目的：探讨轻度认知功能障碍（MCI）中医证素、证型分别与蒙特利尔认知评估量表（ MoCA）的相关性，为 MCI 精准中医辨证提供科学依据。方法选取2008年1月—2015年1月在复旦大学附属华东医院门诊及静安区江宁路社区卫生服务中心、黄浦区半淞园街道社区卫生服务中心就诊的老年 MCI 患者516例。运用《轻度认知障碍中医证素诊断评分表》对 MCI 患者中医证素及证型进行分型；运用 MoCA 对患者进行测试评分。结果 MCI 中医证素为：肾、心、肝、气虚、血虚、阴虚、阳虚、血淤、痰浊；MCI 中医证型为：肾阴虚证、肾阳虚证、肾精亏虚证、肾虚血瘀证、肾虚痰浊证、心气虚证、心血虚证、心阴虚证、心阳虚证、心脉淤阻证、痰蒙心窍证、心气血亏虚证、心肾不交证、肝郁证、痰瘀互阻证。MCI 患者 MoCA 总分为（22.6±2.0）分，视空间及执行功能得分为（3.3±1.0）分，命名得分为（2.4±0.7）分，注意力得分为（5.4±0.8）分，语言得分为（1.5±0.9）分，抽象思维得分为（0.9±0.8）分，延迟回忆得分为（2.7±1.4）分，定向力得分为（5.9±0.4）分。MoCA 总分与证素阴虚积分呈负相关（P ﹤0.05）；命名得分与证素肾、证素阴虚积分呈负相关（P ﹤0.05）；注意力得分与证素肾、证素肝、证素阴虚积分呈负相关，与证素阳虚积分呈正相关（P ﹤0.05）；语言得分与证素气虚积分呈负相关（P ﹤0.05）；抽象思维得分与证素阳虚呈负相关（P ﹤0.05）。MoCA 总分与心气虚亏虚证、肝郁证积分呈负相关（ P ﹤0.05）；命名得分与心阴虚证、肝郁证积分呈负相关（P ﹤0.05）；注意力得分与肾阴虚证、肾阳虚证、肾精亏虚证、肾虚血瘀证、肾虚痰浊证、心阴虚证、心肾不交证、肝郁证积分呈负相关（P ﹤0.05）；抽象思维得分与心气虚证积分呈负相关（P ﹤0.05）；延迟回忆得分与心气血亏虚证积分呈负相关（P ﹤0.05）；定向力得分与痰蒙心窍证积分呈正相关（P ﹤0.05）。结论 MCI中医证素、证型与 MoCA 存在相关性，具有一定的科学性，可为 MCI 精准辨证提供依据。%Objective To investigate the correlations between Traditional Chinese Medicine(TCM)syndrome factor﹠ syndrome type of mild cognitive impairment(MCI)and Montreal cognitive assessment(MoCA),to provide scientific basis for precise TCM syndrome differentiation of MCI. Methods 516 elderly patients with MCI who went to outpatiens clinic of Huadong Hospital Affiliated to Fudan University or Community Health Centers which located in Jiangning road Jing’an district and Bansongyuan street Huangpu district from January 2008 to January 2015,were selected as study subjects. TCM syndrome factor ﹠syndrome type of MCI were identified by The diagnostic scoring scale of TCM syndrome factors of Mild Cognitive Impairment,and MoCA was used to score the patients. Results TCM syndrome factors of MCI included kidney,heart,liver,Qi deficiency, blood deficiency,Yin deficiency,Yang deficiency,blood stasis,phlegm turbidity;TCM syndrome types of MCI included deficiency of kidney Yin,deficiency of kidney Yang,deficiency of kidney - essence,kidney deficiency and blood stasis, kidney deficiency and phlegm turbidity,deficiency of heart Qi,heart blood deficiency,heart Yin deficiency,heart Yang deficiency,blockade of heart vessel,heart spirit confused by phlegm,heart Qi and blood deficiency,disharmony between heart and kidney,liver Qi stagnation,and phlegm accumulating with stagnant blood. MoCA total score of patients with MCI was(22. 6 ± 2. 0),visual spatial and executive function score was(3. 3 ± 1. 0),naming score was(2. 4 ± 0. 7),attention score was (5. 4 ± 0. 8),language score was(1. 5 ± 0. 9),abstract thinking score was(0. 9 ± 0. 8),delayed recall score was(2. 7 ± 1. 4),orientation score was(5. 9 ± 0. 4). There was a negative correlation between MoCA total score and the score of TCM syndrome factor Yin deficiency(P ﹤ 0. 05);there was a negative correlation between the score of naming and the score of TCM syndrome factor kidney,Yin deficiency(P ﹤ 0. 05);there was a negative correlation between the score of attention function and the score of TCM syndrome factor kidney,liver,Yin deficiency(P ﹤ 0. 05);there was a positive correlation between the score of attention function and score of TCM syndrome factor Yang deficiency(P ﹤ 0. 05);there was a negative correlation between language score and the score of TCM syndrome factor Qi deficiency(P ﹤ 0. 05);there was a negative correlation between score of abstract thinking and score of TCM syndrome factor Yang deficiency(P ﹤ 0. 05). There was a negative correlation between the total score of MoCA and the score of heart Qi and blood deficiency syndrome,liver Qi stagnation syndrome(P ﹤ 0. 05);there was a negative correlation between the score of naming and the score of heart Yin deficiency syndrome,stagnation of liver Qi syndrome(both P ﹤ 0. 05);there were negative correlations between the score of attention function and the score of kidney Yin deficiency syndrome,kidney Yang deficiency syndrome,kidney - essence deficiency syndrome,kidney deficiency and blood stasis syndrome,kidney deficiency and phlegm turbidity syndrome,heart Yin deficiency syndrome,disharmony between heart and kidney syndrome,stagnation of liver Qi syndrome(P ﹤ 0. 05);there was a negative correlation between score of abstract thinking and score of heart Qi deficiency syndrome(P ﹤ 0. 05);there was a negative correlation between score of delayed recall and score of heart Qi and blood deficiency syndrome(P ﹤ 0. 05);there was a positive correlation between the score of orientation and heart spirit confused by phlegm syndrome(P ﹤ 0. 05). Conclusion To MCI patients,there are correlations between TCM syndrome factors ﹠ syndrome type and MoCA. The results have certain scientific nature and could provide the references for precise TCM syndrome differentiation of MCI.
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