老年轻度认知功能障碍中医证型的客观化研究

Objectified study on TCM syndromes of senile mild cognitive impairment

目的:探讨老年轻度认知功能障碍(MCI)中医证型与β-淀粉样多肽1-42(Aβ1-42)、白介素6(IL-6)、血栓弹力图(TEG)的相关性,为老年MCI中医辨证分型的客观化提供参考依据。方法:随机选取老年MCI心脾两虚证、肾精亏虚证、痰浊蒙窍证、瘀血阻窍证患者各30例,以同期健康老年体检者30例作为对照组,分别检测和比较各组的Aβ1-42、IL-6和血栓弹力图指标(R、K、Angle、MA)。结果:老年MCI患者的血清Aβ1-42、IL-6均较对照组升高(P<0.05或P<0.01)。各中医证型组间比较,痰浊蒙窍组的Aβ1-42、IL-6显著升高;瘀血阻窍组的Aβ1-42、Angle、MA显著升高,R、K降低。结论:老年MCI的血清Aβ1-42、IL-6较正常老年人显著升高,可以作为老年MCI辨病诊断的参考;老年MCI不同中医证型间Aβ1-42、IL-6和血栓弹力图指标(R、K、Angle、MA)存在差异,可作为辨证分型的参考。

Objective：To approach the correlativity between TCM syndromes of senile mild cognitive impairment （MCI） and β - amyloid peptide 1 - 42 （ Aβ 1- 42）, interleukin 6 （ IL - 6）, thrombelastogram （TEG）, in order to provide a reference basis for objectified TCM syndrome differentiation of senile MCI. Methods ： Each 30 cases of patients with senile MIC of heartspleen deficiency syndrome, kidney -essence deficiency syndrome, syndrome of orifices confused by phlegm and blood - stasis obstruction syndrome were selected randomly. In the same period ,30 cases of healthy senile check -up were taken as the control group. The indexes of Aβ1 -42, I1 -6 and TEG （R, K, Angle, MA） in each group were detected and compared respectively. Results： Aβ1 -42 and IL- 6 in serum of patients with senile MCI were higher than those of control group （ P 〈 0.05 or P 〈 0.01 ）. Com- pared among groups of various TCM syndromes, in the syndrome of orifices confused by phlegm, Aβ1 -42 and IL - 5 were significantly increased ; in the syndrome of blood - stasis obstruction, Aβ1 - 42, Angle and MA were significantly increased,while R and K reduced. Conclusion： Aβ1 -42 and IL -6 in serum of senile MCI are significantly higher than those of normal elderly,which can be used as a reference for diagnosis of senile MCI. Among different TCM syndromes of senile MCI, Aβ1 -42, IL -6 and TEG（ R, K, Angle, MA） are different , which can be used as a reference for syndrome differentiation.