轻度认知障碍中医证候流行病学研究

目的探讨轻度认知障碍(MCI)患者的中医证候特点及其与简易精神状态量表(MMSE)的关系,为MCI的治疗提供科学的依据。方法运用轻度认知障碍中医常见证候流行病学调查问卷,进行临床流行病学调查,筛选出MCI患者为观察对象。参照《中华人民共和国国家标准.中医临床诊疗术语证候部分》,同时结合以往的临床经验,拟定MCI中医辨证草案,对MCI患者进行中医辨证。将量表、流行病学及数理分析方法相结合,探讨MCI患者的中医证候特点及其与MMSE的关系。结果MCI患者的最常见证候是肝肾阴虚,其次是痰蒙清窍、脑痿髓空、瘀血痹阻、气血双亏。经Spearman相关分析发现,中医证候与MMSE之间呈负相关。结论在MCI患者中,多见肝肾阴虚、痰蒙清窍、脑痿髓空、瘀血痹阻、气血双亏证,它们与认知损害之间具有密切关系,这为MCI的辨证论治提供了客观依据。

Epidemiological study on TCM syndromes of mild cognitive impairment

Objective To investigate the TCM syndrome characteristics of mild cognitive impairment(MCI) and the relationship between MCI and the Mini-Mental Status Examination(MMSE) in order to provide a scientific base for MCI treatment.Methods The patients with MCI were chosen and accepted the epidemical survey through the questionnaire of TCM common syndromes of MCI,and then the ground-plan of TCM syndrome differentiation was worked out and the patients were given TCM differentiation on the base of clinical experiences and "State Standard of the People's Republic of China: Clinical Diagnostic and Therapeutic Terminology of Syndromes of Chinese Medicine".The characteristics of TCM syndromes in the patients with MCI and the relationship between these characteristics and MMSE were discussed on the base of combination of MMSE,epidemiology and mathematical analysis.Results In MCI patients the most common syndrome was the syndrome of deficiency of liver-yin and kidney-yin,followed by the syndrome of phlegm clouding the upper orifices,brain paralysis and marrow deficiency,constipation due to blood stasis,and deficiency of both qi and blood.After Spearman's analysis a negative correlation was showed between TCM syndromes and MMSE.Conclusion In MCI patients the common syndromes include the syndrome of deficiency of liver-yin and kidneyyin,followed by the syndrome of phlegm clouding the upper orifices,brain paralysis and marrow deficiency,constipation due to blood stasis,and deficiency of both qi and blood,which are correlated to the cognitive impairment.It provides an objective base for the syndrome differentiation and treatment of MCI.