本文選題：卒中后　切入點(diǎn)：認(rèn)知功能障礙　出處：《廣西中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過研究卒中后認(rèn)知功能障礙(PSCI)中醫(yī)證候的分布情況及PSCI的辨證分型與血脂水平及P300的相關(guān)性,為PSCI辨證分型提供客觀依據(jù)。方法:選擇2014年1月到2015年7月在本院治療的腦卒中患者100例,根據(jù)治療3個月后認(rèn)知功能評估結(jié)果分為認(rèn)知功能障礙組(PSCI組,30例)和認(rèn)知功能正常組(PSNCI組,70例),收集研究對象的基本資料(包括發(fā)病一般情況、臨床表現(xiàn)、舌脈象等),由于病例脫落,共采集30例PSCI患者和65例認(rèn)知功能正�；颊叩难�(xiàng)(包括膽固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、載脂蛋白Al和載脂蛋白B),以及測量各患者的事件相關(guān)電位P300,所得數(shù)據(jù)采用方差分析、t檢驗(yàn)等方法進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1.PSCI患者的證候中虛實(shí)夾雜占83%,6種基本證候中腎虛證比重最大,占80%,其次為血瘀證、痰濁證、脾虛證、心虛證和肝郁證,分別占53%、50%、47%、40%和7%;PSCI組痰濁證和血瘀證明顯高于PSN CI組,差異具有顯著性意義(P0.05);2.PSCI組患者的總膽固醇、低密度脂蛋白、載脂蛋白A1及載脂蛋白B均高于PSNCI組患者,但經(jīng)統(tǒng)計(jì)學(xué)分析,只有總膽固醇、低密度脂蛋白和載脂蛋白B具有顯著性意義(P0.05);痰瘀組甘油三酯為1.41±0.63 mmol/L,非痰瘀組甘油三酯為1.19±0.56 mmol/L,兩組差異具有統(tǒng)計(jì)學(xué)意義(P0.05);痰濁證與血瘀證的甘油三酯分別為1.98±0.66m mol/L、1.85±0.56mmol/L,與PSNCI組比較,差異具有統(tǒng)計(jì)學(xué)意義;痰濁證的低密度脂蛋白為3.52±0.3mmol/L,與PSNCI組比較,差異具有顯著性;痰濁證和血瘀證的載脂蛋白B分別為1.52±0.45.1.45±0.41mmo l/L,與PSNCI組比較,差異具有統(tǒng)計(jì)學(xué)意義;3.PSCI組患者的P300潛伏期為372.8±30.9ms,PSNCI組患者的P300潛伏期為319.1±29.7ms,兩組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);PSCI組患者的P300波幅為6.3±0.7m V,而PSNCI組患者的P300波幅為10.8±1.2m V,兩組比較有統(tǒng)計(jì)學(xué)差異(P0.05);PSCI腎虛證的潛伏期為375.3±31.2ms,與PSNCI組比較,差異具有統(tǒng)計(jì)學(xué)意義;PSCI痰濁證波幅為5.8±0.8m V,與PSNCI組比較,具有顯著性差異;PSCI血瘀證潛伏期為392.3±29.6ms,與PSNCI組比較,統(tǒng)計(jì)學(xué)分析有顯著性意義。結(jié)論:1.PSCI多表現(xiàn)為虛實(shí)夾雜,以腎虛證、痰濁證和血瘀證為主;2.血脂異常多見于PSCI痰瘀證;3.PSCI腎虛證和血瘀證主要表現(xiàn)為P300潛伏期延長,且血瘀證更為明顯,而痰濁證主要表現(xiàn)為波幅降低。
[Abstract]:Objective: to study the distribution of TCM syndromes and the correlation between the syndrome differentiation of PSCI and the level of blood lipid and P300 in patients with cognitive dysfunction after stroke. Methods: from January 2014 to July 2015, 100 stroke patients treated in our hospital were selected. According to the results of cognitive function assessment after 3 months of treatment, they were divided into two groups: cognitive dysfunction group (n = 30) and normal cognitive function group (n = 70). As a result of the exfoliation of tongue pulse, six items of blood lipids (including cholesterol, triglyceride, high density lipoprotein, low density lipoprotein) were collected from 30 patients with PSCI and 65 patients with normal cognitive function. Apolipoprotein Al and apolipoprotein BU, as well as measuring the event-related potentials (P300) of each patient, were statistically analyzed by means of ANOVA / t test. Results 1. The syndrome of PSCI was composed of deficiency and solid inclusions, which accounted for 833% of the 6 basic syndromes. Kidney deficiency syndrome has the largest proportion. The proportion of blood stasis syndrome, phlegm turbidity syndrome, spleen deficiency syndrome, heart deficiency syndrome and liver depression syndrome were 53.50% and 4740% respectively, and the phlegm turbid syndrome and blood stasis syndrome were significantly higher in PSCI group than in PSN CI group, the difference was significant (P 0.05) 2.The total cholesterol and low density lipoprotein (LDL) in PSCI group were significantly higher than those in PSN CI group. Apolipoprotein A1 and apolipoprotein B were higher than those in PSNCI group, but only total cholesterol was found by statistical analysis. Low density lipoprotein (LDL-C) and apolipoprotein B (apolipoprotein B) had significant difference (P 0.05), triglyceride in phlegm stasis group (1.41 鹵0.63 mmol / L), non-phlegm stasis group (1.19 鹵0.56 mmol / L), phlegm turbid syndrome and blood stasis group (1.98 鹵0.66 mmol / L, 1.85 鹵0.56 mmol / L), respectively. The low density lipoprotein (LDL) of phlegm turbid syndrome was 3.52 鹵0.3 mmol / L, which was significantly higher than that of PSNCI group, the apolipoprotein B of phlegm turbid syndrome and blood stasis syndrome was 1.52 鹵0.45.1.45 鹵0.41 mmo / l / L, respectively, compared with that of PSNCI group. 3. The P300 latency of PSCI group was 372.8 鹵30.9 Ms, the P300 latency of PSNCI group was 319.1 鹵29.7ms. The P300 amplitude was 6.3 鹵0.7mV in P0.05PSCI group and 10.8 鹵1.2m V in PSNCI group. The latency of P0.05PSCI was 375.3 鹵31.2mscompared with PSNCI group. Compared with PSNCI group, the latency of blood stasis syndrome was 392.3 鹵29.6ms. compared with PSNCI group, there was significant difference in the amplitude of phlegm turbid syndrome. Conclusion: 1. PSCI is mainly composed of deficiency and deficiency of kidney, and the latent period of PSCI is 392.3 鹵29.6ms.Conclusion: 1. Blood stasis syndrome and phlegm turbid syndrome. 2. Abnormal blood lipid was found in PSCI phlegm stasis syndrome 3.PSCI kidney deficiency syndrome and blood stasis syndrome mainly showed prolonged P300 latency, and blood stasis syndrome was more obvious, while phlegm turbid syndrome mainly showed decreased amplitude.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R277.7

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