腦中風後失智症之中醫證型及證型與失智嚴重度關係之研究

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题名:	腦中風後失智症之中醫證型及證型與失智嚴重度關係之研究
作者:	謝慶良(Hsieh,Ching-Liang);唐娜櫻(Tang,Nou-Ing)
贡献者:	中醫學院中西醫結合研究所;中國附醫中醫內科
关键词:	腦中風後失智症;中醫證型;嚴重度;Post-stroke dementia;Chinese Medicine pattern;Severity
日期:	2007-09-30
上传时间:	2009-09-01 13:30:47 (UTC+8)
摘要:	台灣腦中風佔十大死因的第三位，腦中風發生後常造成患者記憶力及智能功能急速的衰退而引起日常生活功能障礙，即所謂腦中風後失智症。痴呆一旦發生將使國家社會造成很大的負擔，又至今尚未出現有效的藥物。中醫治病利用望、聞、問、切等四診確立中醫證型，辨證施治常可收到良好的治療效果，因此本研究的目的是探討腦中風後失智症之中醫證型及證型與失智嚴重度之關係。我們蒐集神經科門診100位符合美國精神病學會的精神疾病診斷準則手冊第4版（DSM IV）及符合National Institute of Neurological Disorders and Stroke-Association Internationale pour Ia Recherche et I’Enseignement en Neurosciences (NINDS-ALREN)的血管性失智症（vascular dementia）診斷標準之腦中風後失智症病患100位。填寫簡易智能狀態測驗量表（Mini-Mental Status Examination，MMSE），認知功能篩檢表（Cognitive Abilities Screening Instrument，CASI），臨床失智評估量表（Clinical Dementia Rating，CDR）。另外，由兩位資深中醫師利用望、聞、問、切四診填寫血管性失智症中醫辨證量表（The scale for the differentiation of syndromes of vascular dementia，SDSVD）。我們預期本研究的結果可以說明台灣腦中風後失智症的中醫證型以及證型與失智嚴重度的關係。根據本研究的結果可以提供腦中風後失智症的中醫證型，對腦中風後失智的治療和研究發展將有很大的貢獻，並可提供作為中醫的教材。 Stroke is the third of ten etiologies that cause death in Taiwan, and stroke will develop to the memory and intellectual function decline rapidly resulting in the disturbance of daily life activity, i.e. post-stroke dementia. Dementia will result in a great expense of national and social finance. In addition, there are not effective drug to treat post-stroke dementia until now. Chinese Medicine doctor utilizes inspection, listening and smelling, inquiry and palpitation of the four examinations to confirm the Chinese Medicine pattern, then pattern identification and treatment and that may obtain good therapeutic effect. Therefore, the purpose of the present study was to investigate the Chinese Medicine pattern of post-stroke dementia, and the relationship between the pattern and severity of dementia. We accorded to DSM IV diagnostic criteria of American Psychiatric Association and National Institute of Neurological Disorders and Stroke-Association International pour Ia Recherche et I’Enseignement en Neurosciences (NINDS-ALREN )to collect 100 post-stroke dementia patients in the OPD of the neurological department. Mini-Mental Status Examination (MMSE), Cognitive Abilities Screening Instrument (CASI) and Clinical Dementia Rating (SDR) were used to assess the severity of dementia. In addition, The scale for the differentiation of syndromes of vascular dementia (SDSVD) was used to confirm the Chinese Medicine pattern. The score of SDSVD was determined by above-mentioned the four examination of two Chinese Medicine doctors. We predict the results of the present study that can interpret the Chinese Medicine pattern of post-stroke dementia and the relationship between the pattern and the severity of dementia.Present results may provide the Chinese Medicine pattern of post-stroke dementia, and that is advantage of the treatment of post-stroke dementia and research, and the materials of Chinese Medicine education.
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