摘要
目的:调查卒中后认知障碍的中医证候分布与脑影像学改变的关系,确认卒中后认知损害的临床测定值,为卒中后认知损害的中医危险因素的干预和辨证论治提供依据。方法:对住院脑卒中患者进行神经心理学评定与头颅CT检查,并进行中医证候积分评定和相关性分析。结果:脑卒中后认知障碍患者各个证候出现率按概率大小排列为:肾精亏虚证、痰浊阻窍证、瘀血阻络证、肝阳上亢证、腑滞浊留证、热毒内盛证,以及气血亏虚证。多元逐步回归分析结果显示,腑滞浊留对基底节梗塞后认知损害的相对危险度较高,热毒内盛对梗塞伴脑萎缩后认知损害的相对危险度较高,肾精亏虚证对左半球或双侧梗塞后认知损害的相对危险度较高,但气血亏虚对放射冠梗塞后认知损害的影响呈负相关。结论:卒中部位和性质的影像学改变与中医证候有显著相关性,提示肾虚、痰浊、血瘀,以及腑滞、热毒可能是卒中后认知损害的危险因素,但与气血亏虚关系不大。
Objective: To investigate the relationship between distribution of TCM syndromes and changes of cerebral image in patients with cognition disturbance after stroke and determine clinical assay values for congitive impairment so as to provide basis for interfering TCM risk factors of cognitive impairment after stroke and for treatment based on syndrome differentiation. Methods: Inpatients of apoplexy were assessed by neuropsychology and skull CT examination, and assessement of scores for TCM syndromes and analysis of correlativity were conducted. Results: The occurrence rate of the syndromes in patients of cognitive disturbance after stroke in the order of the probability was as following, i. e. deficiency of kidney-essence, retention of phlegm in orifices, stagnation of blood stasis in collaterals, hyperactivity of liver-Yang, retention of indigested food in the bowels, excessive pathogenic heat in the interior and deficiency of Qi and blood. Retention of turbid in bowels for cognitive impairment after basal ganglion infarction, excessive pathogenic heat in the interiror for cognitive impairment after infarction accompanied by encephalatrophy , deficiency of kidney-essence for cognitive impairment after left hemisphere or bilateral infarction had higher relative risk, but the effect of deficiency of Qi and blood on cognitive impairment after infarction in corona radiata showed negative correlation. Conclusion: There is significant correlativity of image alterations of apoplexy position and property of apoplexy with TCM syndromes, suggesting that kidney deficinecy, phlegm turbit , blood stasis and retention in bowels and pathogenic heat are possibly risk factors of cognitive impairment after stroke, but it is not closely related to deficiency of Qi and blood.
出处
《中医杂志》
CSCD
北大核心
2004年第2期132-134,5,共4页
Journal of Traditional Chinese Medicine
基金
国家人事部回国人员科研基金
长江学者奖励计划特聘教授基金
关键词
中风/放射照像术
辨证分型
脑影像学
Stroke/radiophotography
Syndrome differentiation: @Cerebral image
