血管性痴呆认知障碍特征与中医证型的相关性研究

目的：探讨血管性痴呆（VD）患者认知障碍特征及与中医证型的相关性,为中医临床辨证提供依据。方法：根据临床痴呆量表选择4组实验对象,分别为认知正常组（NC）、血管性认知损害未达痴呆诊断组（VCIND）、轻度VD组（VD1）和中度VD（VD2）组。各组均分别进行神经心理学量表评测和中医辨证分型。结果：与NC组相比,VCIND组存在某些方面的认知障碍,痴呆组则有广泛的认知损害,且随着痴呆程度加重而加重。中医证候诊断中,VCIND组的肾精亏虚证候比NC组明显,VD1组的痰浊阻窍证候比VCIND组和NC组明显,VD2组的瘀血阻络证候比NC、VCIND、VD1组明显,肾精亏虚、痰浊阻窍、瘀血阻络证候均与各认知量表得分、痴呆程度相关。结论：认知量表结合证候分析可能可以预测认知损害的变化。肾精亏虚、痰浊阻窍、瘀血阻络证候与认知损害关系密切,对中医证候的干预可能对防治VD有意义。

A study on relationship between cognitive manifestation and TCM differentiation dementia

Objective: To discuss the relationship between cognitive impairment and TCM syndromes in vascular dementia(VD). Method: Subjects were divided into 4 groups according to Clinical Dementia Rating: normal cognition (NC), vascular cognitive impairment no dementia (VCIND), mild VD (VD1) and moderate degree VD (VD2) groups. All the subjects accepted neuropsychological measures and differentiation of TCM syndrome. Result: Compared with cases in NC group, certain cognitive deficits presented in VCIND group, but comprehensive deficits manifested in two VD groups, which related to the degree of dementia. Among the TCM syndromes, there were 3 syndromes, deficiency of kidney essence, obstruction of phlegm in orifice and block of blood stasis in collaterals, correlated with neuropsychological measures and dementia grade as well. Conclusion: TCM syndromes combined with cognitive scales may predict the change of cognitive deficits in VD. The syndromes of deficiency of kidney essence, obstruction of phlegm in orifice and block of blood stasis in collaterals may be the impact factors on cognitive functions. The intervention on the syndromes may benefit prevention and treatment on cognitive impairment.