發(fā)布時(shí)間：2018-02-24 16:11

  本文關(guān)鍵詞： 輕度認(rèn)知功能障礙 辨證分型 主觀(guān)幸福感 社會(huì)心理因素　出處：《廣州中醫(yī)藥大學(xué)》2005年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:輕度認(rèn)知功能障礙(MCI)因?yàn)槠涓叨鹊腁D危險(xiǎn)性已成癡呆研究領(lǐng)域的的熱點(diǎn)課題,研究MCI有助于識(shí)別癡呆高危個(gè)體并對(duì)探索有效干預(yù)途徑有重要作用。其中有關(guān)輕度認(rèn)知功能損害者心理狀況的研究顯示:長(zhǎng)期的消極情感可加速認(rèn)知功能的減退,可能是MCI發(fā)病的相關(guān)因素之一。而中醫(yī)理論中,七情失度及心脾二臟失調(diào)與“憶、意、志、思、慮、智”的意識(shí)思維活動(dòng)功能密切相關(guān),可進(jìn)一步導(dǎo)致健忘的產(chǎn)生。目前尚無(wú)研究涉及MCI、心脾兩虛及心理健康(由幸福感指標(biāo)評(píng)價(jià))之間的相關(guān)性,本研究初步探討MCI心脾兩虛型與心理健康之間是否存在以下的相關(guān)性:1、心理健康水平下降是MCI的相關(guān)因素;2、MCI心脾兩虛證與心理健康顯著相關(guān)。 方法:本研究為橫斷面調(diào)查。根據(jù)國(guó)內(nèi)外有關(guān)MCI的研究報(bào)道、中醫(yī)理論,制定中醫(yī)證候觀(guān)察表及確定相關(guān)神經(jīng)心理學(xué)量表,用之調(diào)查廣東省中醫(yī)院門(mén)診就診、住院及社區(qū)中50～80歲人群共89人:MCI組44名,認(rèn)知功能正常者45名�，F(xiàn)場(chǎng)調(diào)查收集包括一般人口學(xué)資料、中醫(yī)證候及《紐芬蘭紀(jì)念大學(xué)幸福度量表》、MMSE、ADL等,并用SPSS11.0軟件建立數(shù)據(jù)庫(kù)。研究:1、社會(huì)心理因素對(duì)認(rèn)知功能(MMSE成績(jī))影響的單因素、多因素分析;2、MCI的中醫(yī)基本證候初步研究;3、對(duì)MCI患者及正常對(duì)照組、MCI心脾兩虛組及非心脾兩虛組分別進(jìn)行1:1的病例對(duì)照研究。分析幸福感(正性情感、負(fù)性情感、正性體驗(yàn)、負(fù)性體驗(yàn)、總幸福感)與MCI、幸福感與心脾兩虛證的相關(guān)性,以及不同中醫(yī)基本證型的幸福感比較。 結(jié)果:1、影響MCI患者的社會(huì)心理因素主要為年齡、教育程度、職業(yè)性質(zhì)、病程。年齡增長(zhǎng)、體力勞動(dòng)、60歲前離退休、病程長(zhǎng)是認(rèn)知功能下降的危險(xiǎn)因素,受教育程度高是保護(hù)因素。2、70歲以上、初中以下文化程度者M(jìn)CI檢出率顯著增加,腦力勞動(dòng)者與體力勞動(dòng)者、離退休者之間MCI檢出率差異均有顯著性意義。3、中醫(yī)基本證候分析結(jié)果提示兩組在心血虛證、脾氣虛證分布差異有顯著性意義。MCI的中醫(yī)證候以多證兼夾為常見(jiàn),虛實(shí)夾雜者占多數(shù)。4、正性體驗(yàn)、總幸福度與認(rèn)知功能成正相關(guān);負(fù)性體驗(yàn)與認(rèn)知功能呈負(fù)相關(guān)。其中正性體驗(yàn)得分高是認(rèn)知功能的保護(hù)性因素,而負(fù)性體驗(yàn)得分高是認(rèn)知功能的危險(xiǎn)因素。5、MCI心脾兩虛組負(fù)性體驗(yàn)高于非心脾兩虛組,總幸福度低于非心脾兩虛組,兩組的差異均具有顯著性意義。6、中醫(yī)基本證型中,心血虛組與非心血虛組的負(fù)性體驗(yàn)及總幸福度的差異有統(tǒng)計(jì)學(xué)意義,脾氣虛組與非脾氣虛組的負(fù)性情感、負(fù)性體驗(yàn)及總幸福度得分差異均有顯著性意義。其余基本證型未見(jiàn)與幸福感的存在相關(guān)。
[Abstract]:Objective: mild cognitive impairment (MCI) has become a hot topic in the field of dementia because of its high AD risk. The study of MCI helps to identify individuals at high risk of dementia and play an important role in exploring effective approaches to intervention. It may be one of the related factors in the pathogenesis of MCI. In the theory of TCM, the loss of seven emotions and the disorder of heart and spleen are closely related to the function of mental activities of "memory, will, mind, thought, mind, intelligence". There is no study on the relationship between MCI, deficiency of heart and spleen, and mental health (evaluated by well-being index). This study preliminarily explored whether there was the following correlation between the deficiency of heart and spleen and mental health in MCI. The decrease of mental health level was the related factor of MCI. There was a significant correlation between the deficiency of heart and spleen and mental health. Methods: this study was a cross-sectional investigation. According to the domestic and foreign research reports about MCI, the theory of TCM, the observation list of TCM syndromes and the related neuropsychological scale were made, and the outpatient clinics of Guangdong traditional Chinese Medicine Hospital were investigated. A total of 89 people aged 50 to 80 years old in hospital and community were enrolled in the study, 44 in the MCI group and 45 in the normal cognitive function group. The field investigation included general demographic data, TCM syndromes and MMSE ADL, and so on, and the scale of Happiness of Memorial University of Newfoundland. Using SPSS11.0 software to establish database. To study the single factor of the influence of social and psychological factors on cognitive function and score of MMSE. A preliminary study on the basic syndromes of traditional Chinese Medicine (TCM) in patients with MCI and normal control group was carried out with 1: 1 ratio of 1: 1 in patients with MCI and those with non-deficiency of heart and spleen respectively. The well-being (positive emotion, negative emotion, positive experience) was analyzed. Negative experience, total well-being) and MCI, the relationship between happiness and deficiency of heart and spleen, as well as the comparison of happiness of different TCM basic syndrome types. Results the main psychosocial factors affecting MCI patients were age, education level, occupation nature, course of disease, age increase, physical labor and retirement before 60 years old. The long course of disease was the risk factor of cognitive decline. The high level of education was the protective factor over 70 years old. The positive rate of MCI was significantly increased in those with less than junior middle school education, mental workers and manual workers. There were significant differences in the detection rate of MCI among retirees. The analysis of basic syndromes of TCM indicated that there were significant differences in the distribution of TCM syndromes between the two groups in the deficiency of heart and blood, and the syndrome of multiple syndromes and clippings was common in the two groups. Positive experience, total happiness and cognitive function were positively correlated, negative experience was negatively correlated with cognitive function, and positive experience score was the protective factor of cognitive function. The negative experience score was higher than that in the non-heart and spleen deficiency group, and the total happiness degree was lower than that in the non-heart and spleen deficiency group. The difference between the two groups was significant. 6, in the basic syndrome type of TCM, the negative experience was higher in the MCI group than in the non-heart and spleen deficiency group, and the total happiness degree was lower than that in the non-heart and spleen deficiency group, and the difference between the two groups was significant. There were significant differences in negative experience and total happiness between the heart blood deficiency group and the non-heart blood deficiency group, and the negative emotion between the spleen qi deficiency group and the non-spleen qi deficiency group. There were significant differences in the scores of negative experience and total happiness, and there was no correlation between the other basic syndromes and the existence of happiness.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2005
【分類(lèi)號(hào)】：R395.6

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