Relationship Between Changes In Cognitive Function After Ischemic Stroke And Traditional Chinese Medicine (TCM) Syndrome Differentiation-Type

Objective:To investigate epidemiology of changes in cognitive function after ischemic stroke and Traditional Chinese Medicine(TCM) Syndrome Differentiation-Type(SDT) by the collection of clinical cases,to illuminate the relationship between the changes in cognitive function after ischemic stroke and TCM Syndrome Differentiation-Type,to analysis of TCM factors which impact cognitive function,to provide an evidence for prevention and treatment for decline of cognitive function after ischemic stroke and vascular dementia by TCM,to ischemic stroke patients in order to improve the living quality,and to reduce the burden of the family and society.Object and Method:First of all,the light in 1995 the fourth National Conference on Cerebrovascular Disease,through the "various types of cerebral vascular disease diagnosis," ~[1],specifically in patients with ischemic stroke diagnosis and staging;summary mini-mental state examination(MMSE) and Index of Independence in Activity of Daily Life(ADL) for cognitive function score;Then four examines using the Chinese medicine observation gathers senate's diagnosis mentality,as well as my grade old doctor of traditional Chinese medicine clinical dialectical,to collects from my courtyard nerve internal medicine department and the nerve recovery branch to 84 example cerebral infarction recovery period patient carries on the dialectical minute,And the empty card referred to 1986 the nation cooperation of Chinese and Western medicine empty card and the diseases of the aged research specialized committee revises "Chinese medicine Empty Card Dialectical Reference standard";The real diagnosis referred to 1994 the National Science committee research project 85-919-02-01 through "the Stroke Got sick the Dialectical Diagnosis Standard(Implementation)".At the same time, carries on grading to patient's nerve function damage degree,discussion nerve function damage degree and various cards between relations.Moreover,is hospitalized the blood biochemistry to the patient and the head CT/MRI inspection data next carries on the analysis,discussion the above factors and the card between relevance.To may carry on statistics analysis the data,uses the spss13.0 statistics software to carry on processing.Results:1.The primary deficient TCM SDT of patients with cognitive impairment after ischemic stroke was Yin deficiency of liver and lidney.There were 60 cases whose proportion was 71.43%.The secondary SDT was Qi deficiency,in which there were7 cases,occupy 8.33 %.The primary sthenia TCM SDT is blockage of phlegm and stasis,and there were 42 cases whose proportion was 50%.The secondary SDT was Qi-stagnancy and blood stasis,in which there were28 cases,occupy 33.33%.SDT of asthenia in origin and sthenia in superficiality was primary in Yin deficiency of liver and lidney and blockage of phlegm and stasis,and there were 34 cases whose proportion was 40.48%.The secondary SDT was Yin deficiency of liver and lidney and Qi-stagnancy and blood stasis,in which there were 25 cases,occupy 29.76%.2.Patients with hypertension were primary in Yin deficiency of liver and lidney and blockage of phlegm and stasis,and patients with coronary heart disease were primary in Yin deficiency of liver and lidney and Qi-stagnancy and blood stasis,while patients with Type 2 diabetes were primary in Qi deficiency and blood stasis.3.Plasma fibrinogen and blood lipids in ischemic stroke patients with mild cognitive impairment increased in varying degrees,plasma fibrinogen in deficiency of liver and kidney,stagnation of qi and blood stasis group andblood stasis due to qi deficiency group increased more significantly,considering the possibility that atherosclerosis induced by FIB, blood coagulation mechanism and transportation of blood disorders have in common.4.The degree of neurological deficit between different Syndrome compared have no statistical significance,suggested that the degree of neurological deficit can not be objective indicators which guided clinical differentiation.5.The level of Activity of Daily Life(ADL) and Mini-mental State Examination(MMSE) declined in varying degrees in ischemic stroke patients with mild cognitive impairment,and patients with Syndrome of Yin-deficiency of liver and kidney declined more significantly.It suggested that Yin-deficiency of liver and kidney take more important part in cognitive impairment after stroke.Otherwise,MMSE declined mainly reflected in an important aspect of the attention,calculation,delayed recall and execution capabilities.6.According to head CT / MRI,most patients were prompted lacunar cerebral infarction and cerebral infarction existed meanwhile and there were changes of white matter and encephalatrophy in varying degrees,which was demonstrated one of the high-risk factors. While patients with left cerebral hemisphere stroke accounted for 25.7%,so patients with the left cerebral hemisphere stroke should be on high alert.Conclusion:Syndrome of Yin-deficiency of liver and kidney and stagnation of qi and blood stasis take the initiative in the character of TCM SDT in ischemic stroke patients with mild cognitive impairment.Plasma fibrinogen in Syndrome of Yin-deficiency of liver and kidney and stagnation of qi and blood stasis group and blood stasis due to qi deficiency group increased more significantly.Changes of cognitive dysfunction after ischemic stroke of patients mainly reflected in an important aspect of the attention,calculation,delayed recall and execution capabilities,while the effct of Yin-deficiency of liver and kidney on these patients is more significant than other TCM risk factors.