基底节梗塞后认知障碍与中医证候的相关性分析

Analysis of the Correlation Between Cognitive Impairment and TCM Syndromes After the Onset of Basal Ganglia Infarction

目的 探讨基底节梗塞后认知障碍与中医证候的相关性。方法 对 82例基底节梗塞后出现认知损害的患者进行神经心理学评定和中医证候评定 ,30例头颅CT无梗塞表现的患者作为对照组 ,Logistic回归分析等统计学方法用于上述因素的相关性分析。结果 基底节梗塞后认知障碍最常出现的证型是肾精亏虚证、痰浊证、血瘀证 ,而痰浊阻窍、腑滞浊留证与认知损害积分呈负性相关关系 ,即痰浊、腑滞越重 ,患者的认知得分就越低 ;且热毒内盛和腑滞浊留两者相互作用 ,提高了基底节梗塞后痴呆发生的危险性。结论 痰浊阻窍、腑滞浊留与基底节梗塞认知功能损害具有相关性 。

Objective To investigate the correlation between the cognitive impairment and TCM syndromes after the onset of basal ganglia infarction. Methods 82 patients with cognitive impairment after the onset of basal ganglia infarction were assessed by using the neuropsychological examination scales and TCM syndrome differentiation. 30 Cases without basal ganglia infarction approved by cranial CT were included in the coutrol group. The analysis of the correlation between the relevant criteria was carried out by Logistic regression analysis. Results The most TCM syndromes of the cognitive impairment manifested after the onset of basal ganglia infarction were kidney-essence deficiency, phlegm-turbidness, and blood stagnation. It was found that there was a negative correlation between the cognitive scores and the following two syndromes, namely the syndrome of mentality obstruction by phlegm-turbidness and the syndrome of fu-organ turbidness stagnation, i.e. the severer the two syndromes were, the lower the cognitive scores tended to be. It was also found that the interaction of the exuberance of internal heat toxin and fu-organ turbidness stagnation enlarged the risk of the onset of dementia after basal ganglia infarction. Conclusion There is a correlation between the cognitive impairment after basal ganglia infarction and the two TCM syndromes, namely the syndrome of mentality obstruction by phlegm-turbidness and the syndrome of fu-organ turbidness stagnation; and the analyisis verifies the existence of the two TCM syndromes in the course of the development of vascular dementia.