轻度认知障碍患者证素分布规律与其合并症相关性研究
|
摘要
目的:初步探讨轻度认知功能障碍(MCI)证素分布特点及其与合并症的相关性,从而揭示MCI及其合并症的中医证素分布规律,为MCI的中医临床实践提供依据。方法:以福州市社区MCI老年患者为研究对象,采用横断面研究设计,通过中医四诊信息表收集证素信息并结合证素辨证法计算证素频数、卡方检验等方法进行统计分析。结果:纳入的306例MCI患者中病位证素分布以肝(49.02%)、肾(48.37%)多见,其次为心(31.05%)、心神(脑)(20.26%)和胆(18.63%)。病性证素的虚性证素主要表现为阳虚(57.84%)、血虚(55.56%)、阴虚(53.59%)和气虚(50.98%);实性证素则主要为痰(33.66%)、气滞(32.68%)和湿(22.88%)。在常见的合并慢性病中,有糖尿病者气滞证素明显高于无糖尿病者(P<0.05);有高脂血症者在病位证素上的肾、心、胆证素明显偏多(P<0.05),病性证素的阳虚、气虚、痰、气滞证素明显增多(P<0.05);合并心脏病者中的痰证素高于无心脏病者(P<0.05);而肥胖者阴虚证素高于无肥胖者(P<0.05)。结论:MCI老年患者的中医病位证素以肝、肾多见,病性证素的虚证主要表现为阳虚和血虚,实证主要为痰和气滞,而常见慢性病(症)对其分布规律有一定影响。
Objective:To explore the correlation between various complications of mild cognitive impairment(MCI)patients and Chinese medical syndromes,thus indicating distribution laws of Chinese medical syndromes in various complications of MCI patients,to provide basis for MCI traditional Chinese medicine clinical practice.Methods:The elderly population of MCI community in fuzhou city was incorporated into the study.A cross-sectional study design was used to collect the information of syndromes through the four diagnostic information tables of traditional Chinese medicine and to calculate the number of syndromes and chi-square test by combining the syndrome differentiation method.Results:Among the 306 patients with MCI,the distribution of the main syndrome elements of disease locations is given priority to with liver(49.02%),kidney(48.37%),then followed by heart(31.05%),brain(20.26%)and gallbladder(18.63%);Yang deficiency(57.84%),blood deficiency(55.56%),Yin deficiency(53.59%),qi deficiency(50.98%)are main in deficiency syndrome;while phlegm(33.66%),qi stagnation(32.68%),dampness(22.88%)are the main syndrome elements in excess syndrome.In common chronic diseases,patients with diabetes were significantly higher than those without diabetes(P<0.05).Patients with hyperlipidemia were significantly more likely to have kidney,heart,and gallbladder syndrome than those with the syndrome(P<0.05),and the deficiency of symptoms,qi deficiency,phlegm,and qi stagnation of the syndrome were significantly increased(P<0.05).The phlegm in patients with heart disease was higher than those without heart disease(P<0.05).However,the deficiency of the obese person was higher than that of the non-obese(P<0.05).Conclusion:The distribution of the main syndrome elements of disease locations is given priority to with liver and kidney,deficiency syndrome is mainly manifested as Yang deficiency and blood deficiency.,and the main excess syndrome is phlegm and qi stagnation.
Objective:To explore the correlation between various complications of mild cognitive impairment(MCI)patients and Chinese medical syndromes,thus indicating distribution laws of Chinese medical syndromes in various complications of MCI patients,to provide basis for MCI traditional Chinese medicine clinical practice.Methods:The elderly population of MCI community in fuzhou city was incorporated into the study.A cross-sectional study design was used to collect the information of syndromes through the four diagnostic information tables of traditional Chinese medicine and to calculate the number of syndromes and chi-square test by combining the syndrome differentiation method.Results:Among the 306 patients with MCI,the distribution of the main syndrome elements of disease locations is given priority to with liver(49.02%),kidney(48.37%),then followed by heart(31.05%),brain(20.26%)and gallbladder(18.63%);Yang deficiency(57.84%),blood deficiency(55.56%),Yin deficiency(53.59%),qi deficiency(50.98%)are main in deficiency syndrome;while phlegm(33.66%),qi stagnation(32.68%),dampness(22.88%)are the main syndrome elements in excess syndrome.In common chronic diseases,patients with diabetes were significantly higher than those without diabetes(P<0.05).Patients with hyperlipidemia were significantly more likely to have kidney,heart,and gallbladder syndrome than those with the syndrome(P<0.05),and the deficiency of symptoms,qi deficiency,phlegm,and qi stagnation of the syndrome were significantly increased(P<0.05).The phlegm in patients with heart disease was higher than those without heart disease(P<0.05).However,the deficiency of the obese person was higher than that of the non-obese(P<0.05).Conclusion:The distribution of the main syndrome elements of disease locations is given priority to with liver and kidney,deficiency syndrome is mainly manifested as Yang deficiency and blood deficiency.,and the main excess syndrome is phlegm and qi stagnation.
引文
[1]PETERSEN R C,DOODY R,KURZ A,et al.Current concepts in mild cognitive impairment[J].Arch Neurol,2001(58):1985-1992.
[2]曹颖,吕洋.轻度认知功能障碍向痴呆进展的危险因素研究进展[J].医学综述,2015,21(17):3076-3079.
[3]周仲瑛.中医内科学[J].第2版.北京:中国中医药出版社,2007:152-153.
[4]余忠海,李亚明.轻度认知障碍的中医证候研究概况及其思考[J].时珍国医国药,2013,24(3):689-691.
[5]杨秀丽.老年轻度认知功能障碍的病因病机与治疗[J].光明中医,2008,23(3):342-343.
[6]汪小波,刘晓丹,余凯.轻度认知功能障碍的中医药研究进展[J].江西中医药,2011,42(8):70-72.
[7]曹慧娟,郁志华,陈久林.轻度认知障碍的中医研究进展[J].世界科学技术-中医药现代化,2015,17(8):1729-1733.
[8]戈改真,汤哲,孙菲,等.北京社区老年人轻度认知障碍与慢性病的相关性研究[J].中华老年心脑血管病杂志,2009,11(7):518-520.
[9]孙海英,刘晓婷.轻度认知障碍危险因素分析[J].齐鲁护理杂志,2017,23(1):29-31.
[10]王婷婷,曹诚,邓境,等.重庆市老年人轻度认知障碍的流行率及其影响因素[J].中国康复理论与实践,2017,23(7):833-838.
[11]朱文锋.创立以证素为核心的辨证新体系[J].湖南中医学院学报,2004,24(12):38-39.
[12]黄碧群,曲超,向岁,等.中医证素辨证研究概况[J].湖南中医药大学学报,2013,33(1):24-31.
[13]PETERSEN R C,SMITH G E,WARING S C,et al.Mild cognitive impairment:clinical characterization and outcome[J].Arch Neurol,1999,56(3):303-308.
[14]朱文锋.中医主症鉴别诊断学[M].长沙:湖南科学技术出版社,2000:316-331.
[15]朱文锋.证素辨证学[M].北京:人民卫生出版社,2008:37-60.
[16]杨雪梅,甘慧娟,赖新梅,等.基于证素辨证模型的中医健康管理系统研发[J].中华中医药杂志,2015,30(8):2681-2683.
[17]关徐涛,詹向红,王冰.“肝失疏泄致衰”相关说理论探讨[J].时珍国医国药,2015,26(4):937-939.
[18]沈玮,詹向红.疏肝法对轻度认知障碍患者工作记忆影响的研究思路[J].中华中医药杂志,2016,31(9):3628-3631.
[19]郭仁真,李浩,周文泉.周文泉从痰论治老年轻度认知障碍[J].中医杂志,2009,50(9):784-785.
[20]张磊,王飞,赵波,等.轻度认知障碍临床研究简况[J].实用中医内科杂志,2015,29(2):178-181.
[21]王燕国,陈文群.浅谈糖尿病“病在气,伤在津”[J].贵阳中医学院学报,2012,34(2):142-144.
[22]黎元元,郭蕾,高思华.基于专家观点的糖尿病证候要素提取文献分析[J].现代中西医结合杂志,2012,21(6):571-572.
[23]常静娟,岳仁宋.论消渴治疗当重调“气”[J].医学争鸣,2014,5(3):57-59.
[24]张国胜.高脂血症的中医临床治疗进展[J].中国医药导报,2011,8(33):121-123.
[25]庞芳,杨志宏,许红.中医治疗高脂血症研究进展[J].河南中医,2014,34(5):984-986.
[26]郭姣,朴胜华,石忠峰,等.高脂血症中医证候分布规律文献研究[J].广州中医药大学学报,2013,30(5):609-614.
[27]王智玉.浅析高脂血症与中医体质的相关性[J].世界中西医结合杂志,2012,7(7):604-606.
[28]TERVO S,KIVIPELTO M,HANNINEN T,et al.Incidence and risk factors for mild cognitive impairment:apopulationbased three-year follow-up study of cognitively healthy elderly subjects[J].Dementia&Geriatric Cognitive Disorders,2004,17(3):196-203.
[29]李建生,余学庆.慢性肺原性心脏病中医诊疗指南(2014版)[J].中医杂志,2014,55(6):526-531.
[30]黄崇先.从痰饮论治肺源性心脏病体会[J].实用中医药杂志,2012,28(1):51.
[31]司富国,陈瑞,司季青,等.肥胖的中医证型和方药规律分析[J].河南中医,2016,36(11):2032-2035.
[2]曹颖,吕洋.轻度认知功能障碍向痴呆进展的危险因素研究进展[J].医学综述,2015,21(17):3076-3079.
[3]周仲瑛.中医内科学[J].第2版.北京:中国中医药出版社,2007:152-153.
[4]余忠海,李亚明.轻度认知障碍的中医证候研究概况及其思考[J].时珍国医国药,2013,24(3):689-691.
[5]杨秀丽.老年轻度认知功能障碍的病因病机与治疗[J].光明中医,2008,23(3):342-343.
[6]汪小波,刘晓丹,余凯.轻度认知功能障碍的中医药研究进展[J].江西中医药,2011,42(8):70-72.
[7]曹慧娟,郁志华,陈久林.轻度认知障碍的中医研究进展[J].世界科学技术-中医药现代化,2015,17(8):1729-1733.
[8]戈改真,汤哲,孙菲,等.北京社区老年人轻度认知障碍与慢性病的相关性研究[J].中华老年心脑血管病杂志,2009,11(7):518-520.
[9]孙海英,刘晓婷.轻度认知障碍危险因素分析[J].齐鲁护理杂志,2017,23(1):29-31.
[10]王婷婷,曹诚,邓境,等.重庆市老年人轻度认知障碍的流行率及其影响因素[J].中国康复理论与实践,2017,23(7):833-838.
[11]朱文锋.创立以证素为核心的辨证新体系[J].湖南中医学院学报,2004,24(12):38-39.
[12]黄碧群,曲超,向岁,等.中医证素辨证研究概况[J].湖南中医药大学学报,2013,33(1):24-31.
[13]PETERSEN R C,SMITH G E,WARING S C,et al.Mild cognitive impairment:clinical characterization and outcome[J].Arch Neurol,1999,56(3):303-308.
[14]朱文锋.中医主症鉴别诊断学[M].长沙:湖南科学技术出版社,2000:316-331.
[15]朱文锋.证素辨证学[M].北京:人民卫生出版社,2008:37-60.
[16]杨雪梅,甘慧娟,赖新梅,等.基于证素辨证模型的中医健康管理系统研发[J].中华中医药杂志,2015,30(8):2681-2683.
[17]关徐涛,詹向红,王冰.“肝失疏泄致衰”相关说理论探讨[J].时珍国医国药,2015,26(4):937-939.
[18]沈玮,詹向红.疏肝法对轻度认知障碍患者工作记忆影响的研究思路[J].中华中医药杂志,2016,31(9):3628-3631.
[19]郭仁真,李浩,周文泉.周文泉从痰论治老年轻度认知障碍[J].中医杂志,2009,50(9):784-785.
[20]张磊,王飞,赵波,等.轻度认知障碍临床研究简况[J].实用中医内科杂志,2015,29(2):178-181.
[21]王燕国,陈文群.浅谈糖尿病“病在气,伤在津”[J].贵阳中医学院学报,2012,34(2):142-144.
[22]黎元元,郭蕾,高思华.基于专家观点的糖尿病证候要素提取文献分析[J].现代中西医结合杂志,2012,21(6):571-572.
[23]常静娟,岳仁宋.论消渴治疗当重调“气”[J].医学争鸣,2014,5(3):57-59.
[24]张国胜.高脂血症的中医临床治疗进展[J].中国医药导报,2011,8(33):121-123.
[25]庞芳,杨志宏,许红.中医治疗高脂血症研究进展[J].河南中医,2014,34(5):984-986.
[26]郭姣,朴胜华,石忠峰,等.高脂血症中医证候分布规律文献研究[J].广州中医药大学学报,2013,30(5):609-614.
[27]王智玉.浅析高脂血症与中医体质的相关性[J].世界中西医结合杂志,2012,7(7):604-606.
[28]TERVO S,KIVIPELTO M,HANNINEN T,et al.Incidence and risk factors for mild cognitive impairment:apopulationbased three-year follow-up study of cognitively healthy elderly subjects[J].Dementia&Geriatric Cognitive Disorders,2004,17(3):196-203.
[29]李建生,余学庆.慢性肺原性心脏病中医诊疗指南(2014版)[J].中医杂志,2014,55(6):526-531.
[30]黄崇先.从痰饮论治肺源性心脏病体会[J].实用中医药杂志,2012,28(1):51.
[31]司富国,陈瑞,司季青,等.肥胖的中医证型和方药规律分析[J].河南中医,2016,36(11):2032-2035.