知损害自评和客观认知表现关系密切,肝郁可能是SMC中医病机之一。

Objective To study the relationship among subjective memory complaints （SMC） , objective cognitive impairment, depression, and liver depression syndrome. Methods Subjects were comprised of two groups： SMC group （ n = 95 ） and control group without SMC （ n = 19 ）. Subjective memory complaints were assessed by subjective memory complaints visual analog Scale （SMC-VAS）. Objective cognitive were examined by mini-mental state examination （MMSE） and Montreal cognitive assessment （MoCA）. Depression was evaluated by Hamilton depression rating scale （HAMD）. And the scores of liver depression syndrome were calculated. Then, the regression analysis of factors on SMC were conducted. Results MMSE and MoCA scores in SMC group were lower than control group（P 〈 0.05 ）, while HAMD score was higher（P 〈 0.05 ）. The scores of liver depression syndrome in SMC group were higher than control group （ P 〈 0.05 ）. Logistic regression analysis showed that lower MMSE and higher HAMD scores predicted more incidence of SMC. Linear regression analysis indicated that lower MMSE scores, higher HAMD scores, first-degree relatives with dementia and living alone all predicted worse memory self-assessment. Conclusion SMC is closely allied to objective cognitive and depression. Liver depression syndrome is connected with subjective or objective cognitive impairment. Liver qi stagnation may be the main pathogenesis of SMC in TCM.