遗忘型轻度认知损害患者认知功能水平与其中医证候的相关性探讨

摘要

Objective To study on characteristic of TCM clinic presentations of the amnestic mild cognitive impairment (Amci) patients and correlation between TCM clinic presentations and cognition level. Methods The cognitive function of 129 persons from Dongzhi-men Hospital or Haiyuncang Community were evaluated using Chinese version of Mini-Mental State Examination (MMSE), delayed memory of Wechsler Memory Scale (WMS) and Clinical Dementia Rating (CDR), and then they were divided into Amci, normal cognitive state (NCS) and Alzheimer's disease (AD) groups. All groups were scored referring to the standard draft of TCM differentiation of symptoms. Results The incidence of phlegm-turbid syndrome and heat-poison in the interior syndrome were lower in the Amci group than in the AD group (P<0.05). The score of phlegm-turbid syndrome of the Amci group was higher than the NCS group (P<0.05), but lower than the AD group, while the score of the deficiency of Qi and blood syndrome was lower than the AD group (P<0.01). There was a negative correlation between the score of syndrome of deficiency of kidney essence and the score of clock-drawing test (CDT), spatial orientation in the Amci group (P<0.05), as well as between the score of the deficiency of Qi and blood syndrome and the total score of MMSE, time orientation, immediate recall, and executive ability(P<0.05); the phlegm-turbid syndrome and calculation (P<0.05), heat-poison in the interior and time orientation (P<0.05). Conclusion There were negative correlations between the TCM syndrome and some cognitive functions in Amci patients.%目的 探讨遗忘型轻度认知损害(aMCI)患者的认知功能水平及其与中医证候特征的相关性。方法 采用简易精神状态检查表(MMSE)中文版、韦氏记忆量表中延迟故事回忆、临床痴呆分级量表(CDR)，对来源于北京中医药大学东直门医院老年病科门诊和海运仓社区的居民129例进行进行认知功能评估，并筛选出aMCI患者、认知正常者(NCS)和阿尔茨海默病(AD)患者，参照MCI中医证候辨证草案对3组人群进行中医证候要素评分。结果 aMCI组中痰浊证和热毒内盛证发生率低于AD组(P＜0.05)。aMCI组的痰浊证评分高于NCS组，低于AD组(P＜0.05)，气血亏虚证评分明显低于AD组(P＜0.01)。aMCI组患者肾精亏虚证评分与画钟试验、空间定向力得分呈负相关(P＜0.05)；气血亏虚证评分与MMSE总分、时间定向力、即刻回忆、语言执行力呈负相关(P＜0.05)；痰浊证评分与注意计算力负相关(P＜0.05)；热毒内盛评分与时间定向力呈负相关(P＜0.05)。结论 肾精亏虚证、气血亏虚证、痰浊证、热毒内盛证与部分认知功能水平呈负相关性。