Shi Jing, Wei Ming-qing, Ma Fu-yun, Miao Ying-chun, Tian Jin-zhou
Department of Geriatric Diseases, Beijing University of Chinese Medicine, Beijing, China.
Zhong Xi Yi Jie He Xue Bao. 2011 Oct;9(10):1075-82. doi: 10.3736/jcim20111007.
To investigate the correlation between cognitive function and the Chinese medicine syndrome characteristics of vascular cognitive impairment (VCI).
A total of 774 subjects (age from 41 to 87 years old) from Beijing of China accepted neuropsychological assessments and differentiation of Chinese medicine syndromes. The mini-mental state examination (MMSE) and clinic dementia rating (CDR) were used to access the global cognitive function; the Hachinski ischemia scale (HIS) and the Hamilton depression scale (HAMD) were used for differential diagnosis; the ability of daily living (ADL) scale was used to assess the ability of daily living; the clock drawing test was used to access the executive function; the investigation of syndrome manifestations and the syndrome differentiation scale of vascular dementia (SDSVD) were used for diagnosis of syndrome manifestations. According to the diagnostic criteria of vascular cognitive impairment, subjects were subgrouped as normal cognition (NC) group and VCI group, and then the correlation between the cognitive functions and Chinese medicine syndromes was analyzed.
The correlation between cognitive scales and Chinese medical syndrome: in the VCI group, the syndrome of phlegm turbid blocking upper orifices showed negative correlation with the scores of MMSE and CDT (r=-0.525, r=-0.321, P=0.000, P=0.001), and the ADL demonstrated positive correlation to the syndrome (r=0.424, P=0.000). The correlation between cognitive function and Chinese medical syndrome: the phlegm turbid blocking upper orifices was closely correlated with the total orientation, time orientation and place orientation (r=-0.451, r=-0.448, r=-0.392, P=0.001, P=0.000, P=0.004); instant word recall and delayed word recall were closely correlated with the syndrome of phlegm turbid blocking upper orifices (r=-0.355, r=-0.225, P=0.000, P=0.021); calculation/attention, language function and executive function had negative correlation to the syndrome of phlegm turbid blocking upper orifices (r=-0.379, r=-0.448, r=-0.321, P=0.000, P=0.000, P=0.013). The scores of orientation, calculation/attention, delayed word recall and language function in the patients with phlegm turbid blocking upper orifices were significantly lower than the patients with non-phlegm turbid blocking upper orifices (P<0.05).
The syndrome of phlegm turbid blocking upper orifices is significantly correlated to the scores of MMSE and ADL, indicating that the phlegm turbid blocking upper orifices is related to the cognitive function and ability of daily living in the VCI patients. Treatment of the phlegm is important in the cognitive impairment in VCI patients.
探讨血管性认知障碍（VCI）认知功能与中医证候特征之间的相关性。
选取来自中国北京的774名受试者（年龄41至87岁），接受神经心理学评估及中医证候辨证。采用简易精神状态检查表（MMSE）和临床痴呆评定量表（CDR）评估整体认知功能；采用哈金斯基缺血量表（HIS）和汉密尔顿抑郁量表（HAMD）进行鉴别诊断；采用日常生活能力（ADL）量表评估日常生活能力；采用画钟试验评估执行功能；采用证候表现调查及血管性痴呆证候辨证量表（SDSVD）诊断证候表现。根据血管性认知障碍的诊断标准，将受试者分为正常认知（NC）组和VCI组，然后分析认知功能与中医证候之间的相关性。
认知量表与中医证候的相关性：在VCI组中，痰浊阻窍证与MMSE和CDT评分呈负相关（r=-0.525，r=-0.321，P=0.000，P=0.001），ADL与该证候呈正相关（r=0.424，P=0.000）。认知功能与中医证候的相关性：痰浊阻窍证与定向总分、时间定向和地点定向密切相关（r=-0.451，r=-0.448，r=-0.392，P=0.001，P=0.000，P=0.004）；即刻词语回忆和延迟词语回忆与痰浊阻窍证密切相关（r=-0.355，r=-0.225，P=0.000，P=0.021）；计算/注意力、语言功能和执行功能与痰浊阻窍证呈负相关（r=-0.379，r=-0.448，r=-0.321，P=0.000，P=0.000，P=0.013）。痰浊阻窍证患者的定向、计算/注意力、延迟词语回忆和语言功能得分显著低于非痰浊阻窍证患者（P<0.05）。
痰浊阻窍证与MMSE和ADL评分显著相关，表明痰浊阻窍与VCI患者的认知功能及日常生活能力有关。化痰治疗对VCI患者的认知障碍具有重要意义。
