中老年轻度认知功能障碍患者中医证候要素与MMSE及MoCA量表评分相关性研究

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中文摘要：目的:探讨中老年轻度认知功能障碍(MCI)患者的中医证候要素与简易精神状态检查量表(MMSE)及蒙特利尔认知评估量表(MoCA)评分的相关性.方法:采取整群随机抽样方法,随机选取西咸主城区7个社区,以50～89岁中老年人群作为筛查对象,通过受筛人群的一般资料和病史,结合认知能力检测与规范的诊断标准,筛查出MCI患者.分析MCI患者的中医证候要素与MMSE及MoCA量表评分之间的相关性.结果:女性MCI患病人数多于男性;MCI的虚证病性证素分布频次为肾虚＞髓减＞阴虚＞气虚＞脾虚＞阳虚＞血虚.实证病性证素分布频次为痰浊＞内热>血瘀>阳亢;MCI的中医证素以2种证素兼见(70/206,33.98％)及3种证素兼见(49/206,23.79％)为主;认知功能损害在MMSE量表中主要集中在注意力和计算力、结构能力、书写能力、延迟回忆等领域,在MoCA量表中主要集中在注意力、语言能力、视空间与执行功能及延迟回忆等领域;MMSE总分与阳亢呈负相关(P＜0.05);即刻记忆得分与痰浊呈负相关(P＜0.05);延迟回忆得分与髓减呈负相关(P＜0.05);书写能力得分与髓减呈正相关(P＜0.01);复述能力得分与内热呈正相关(P＜0.05);阅读能力得分与血瘀呈负相关(P＜0.05);结构能力得分与肾虚呈负相关(P＜0.01).MoCA总分与内热呈正相关(P＜0.01);视空间与执行功能与内热呈正相关(P＜0.01),与血瘀呈负相关(P＜0.05);命名得分与髓减呈负相关(P＜0.05);注意力得分与内热呈正相关(P＜0.05),与血瘀呈负相关(P＜0.05);语言能力得分与髓减呈负相关(P＜0.05),与内热呈正相关(P＜0.01).结论:中老年MCI患者的中医证素主要集中在肾虚、髓减、内热、痰浊等,是多种病理因素相互作用的结果,MCI与中医证候要素之间存在一定的相关关系,但研究结论尚未统一,还需要进一步研究.

外文标题：Study on the correlation between traditional Chinese medicine syndrome elements and MMSE and MoCA scores in middle-aged and elderly patients with mild cognitive impairment

外文摘要：To explore the correlation between traditional Chinese medicine(TCM)syndrome elements and the scores of the mini mental state examination(MMSE)and Montreal cognitive assessment(MoCA)in middle-aged and elderly patients with mild cognitive impairment(MCI).Methods:A cluster random sampling method was adopted to randomly select 7 communities in the main urban area of Xixian.The middle-aged and elderly population aged 50 to 89 were selected as screening targets.MCI patients were screened based on the general information and medical history of the screened population,combined with cognitive ability testing and standardized diagnostic criteria.The correlation between TCM syndrome elements of MCI patients and MMSE and MoCA scale scores was analyzed.Results:Women had more MCI cases than men;The distribution frequency of deficiency pathological syndrome elements in MCI was kidney deficiency＞marrow deficiency＞yin deficiency＞qi deficiency＞spleen deficiency＞yang deficiency＞blood deficiency;The distribution frequency of empirical pathological syndrome elements was phlegm turbidity＞intemal heat＞blood stasis＞yang hyperactivity;The TCM syndrome elements of MCI were mainly characterized by two types of syndrome elements coexisting(70/206,33.98％)and three types of syndrome elements coexisting(49/206,23.79％);Cognitive impairment was mainly concentrated in areas such as attention and computing power,structural ability,writing ability,and delayed recall in the MMSE scale,while in the MoCA scale,it was mainly concentrated in areas such as attention,language ability,visual space and executive function,and delayed recall;The total score of MMSE was negatively correlated with yang hyperactivity(P＜0.05);The immediate memory score was negatively correlated with phlegm turbidity(P＜0.05);The delayed recall score was negatively correlated with marrow deficiency(P＜0.05);The score of writing ability was positively correlated with deficiency(P＜0.01);The score of retelling ability was positively correlated with internal heat(P＜0.05);The reading ability score was negatively correlated with blood stasis(P＜0.05);The score of structural ability was negatively correlated with kidney deficiency(P＜0.01);The total score of MoCA was positively correlated with internal heat(P＜0.01);Visual space and executive function were positively correlated with internal heat(P＜0.01),and negatively correlated with blood stasis(P＜0.05);The score of naming was negatively correlated with marrow deficiency(P＜0.05);Attention score was positively correlated with internal heat(P＜0.05)and negatively correlated with blood stasis(P＜0.05);The language ability score was negatively correlated with marrow deficiency(P＜0.05)and positively correlated with internal heat(P＜0.01).Conclusion:TCM syndrome elements in middle-aged and elderly MCI patients are mainly concentrated in kidney deficiency,marrow deficiency,internal heat,phlegm turbidity,etc.,which is the result of the interaction of multiple pathological factors.There is a certain correlation between MCI and TCM syndrome elements,but the research conclusions are not yet unified and further research is needed.

外文关键词：

Mild cognitive impairmentAlzheimer's diseaseTraditional Chinese medicine syndrome elementCognitive domainAnalysis of correlationNeuropsychological scale

作者：

张虎、第五永长、杨谦、王登坤、刘奇、周源

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作者单位：

陕西中医药大学第一临床学院,咸阳 712046

陕西中医药大学基础医学院,咸阳 712046

关键词：

轻度认知功能障碍阿尔茨海默病中医证素认知域相关性分析神经心理学量表

基金：

国家自然科学基金陕西中医药大学神经退行性疾病中医药防治研究学科创新团队项目陕西省特支计划科技创新领军人才项目

项目编号：

820745032019-QN05陕组通字[2018]33号

出版年：

2024

中华中医药杂志

中华中医药学会

中华中医药杂志

CSTPCD北大核心

影响因子：1.135

ISSN：1673-1727

年,卷(期)：2024.39(4)

参考文献量28