脑萎缩指标与血管性痴呆认知障碍及中医证型的相关性研究

为探讨神经影像学在血管性痴呆(VD)认知障碍评价中的意义及与中医证型的相关性,采用临床痴呆量表选择4组实验对象进行神经心理学量表测评、CT、检测脑萎缩相关指标和中医辨证分型.结果:与认知正常组相比,脑卒中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.VD存在明显的脑萎缩和白质疏松,且与认知障碍程度相关.中医证候诊断中,脑卒中组的肾精亏虚证候比认知正常组明显,轻度VD组的痰浊阻窍证候比脑卒中组和认知正常组明显,中度VD组的瘀血阻络证候比其它3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、白质密度、脑萎缩相关.尤以瘀血阻络证候明显.说明神经影像学指标与VD认知障碍相关,肾精亏虚、痰浊阻窍、瘀血阻络证候与认知损害关系密切,与脑萎缩指标也相关,而标实的影响可能比本虚更大.

Relationship between Characteristics of Neuroimaging and TCM Differentiation of Syndromes on Cognitive Impairment in Vascular Dementia

To discuss the significance of neural image in vascular dementia(VD),and the relationship between cognitive impairment,cerebral atrophy and TCM syndromes of VD.According to clinical dementia rating,subjects were divided into 4 groups,i.e.normal cognition(NC),vascular cognitive impairment no dementia(VCIND),mild VD(VD1)and middle degree VD(VD2),all groups were accepted neuro-psychological measures,CT examination and TCM differentiation of syndromes.The results showed that certain cognitive deficits presented in VCIND group,but comprehensive deficits manifested in two VD groups compared with NC group.Cerebral atrophy and leukoaraiosis significantly presented in VD cases,which were related with cognitive impairment,dementia degree and 3 TCM syndromes(deficiency of kidney-essence,obstruction of phlegm in orifices and block of blood stasis in collaterals).Conclusion:Indexes of neural image have related to cognitive deficits,and three syndromes above may impact on cognitive functions.