脑出血后认知障碍和中风中医辨证分型的关系探讨

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1、目录中文摘要···················································1英文摘要···················································3引言····················································6正文····················································71.资料······························

2、·····················71.1相关标准·················································71.2研究对象················································102.方法················································102.1研究方法················································102.2统计方法····

3、············································113.结果················································114.讨论················································155.存在的问题和展望······································21结论··················································22

4、参考文献··················································23附录··················································25综述··················································27致谢··················································36攻读学位期间发表的学术论文目录·······················37

5、作者声明··················································38个人简历··················································39中文摘要目的:通过探索脑出血（IntracerebralHemorrhage,ICH）后认知障碍(CognitiveImpairment，CI)与中风中医辨证分型的关系，认识其发病机制和规律，为今后开展中医药对认知障碍的早期干预提供参考。方法:收集134名脑出血患者，经头颅CT及MRI证实，

6、通过简易精神状态量表测定分为认知障碍组61例与非认知障碍组73例。各组分别进行简易精神状态量表(MiniMentalStateExamination，MMSE)评测、事件相关电位（Event-relatedPotential,ERP）-P300检测、中医辨证分型。研究各部分指标与认知障碍的相关性，对脑出血后认知障碍与中医辨证分型的关系予以探讨。结果:1.MMSE评分:脑出血病人MMSE评分显著低于正常对照组(P<0.01)，且脑出血后CI组MMSE评分显著低于脑出血后无CI组(P<0.01)。2.ERP－P30

7、0测定：脑出血后CI组P300潜伏期较脑出血后无CI组和正常对照组显著延长(P<0.01)，尽管脑出血后无CI组的P300潜伏期较正常对照组有所延长，但无统计学差异(P>0.05)，P300波幅在正常对照组、脑出血后无CI组及脑出血后CI组依次降低，但相互之间无统计学差异(P>0.05)。3.中医辨证分型中，各证型在脑出血后CI组分布:痰湿蒙塞心神型＞风痰瘀血痹阻脉络型＞痰热腑实风痰上扰型＞痰热内闭清窍型＞风火上扰清窍型＞肝阳暴亢风火上扰型；经X2检验痰湿蒙塞心神证、风痰瘀血痹阻脉络证、痰热腑实风痰上扰证在脑出

8、血后CI组分布明显大于其余各组，差异具有统计学意义(P＜0.05)。4.经logistic回归分析，痰湿蒙塞心神证、风痰瘀血痹阻脉络证、痰热腑实风痰上扰证三型为脑出血后CI的危险因素(P<0.05)。结论:1.脑出血后认知障碍病人MMSE评分明显降低。2.脑出血后认知障碍病人P300潜伏期延长及波幅降低。3.痰湿蒙塞心神证、风痰瘀血痹阻脉络证、痰热腑实风痰上扰证三种证型在脑出血后出现认