南宁市社区轻度认知功能障碍患者中医证候分布规律分析

Analysis of the distribution rules of TCM syndromes in patients with mild cognitive impairment in the communities of Nanning city

目的探讨南宁市社区轻度认知功能障碍(MCI)人群中医证候的分布规律,为MCI的临床辨证施治和研究提供客观依据。方法采用整群随机抽样的方法,选取101例2020年7—10月南宁市不同城区5个社区60岁及以上常住居民为调查对象,选择简易精神状态评价量表(MMSE)、临床痴呆评定量表(CDR)、日常生活能力量表(ADL)、Hachinski缺血指数量表(HIS)筛查MCI患者以及采集中医四诊信息通过中医辨证得出中医证候,归纳并总结101例MCI患者中医证候分布特征及规律。结果MCI患者多有高血压、糖尿病、动脉硬化等基础疾病;发病年龄区间60~79岁人群占84.16%,主要集中在60~69岁(50.50%);MCI中医证型发生率依次为:痰湿证>血瘀证>阳虚寒湿证>气血亏虚证>肝肾阴虚证。各中医证型与性别、年龄比较,差异无统计学意义(P>0.05),但痰湿证、血瘀证、阳虚寒湿证与基础疾病存在密切联系。结论南宁市社区MCI中医基本病机呈现出以痰、湿、瘀为主的标实证,以阳虚、气血亏虚证为多的本虚证的主要规律;且与高血压、糖尿病、动脉硬化等基础疾病密切相关。这些发现可为临床进一步防治和研究MCI提供客观的中医证型依据。

Objective To explore the distribution rules of traditional Chinese medicine(TCM)syndromes in population with mild cognitive impairment(MCI)in the communities of Nanning city,and provide an objective basis for clinical treatment based on syndrome differentiation and research on MCI.Methods A total of 101 cases of inhabitants aged 60 years and above in five communities in different urban areas of Nanning city from July to October 2020 were selected as the study subjects by cluster random sampling method.The Simple Mental State Evaluation Scale(MMSE),Clinical Dementia Rating Scale(CDR),Activity of Daily Living Scale(ADL)and Hachinski Ischemic Scale(HIS)were selected to screen MCI patients.The information from the TCM four diagnostic methods was collected to identify the s yndromes by T CM syndrome differentiation.The distribution characteristics and rules of the TCM syndromes in 101 MCI patients were summarized.Results MCI patients mostly had underlying diseases such as hypertension,diabetes mellitus and arterios clerosis.T he ons et age range of 60-79 years old accounted for 84.16%of population,and m ainly concentrated in the age group of 60-69 years old(50.50%).The incidence of TCM syndrome types in MCI was in the following order:phlegm-dampness syndrome>blood stasis syndrome>Yang deficiency cold-dampness syndrome>Qi-blood deficiency syndrome>liver-kidney Yin deficiency syndrome.There were no statistically significant relationships between each TCM syndrome type and gender and age(P>0.05),but there was a close relationship between phlegm-dampness syndrome,blood stasis syndrome and Yang deficiency cold-dampness syndrome and underlying diseases.Conclusion The basic TCM pathogenesis of MCI in the communities of Nanning city shows the main rules of excess in superficiality syndromes characterized by phlegm,dampness and stasis,ami deficiency in origin syndromes characterized by Yang deficiency and^i—blood deficiency.And it's closely related to underlying diseases such as hypertension,diabetes mellitus and arteriosclerosis.These findings can provide an objective basis of TCM syndrome types for further clinical prevention and treatment and research on MCI.