血管性认知障碍患者虚实证候与认知功能的相关性

Correlation study of deficiency and excess syndrome and cognitive function in patients with vascular cognitive impairment

目的:探讨血管性认知障碍(VCI)患者中医证候分布规律及认知损害特点,为防治VCI提供理论依据。方法:采取多中心、横断面研究,选取5家三级甲等中医院,纳入符合标准362例VCI患者,应用蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)、血管性痴呆中医辨证量表(the scale for the differentiation of syndromes of vascular dementia,SDSVD)进行评估,经过数据处理和统计学分析方法进行比较。结果:VCI患者以肾精亏虚证型最为多见,中医证型组合形式以两种证型或1种证型组合形式为主,其中虚实结合证型例数最多,占54.97%。虚证组与实证组、虚实结合证候2组在体重、BMI指数差异有统计学意义(P<0.01)。实证组在MoCA量表总分、命名因子分明显高于虚实结合证型组,差异有统计学意义(尸<0.05)。实证组在延迟回忆因子分与另外2组差异也有统计学意义(PV 0.05)。结论:VCI不同虚实证候组的认知功能损害存在差异,VCI患者中医证候以虚实夹杂为主,治疗上首当分清虚实。

Objective:To investigate the distribution of TCM syndromes and the characteristics of cognitive impairment in patients with vascular cognitive impairment(VCI),and to provide evidence for the prevention and treatment of VCI.Methods:A multi-center,cross-sectional study was adopted.362 VCI patients who met the criteria were enrolled among 5 class A tertiary TCM hospitals,and were evaluated with MoCA scale and SDSVD scale.Then processing and analysing the data collected.Results:The most common type of syndrome of VCI patients was kidney deficiency sydrome.The combination of TCM syndromes was mainly composed of two types of syndromes or one type of syndrome.Among them,the number of combination of deficiency and excess sydrome was the majority,accounting for 54.97%.There are significant differences in body weight and BMI index between the deficiency syndrome group and the excess syndrome group,and between the deficiency sydrome group and the combination of deficiency and excess syndromes group(P<0.01).The total score and naming sub-domain score of the MoCA scale of the excess group were significantly higher than that of the combined syndrome group,the difference was statistically significant.The delayed recall sub-domain of the excess group was significantly higher than that of the other two groups,the differences between the excess sydrome and the other two groups were of great significance(P<0.05).Conclusion:There are differences in the cognitive impairment among different TCM sydrome groups in VCI.TCM syndromes of VCI patients are mainly a combination of deficiency and excess,and the treatment should be to distinguish the deficiency and excess sydromes first.