慢性疲劳综合征主要中医证型患者认知功能特点的研究

Study on cognitive function characteristics of patients with chronic fatigue syndrome of main traditional Chinese medicine syndrome

[目的]探索慢性疲劳综合征(CFS)主要中医证型患者的认知功能特点。[方法]采用病例对照研究,对CFS肝郁脾虚组、肝肾不足组、气滞痰阻组、心脾两虚组和正常组患者分别通过蒙特利尔认知评估(MoCA)量表、E-prime认知心理学测试开展认知功能评价。[结果]各主要中医证型组CFS患者MoCA量表总分及各模块分均低于正常组(P<0.05);肝肾不足组MoCA总分、视空间与执行功能模块分、注意模块分均低于肝郁脾虚组和气滞痰阻组,且延迟回忆模块分低于气滞痰阻组(P<0.05);心脾两虚组MoCA量表总分、注意模块分均低于气滞痰阻组(P<0.05)。各组存在轻度认知功能障碍的例数为肝郁脾虚组2例、肝肾不足组7例、气滞痰阻组0例、心脾两虚组4例、正常组0例;肝肾不足组认知功能水平较正常组下降(P<0.05)。各主要中医证型组CFS患者的B反应时长于正常组(P<0.05),T2|T1正确率和One-back正确率均低于正常组(P<0.05)。肝肾不足组、心脾两虚组与气滞痰阻组相比,B反应时延长、T2|T1正确率下降(P<0.05);肝肾不足组T2|T1正确率低于肝郁脾虚组,One-back正确率低于气滞痰阻组和心脾两虚组(P<0.05)。[结论]各主要中医证型CFS患者均存在认知功能受损,且各组受损程度不一。肝肾不足组和心脾两虚组认知功能受损程度较重,气滞痰阻组、肝郁脾虚组较轻,且肝肾不足组CFS患者出现轻度认知障碍(MCI)较其他证型多,可早期对该证型CFS患者开展中医药干预以防治其认识功能受损、延缓MCI进程。

[Objective]To observe the cognitive function characteristics of chronic fatigue syndrome(CFS)patients in major traditional Chinese medicine(TCM)syndromes types.[Methods]A case-control study was conducted to evaluate the cognitive function of patients with CFS of liver depression and spleen deficiency,liver and kidney deficiency,qi stagnation and phlegm obstruction,heart and spleen deficiency and normal group through MoCA scale and E-prime cognitive psychology test respectively.[Results]The total scores and module scores of MoCA scale in CFS patients in all major TCM syndrome types groups were lower than those in normal group(P<0.05).The MoCA total score,visual space and executive function module score,attention module score in liver and kidney deficiency group were lower than those in liver depression and spleen deficiency group and qi stagnation and phlegm obstruction group,and the delayed recall module score was lower than that in qi stagnation and phlegm obstruction group(P<0.05).The number of cases with mild cognitive impairment in each group was 2 cases with liver depression and spleen deficiency,7 cases with liver and kidney deficiency,0 cases with qi stagnation and phlegm obstruction,4 cases with deficiency of both heart and spleen,and 0 case with normal group.Compared with the normal group,the cognitive function level of liver and kidney deficiency group decreased(P<0.05).The B reaction time of CFS patients in the main TCM syndrome groups was longer than that of the normal group(P<0.05),while the accuracy of T2|T1 and One-back was lower than that of the normal group(P<0.05).Compared with the qi stagnation and phlegm obstruction group,the B reaction time was prolonged and the accuracy of T2|T1 was decreased in liver and kidney deficiency group and heart and spleen deficiency group.The accuracy of T2|T1 in liver and kidney deficiency group was lower than that in liver depression and spleen deficiency group,and the accuracy of One-back was lower than that in qi stagnation and phlegm obstruction group and heart and spleen deficiency group(P<0.05).[Conclusion]The patients in the main TCM syndrome types with CFS have impaired cognitive function,while the cognitive impairment in each group is different.Cognitive function was impaired more seriously in deficiency of the liver and kidney group or deficiency of both heart and spleen group,than those in qi stagnation and phlegm obstruction group or liver depression and spleen deficiency group.There were more patients with MCI in deficiency of liver and kidney group,so early intervention with Chinese medicine can prevent and cure cognitive impairment and delay MCI process.