摘要
目的:探讨急性脑梗死后认知障碍与中医证型的相关性,为中医药早期干预脑卒中后认知障碍提供依据。方法:研究对象为2003-09/2004-03上海市中医药大学附属岳阳中西医结合医院神经内科收治的41例急性脑梗死后认知障碍患者,对患者进行神经心理学测试,参照《血管性痴呆辨证量表》进行中医辨证分型并给予量化评分。结果:急性脑梗死后认知障碍患者最常见的中医证型是肾精亏虚证,其次是痰浊阻窍证、腑滞浊留证、瘀血阻络证、热毒内盛证、肝阳上亢证和气血亏虚证。经相关分析发现中医证候积分与神经心理学成绩之间具有显著相关性:①与痰浊阻窍证呈显著负相关的是简易精神状态量表(MMSE)(P<0.01),计算力、临摹得分、回忆得分、符数个数、划消个数(P<0.05);呈显著正相关的是连线1、连线2(P<0.01),划消时间(P<0.05)。②与腑滞浊留证呈显著负相关的是临摹得分、回忆得分、划消个数(P<0.01),符数个数(P<0.05),呈显著正相关的是连线测验2(P<0.01)。结论:急性脑梗死后认知障碍患者中,中医证型以肾精亏虚证、痰浊阻窍证、腑滞浊留证为常见。痰浊阻窍证、腑滞浊留证与急性脑梗死后认知障碍显著相关。急性脑梗死后认知障碍是多种因素协同作用的结果,痰浊和腑滞可能是引起认知障碍的重要致病因素。对急性脑梗死后出现痰浊阻?
AIM: To investigate the correlation between the cognitive impairment (CI) and traditional Chinese medicine (TCM) syndromes after acute cerebral infarction (ACI), and provide data for early intervention in poststroke CI with TCM.METHODS: Totally 41 post- ACI patients with CT,selected from the Department of Neurology, Yueyang Hospital of Combination of Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine from September 2003 to March 2004, were assessed by using the neuropsychological examination scales,and according to the scale for the differentiation of syndromes of vascular dementia, the quantitative scores,TCM syndromes differentiation were defined for quantitative scoring.RESULTS: The most common TCM syndrome of CI after ACI was kidney- essence deficiency.The other ones were mentality obstruction by phlegm- turbidness, fu- organ turbidness stagnation, blood stagnation blocked in branch channel, exuberance of internal heat toxin, hyperactivity of liver- yang and Qi- blood deficiency. It was found that there was a marked correlation between the neuropsychological examination scores and the scales of TCM syndromes by the correlation analysis.① There was a negative correlation between the syndrome of mentality obstruction by phlegm- turbidness and mini- mental state examination(MMSE)(P< 0.01), calculation ability, copy score, memory score, symbol digit number, cancellation number(P< 0.05), and a significantly positive correlation with trail making test 1 and 2 (P< 0.01), and cancellation time (P< 0.05). ② There was a negative correlation between the syndrome of fu- organ turbidness stagnation and copy score, memory score, cancellation number(P< 0.01), symbol digit number(P< 0.05), and a significantly positive correlation with the trail making test 2 (P< 0.05). CONCLUSION: Among the post- ACI CI patients, the TCM syndromes of kidney- essence deficiency, mentality obstruction by phlegm- turbidness, and fu- organ turbidness stagnation are common. There is a remarkable correlation between the cognitive impairment and the two following syndromes, namely,the syndrome of mentality obstruction by phlegm- turbidness and fu- organ turbidness stagnation.The post- ACI CI is a result of many factors collaboration with each other among them. Phlegm- turbidness and fu- organ are important pathologic factors causing cognitive impairment. TCM can be used to improve cognitive function in the post- ACI CI patients with the syndromes of mentality obstruction by phlegm- turbidness and fu- organ turbidness stagnation.
出处
《中国临床康复》
CSCD
北大核心
2005年第9期1-3,共3页
Chinese Journal of Clinical Rehabilitation
