摘要
目的 探讨高血压脑白质病变出现认知障碍患者的中医证候分布及相关因素。方法 选择北京市丰台中西医结合医院脑病科2020—2022年收治的高血压合并脑白质病变患者156例,通过蒙特利尔认知评估(Montreal cognitive assessment, MoCA)量表评估患者是否存在认知功能障碍,分析出现认知障碍患者的中医证候分布,同时利用Logistic多因素回归分析探讨发生认知障碍的相关因素。结果 纳入的患者中有68例发生认知功能障碍,中医证候以肾精亏虚(37例,54.41%)、痰浊阻窍(20例,29.41%)及瘀血阻络(16例,23.53%)为主,其中肾精亏虚(OR=1.205,95%CI 1.102-1.316,P<0.05)、痰浊阻窍(OR=0.944,95%CI 0.899-0.991,P<0.05)与患者年龄具有相关性;Logistic多因素回归分析显示:高血压脑白质病变患者年龄、糖尿病史、脑白质病变Fazekas分级、同型半胱氨酸(homocysteine, HCY)及尿酸(uric acid, UA)水平与认知障碍的发生具有相关性(P<0.05)。结论 高血压脑白质病变患者出现认知功能障碍的中医证候主要表现为肾精亏虚、痰浊阻窍、瘀血阻络,且认知障碍的发生与年龄、糖尿病史、脑白质病变Fazekas分级、HCY水平及UA水平具有相关性。
Objective To investigate the distribution of TCM syndrome and related factors of cognitive disorder in patients with white matter lesions in hypertension.Methods A total of 156 patients with hypertension and white matter lesions admitted to the department of encephalopathy of Beijing Fengtai integrated traditional Chinese and western medicine hospital from 2020 to 2022 were selected.The presence of cognitive disorder was assessed by the Montreal cognitive assessment(MoCA).And the distribution of TCM syndrome of patients with cognitive disorder were analyzed.At the same time, the related factors of cognitive disorder were explored by logistic regression analysis.Results Sixty-eight patients of the included had cognitive disorder.The main TCM syndrome were deficiency of kidney essence(37 cases, 54.41%),phlegm-turbidity blocking orifices(20 cases, 29.41%)and static blood blocking collaterals(16 cases, 23.53%).Deficiency of kidney essence(OR=1.205,95% CI 1.102-1.316,P<0.05)and phlegm-turbidity blocking orifices(OR=0.944,95%CI 0.899-0.991,P<0.05)were related to the age of patients.Logistic regression analysis showed that age, history of diabetes, Fazekas grade, homocysteine(HCY),uric acid(UA)levels of hypertension patients with white matter lesions were correlated with the occurrence of cognitive disorder(P<0.05).Conclusion The main TCM syndrome of cognitive disorder in patients with hypertension and white matter lesions were deficiency of kidney essence, phlegm-turbidity blocking orifices and static blood blocking collaterals.Moreover, the occurrence of cognitive disorder was correlated with age, history of diabetes, Fazekas grade of white matter lesions, HCY and UA levels.
作者
王晓旭
WANG Xiaoxu(Department of Encephalopathy,Fengtai Integrated Traditional Chinese and Western Medicine Hospital,Beijing 100072,China)
出处
《中西医结合研究》
2023年第1期9-12,29,共5页
Research of Integrated Traditional Chinese and Western Medicine
关键词
高血压
脑白质病变
认知障碍
中医证候
相关性分析
hypertension
white matter lesions
cognitive disorder
TCM syndrome
correlation analysis
