不同中医证型的Wilson病患者智力水平及智力结构探讨
An Analysis of Intelligence Level and Intelligence Structure in Patients with Different Traditional Chinese Medicine Syndrome Types of Wilson's Disease
  
DOI:
中文关键词:  Wilson 病  晶体智力  流体智力  中医证型  相关性
英文关键词:Wilson's disease  Crystalized intelligence  Fluid intelligence  Traditional Chinese medicine syndrome type  Correlation
基金项目:国家自然科学基金项目(81573954);国家临床重点专科建设开放基金项目(2014lckf02033)
作者单位
李 波,史梦楠,耿 昊,程 楠,王共强,韩永升,韩咏竹 1.安徽中医药大学研究生院安徽 合肥 2300122.安徽中医药大学神经病学研究所附属医院安徽 合肥 230061 
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中文摘要:
      目的 观察Wilson病(Wilsons disease,WD)患者不同中医证型的晶体智力与流体智力水平及其与年龄、性别、病程、临床严重程度分级(Goldstein分级)评分及中医证型之间的关系。方法 对84例中医辨证符合湿热内蕴证(39例)、肝肾阴虚证(24例)、气血亏虚证(21例)的WD患者以及38例健康者进行韦氏智力测评(Wechsler Adult Intelligence Scale,WAIS )及瑞文标准推理测评(Ravens Standard Progressive Matrices,RSPM)。结果 与正常组比较,肝肾阴虚证患者操作智商(performance intelligence quotient,PIQ)及全智商(fall intelligence quotient,FIQ)评分均减少(P<0.05),气血亏虚证患者言语智商(verbal intelligence quotient,VIQ)、PIQ及FIQ均减少(P<0.05),湿热内蕴证患者各评分差异无统计学意义(P>0.05);与湿热内蕴证比较,肝肾阴虚证患者VIQ及FIQ均减少(P<0.05),气血亏虚证患者VIQ、PIQ及FIQ均减少(P<0.05);与肝肾阴虚证比较,气血亏虚证患者PIQ及FIQ均减少(P<0.05)。与正常组比较,气血亏虚证患者“类同比较”“比较推理”“系列关系”“抽象推理”评分及RSPM总分均减少(P<0.05),湿热内蕴证及肝肾阴虚证患者各项得分差异均无统计学意义(P>0.05);与湿热内蕴证比较,肝肾阴虚证患者各项得分差异均无统计学意义(P>0.05),气血亏虚证患者的“类同比较”“比较推理”“系列关系”“抽象推理”评分及RSPM总分均减少(P<0.05);与肝肾阴虚证比较,气血亏虚证患者的“类同比较”评分降低(P<0.05)。3种中医证型WD患者FIQ、RSPM总分与Goldstein评分均呈负相关(P<0.05),FIQ与病程呈负相关(P<0.05)。结论 3种中医证型中气血亏虚证WD患者智力损伤最明显,其次是肝肾阴虚证,而湿热内蕴证无智力损伤。3种证型患者晶体及流体智力水平与Goldstein评分均具有相关性,晶体智力水平与病程具有相关性。
英文摘要:
      Objective To investigate the levels of crystalized intelligence and fluid intelligence in patients with different traditional Chinese medicine (TCM) syndrome types of Wilsons disease (WD) and their association with age, sex, course of disease, Goldstein grade, and TCM syndrome type. Methods A total of 84 patients with WD were enrolled, among whom 39 had internal retention of damp heat, 24 had liver kidney Yin deficiency, and 21 had deficiency of Qi and blood based on TCM syndrome differentiation, and 38 healthy individuals were enrolled as normal group. All subjects were assessed using Wechsler Adult Intelligence Scale (WAIS) and Ravens Standard Progressive Matrices (RSPM). Results Compared with the normal group, the patients with liver kidney Yin deficiency had significantly lower performance intelligence quotient (PIQ) and full intelligence quotient (FIQ) (P<0.05), and those with deficiency of Qi and blood had significantly lower verbal intelligence quotient (VIQ), PIQ, and FIQ (P<0.05); there were no significant differences in VIQ, PIQ, and FIQ between the patients with internal retention of damp heat and the normal group (P>0.05). Compared with those with internal retention of damp heat, the patients with liver kidney Yin deficiency had significantly lower VIQ and FIQ (P<0.05), and the patients with deficiency of Qi and blood had significantly lower VIQ, PIQ, and FIQ (P<0.05). The patients with deficiency of Qi and blood had significantly lower PIQ and FIQ than those with liver kidney Yin deficiency (P<0.05). Compared with the normal group, the patients with deficiency of Qi and blood had significantly lower total RSPM score and scores of similar comparison, reasoning comparison, series relationship, and abstract reasoning (P<0.05), and there were no significant differences in these scores between the normal group and the patients with internal retention of damp heat or liver kidney Yin deficiency (P>0.05). There were no significant differences in all scores between the patients with internal retention of damp heat and those with liver kidney Yin deficiency (P>0.05); compared with those with internal retention of damp heat, the patients with deficiency of Qi and blood had significantly lower total RSPM score and scores of similar comparison, reasoning comparison, series relationship,and abstract reasoning (P<0.05);compared with those with liver kidney Yin deficiency, the patients with deficiency of Qi and blood had a significant reduction in the score of similar comparison (P<0.05). In the patients with the three TCM syndrome types of WD, FIQ and total RSPM score were negatively correlated with Goldstein score (P<0.05), and FIQ was negatively correlated with the course of disease (P<0.05). Conclusion WD patients with deficiency of Qi and blood have the highest degree of intellectual damage, followed by those with liver kidney Yin deficiency, and no intellectual damage is observed in WD patients with internal retention of damp heat. The levels of crystalized intelligence and fluid intelligence are correlated with Goldstein score, and the level of crystalized intelligence is correlated with the course of disease.
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