脑小血管病相关认知功能障碍中医证型分布研究

目的 探讨脑小血管病(CSVD)相关认知功能障碍患者中医证候分布情况.方法 采用横断面调查,纳入2016年10月—2019年12月中山市中医院就诊的脑小血管病患者272例,以简易智力状态检查量表(MMSE)结果分为无认知障碍组、轻中度认知障碍组、重度认知障碍组,按影像学总体负荷评分分为负荷1～2分组和负荷3～4分组.采...

Study on the distribution of TCM syndrome of cerebral small vascular disease related cognitive impairment

Objective It is to explore the distribution of TCM syndromes in patients with cerebral small vessel disease(CSVD)related cognitive dysfunction.Methods A cross-sectional survey was used to enroll 272 patients with CSVD who were admitted to Zhongshan Hospital of Traditional Chinese Medicine from October 2016 to December 2019.They were divided into non-cognitive impairment group,mild to medium cognitive impairment group and severe cognitive impairment group according to the results of the Mini Mental State Examination(MMSE),and were divided into load 1-2 group and load 3-4 group according to the overall imaging load score.Their demographic information was collected,the distribution of syndrome types was summarized by the TCM Syndrome Differentiation Scale for Vascular Dementia,and the distribution differences were compared between the groups based on the overall load score of the patient's imaging.Results The highest frequency of TCM syndromes were blood stasis and phlegm(both more than 50%)in 272 cases of CSVD patients,followed by organ turbid(32.72%),deficiency of kidney essence and deficiency of Qi and blood were found in 1/3 of patients.Further analysis showed that there were differences in the distribution of the four syndrome types of phlegm turbidity blocking orifices,blood stasis blocking the collaterals,turbid stasis and turbidity retained,and Qi-blood deficiency among non-cognitive impairment group,mild to medium cognitive impairment group and severe cognitive impairment group,the types of stasis,phlegm,and turbidity in the cognitive impairment group accounted for more than those in the mild cognitive impairment group(all P<0.05).According to imaging load score,the most common syndromes were syndrome of phlegm turbidity blocking orifice and blood stasis obstructing collaterals in load 1-2 groups,and the syndrome of blood stasis blocking collaterals and Qi-blood deficiency as the main syndrome types in load 3-4 groups.There was a statistically significant difference in the composition ratio of blood stasis obstructing the collaterals and Qi-blood deficiency syndromes(P<0.05).The imaging of brain structure reflected that blood stasis was the important pathological factor and root deficiency and tip excess was the important pathogenesis characteristics of collateral disease.Conclusion The distribution of TCM syndrome types of CSVD is characterized by a mixture of deficiency and excess and multiple syndromes.Stasis,phlegm,and turbidity may be important pathological factors for cognitive impairment,and blood stasis in brain collaterals are the main syndrome types.