Correlation Between Cognitive Dysfunction And TCM Syndromes In Vascular Cognitive Impairment

Objective:Vascular Cognitive Impairment(VCI)is a cognitive impairment syndrome caused by vascular factors or related to vascular incidence.With the rising incidence of cardiovascular and cerebrovascular diseases and the aging population,the incidence of VCI is increasing year by year.VCI patients’ quality of life is severely reduced,treatment costs are high,daily care are difficult,and it places a huge burden on patients’ families and society.At present,there is no recognized effective method for treating VCI,but as a preventable disease,VCI is receiving more and more attention.This study starts with TCM syndrome,and focuses on the correlation between TCM syndromes and cognitive impairment in patients with VCI with kidney deficiency,turbidity,blood,and qi and blood deficiency syndromes.For the purpose of providing scientific basis for TCM Syndrome differentiation in VCI patients.Methods:A total of 332 patients with VCI who were treated in the outpatient and inpatient departments of Shenzhen TCM Hospital,Guangdong Traditional Chinese Medicine Hospital,Shenzhen Bao’an Traditional Chinese Medicine Hospital,and Shenzhen Longgang Traditional Chinese Medicine Hospital were selected as observation objects.The TCM syndrome differentiation scale for vascular dementia proposed by Tian Jinzhou in 1997 were used.Cases that meet the syndrome types of "deficiency of kidney essence","stagnation of phlegm and turbidity","stagnation of blood stasis",and "deficiency of both qi and blood" were included in the study;The Montreal Cognitive Assessment scale(MoCA)assesses patients’ cognitive function,calculates MoCA total scores and subdomain scores.Pearson correlation analysis was used to observe the correlation between TCM syndromes and cognitive impairment in patients with VCI.Results:Compared with patients with kidney deficiency syndrome and patients without kidney deficiency syndrome,their ages are significantly different(Mann-Whitney U=5784.500,P=0.019<0.05).The patients with the deficiency of kidney essence syndrome are older;in the Qi and Blood Deficiency Syndrome,the quartile of the ion subdomain is(3,4,5)points,and the quartile of the language subdomain is(1,1,2)points.Compared with the cases of blood deficiency syndrome,the difference was statistically significant(Mann-Whitney U=1 1950.0,12096.5,P=0.038,0.044<0.05).The Spearman correlation found that the total score of MoCA was negatively correlated with the total score of TCM syndromes(r=-0.109,P<0.05).Among them,the scores of attention subdomain,language subdomain and delayed recall subdomain and total score of TCM syndrome Negative correlation(r=-0.112,r=-0.115,r=0.130,P<0.05);Qi and blood deficiency syndrome scores were negatively correlated with attention subdomain and delayed recall subdomain score(r=-0.131,r=0.133,P<0.05).There was no significant correlation between syndrome score execution,naming,abstraction,and directed subdomains.Conclusion:This study embodies the relationship between TCM syndrome types and cognitive function in patients with VCI from the two aspects of TCM’s "holistic concept" and "syndrome differentiation and treatment".First,this study found that there was a correlation between the total score of MoCA and the total score of TCM syndromes.The results showed that the total score of TCM syndromes of VCI patients was negatively correlated with the total score of MoCA,which indicated that the higher the score of TCM syndromes,the lower the score of MoCA,the more serious the damage of cognitive function.This conclusion suggests that in the clinical diagnosis of diseases,it is necessary to grasp the characteristics of systemic syndromes to explain the disease macroscopically.Second,the patients with qi and blood deficiency syndrome have lower language subdomain and abstraction subdomain scores,and are negatively correlated with delayed language subdomain scores,which suggests that when clinically treating patients with VCI whose language subdomain and abstraction subdomain are damaged,it can be supplemented with nurishing qi and blood.The results of this study show that there is no significant correlation between blood stasis syndrome,turbidity syndrome and VCI patients’cognitive function,which is inconsistent with the results of previous scholars’research,which suggests that the characteristics of TCM syndromes may relate to regional limitations and less sample size and other factors,and it is worthy of further exploration.In the future study,the case collection area can be appropriately expanded and the sample size can be increased in order to obtain more satisfactory research results.