CAJ | 학술논문

目的：探讨不同合并症对血管源性轻度认知障碍患者证候要素的影响,为提高临床辨证的准确性提供参考。方法进行多中心合作,纳入血管源性轻度认知障碍患者803例,采用卡方检验、Logistic回归等方法分析不同合并症对证候要素分布的影响。结果合并糖尿病的患者气虚、痰、血瘀、阴虚比例较高,存在火证的风险较低(OR=0.55,95%CI=0.31,0.99)；合并冠心病的患者气虚、血瘀、痰、阳虚比例最高,存在气虚的风险高于无冠心病的患者( OR=3.75,95%CI=2.65,5.31),存在阴虚的风险低于无冠心病的患者(OR=0.38,95%CI=0.23,0.65)；合并脑血管病的患者气虚比例最高,其次为血瘀,存在阳虚的比例高于无脑血管病的患者( OR=1.90,95%CI=1.23,2.95)。结论不同的合并症影响血管源性轻度认知障碍患者的证候要素分布,在四诊合参的同时,结合合并症综合考虑,有助于提高辨证的准确性。
목적：탐토불동합병증대혈관원성경도인지장애환자증후요소적영향,위제고림상변증적준학성제공삼고。방법진행다중심합작,납입혈관원성경도인지장애환자803례,채용잡방검험、Logistic회귀등방법분석불동합병증대증후요소분포적영향。결과합병당뇨병적환자기허、담、혈어、음허비례교고,존재화증적풍험교저(OR=0.55,95%CI=0.31,0.99)；합병관심병적환자기허、혈어、담、양허비례최고,존재기허적풍험고우무관심병적환자( OR=3.75,95%CI=2.65,5.31),존재음허적풍험저우무관심병적환자(OR=0.38,95%CI=0.23,0.65)；합병뇌혈관병적환자기허비례최고,기차위혈어,존재양허적비례고우무뇌혈관병적환자( OR=1.90,95%CI=1.23,2.95)。결론불동적합병증영향혈관원성경도인지장애환자적증후요소분포,재사진합삼적동시,결합합병증종합고필,유조우제고변증적준학성。
Objective To explore the impacts of underlying conditions in patients with vascular mild cognitive impairment, and provide a reference for improving the accuracy of diagnosis of the syndromes of Traditional Chinese Medicine. Methods 803 cases of mild vascular cognitive impairment were included from multi-centers. Chi-square test and Logistic regression were adopted. Results The most common syndrome factors in patients combined with diabetes were qi deficiency, followed by phlegm, blood stasis, yin deficiency. Patients of vascular mild cognitive impairment combined with diabetes had lower risk of fire syndrome than patients combined without diabetes(OR=0. 55,95%CI=0. 31,0. 99). The most common syndrome factors in patients combined with coronary heart disease was qi deficiency, followed by blood stasis, phlegm, and yang deficiency. Patients combined with coronary heart disease had higher risk of qi deficiency (OR=3. 75,95%CI=2. 65,5. 31), lower risk of yin deficiency(OR=0. 38,95%CI=0. 23, 0. 65) than patients combined without coronary heart disease. The most common syndrome factors in patients combined with cerebrovascular disease was qi deficiency, followed by blood stasis. Patients combined with cerebrovascular disease had higher risk of yang deficiency than patients combined without cerebrovascular disease(OR=1. 90,95%CI=1. 23,2. 95). Conclusions Underlying conditions affect syndrome factors in patients with vascular mild cognitive impairment. Considering the underlying conditions may help to improve the accuracy of TCM syndrome diagnosis.