阿尔茨海默病中医证型与焦虑抑郁 情绪及认知功能障碍的关系
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徐明超,男,主治医师,主要研究方向是中西医结合脑病、痴呆。

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R 742

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南阳市科技发展计划项目(KJGG102)


Relationship between Traditional Chinese Medicine Syndrome of Alzheimer's Disease and Anxiety-Depressive Mood and Cognitive Dysfunction
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    摘 要目的:探讨阿尔茨海默病(AD)中医证型与焦虑抑郁情绪及认知功能障碍的关系。 方法:选择 2018 年 3月至2022年3月南阳市中心医院收治的AD患者100例。参照中医证型诊断标准分为肾精亏虚证、瘀血阻窍证、痰浊阻窍证。 采用简易智力状态检查量表(MMSE)、日常生活自理能力量表(ADE)、Hamilton 焦虑量表(HAMA)、Hamilton 抑郁 量表(HAMD)和匹兹堡睡眠指数量表(PSQI)对患者进行行为学评估。 结果:纳入的 100 例 AD 患者中,以肾精亏虚证 为主,共计 48 例(48.00 %);其次为瘀血阻窍证 34 例(34.00 %)和痰浊阻窍证 18 例(18.00 %)。肾精亏虚证组认知功 能障碍患者比例明显高于痰浊阻窍证组和瘀血阻窍证组,差异均有统计学意义(P < 0.05)。痰浊阻窍证组焦虑状态患者 和睡眠障碍患者的比例显著高于瘀血阻窍证和肾精亏虚证,差异均有统计学意义(P < 0.05);瘀血阻窍证组焦虑状态患 者的比例高于肾精亏虚证组,差异有统计学意义(P < 0.05)。 结论:肾精亏虚证易出现认知功能障碍,痰浊阻窍证和瘀 血阻窍证易出现焦虑状态,临床借助精神心理评估辅助 AD 患者的中医辨证可能为疾病的个性化治疗提供一定参考价值。

    Abstract:

    AbstractObjective To explore the relationship between traditional Chinese medicine (TCM) syndromes of Alzheimer's disease (AD) and anxiety, depression and cognitive dysfunction. Methods A total of 100 AD patients admitted to Nanyang Hospital from March 2018 to March 2022 were selected. According to the diagnostic criteria of TCM syndromes, they were divided into kidney essence deficiency syndrome, blood stasis obstruction syndrome and phlegm turidity obstruction syndrome. Behavioral assessment of the patients were performed using the mini–mental state examination (MMSE), the activity of daily living scale (ADL), the Hamilton anxiety scale (HAMA), the Hamilton depression Scale (HAMD) and the Pittsburgh sleep quality Index (PSQI). Results Among the 100 AD patients included, 48 were mainly due to kidney essence deficiency syndrome, accounting for the total 48.00% of the number. It was followed by 34 cases (34.00 %) of syndrome of blood stasis obstruction and 18 cases (18.00 %) of syndrome of phlegm turbidity obstruction. The proportion of patients with cognitive dysfunction in kidney essence deficiency syndrome group was significantly higher than that in phlegm turbidity obstruction syndrome group and blood stasis obstruction syndrome group, and the differences were statistically significant ( P < 0.05). The proportion of patients with anxiety and sleep disorder in phlegm turidity obstruction syndrome group was significantly higher than that in blood stasis obstruction syndrome and kidney essence deficiency syndrome, and the differences were statistically significant ( P < 0.05). The proportion of patients with anxiety in the blood stasis obstruction syndrome group was higher than that in the kidney essence deficiency syndrome group, and the difference was statistically significant ( P < 0.05). Conclusion The syndrome of kidney essence deficiency is prone to cognitive dysfunction, and the syndrome of phlegm turidity obstruction and blood stasis obstruction are prone to anxiety. The clinical use of psychopsychological assessment to assist the TCM syndrome differentiation of AD patients may provide certain reference value for the personalized treatment of the disease.

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  • 收稿日期:2023-07-16
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  • 在线发布日期: 2023-12-18
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