Study On Constitution Of TCM In Patients With Cerebral Small Vessel Disease Complicated With Depression

Purpose:Collection to meet the requirements of this topic,298 cases of patients with cerebral small vascular disease complicated with depression,through the general information(gender,age,BMI,alcohol,tobacco,history,and medical history),such as cranial MRI manifestations,lesion and TCM constitution judgement to evaluate the results summary,summarized CSVD concurrent depression in patients with Chinese medicine physical distribution,and analysis and physical types related laws between the influencing factors,provide CSVD concurrent depression in clinical diagnosis and treatment reference.Methods: 298 patients were from outpatient or inpatient departments of geriatrics,neurology,clinical psychology and encephalopathy of Yunnan First People’s Hospital from January 2020 to January 2021.All of them underwent MRI,which met the imaging standard of cerebral small vessel disease and met the depression standard assessed by Hamilton Depression Scale(HAMD-24 items).Collect the related data of imaging manifestation,lesion location,TCM constitution type and TCM syndrome type,and analyze the data with SPASS23.0 to summarize the correlation between the distribution of TCM constitution of CSVD patients with depression and CSVD imaging type,MRI lesion location and TCM syndrome.Result:1.Among 298 patients with cerebral small vessel disease complicated with depression,there were 154 male patients and 144 female patients,the ratio of male to female was 1.07: 1,and the age ranged from 34 to 93 years,with an average age of 69.2510.33 years,including 29 patients under 49 years old,89 patients between 50 and 64 years old and 121 patients between 65 and 79 years old,59 patients over 89 years old.2.According to CSVD skull MRI findings,among 298 patients with cerebral small vessel disease complicated with depression,skull MRI showed lacunar infarction in 226 cases,lacunar(or)white matter lesions in 76 cases,cerebral microbleeds in 26 cases,perivascular space enlargement in 22 cases and cerebral atrophy in 42 cases(including those with two or more imaging findings at the same time).According to the statistics of imaging lesion location,the lesions were mainly distributed in basal ganglia(141 cases)and beside lateral ventricle(114 cases),followed by parietal lobe(88 cases),frontal lobe(80 cases),center of semioval(42 cases),thalamus(31 cases),cerebellum(26 cases),occipital lobe(19 cases)and temporal lobe(19 cases).3.According to BMI index,the weight of 298 CSVD patients with depression was divided into < 18.5(lean),18.5-23.9(normal),24-28(overweight)and > 28(obesity),among which 11 were lean,221 were normal,62 were overweight and 4 were obese.4.298 CSVD concurrent depression patients,TCM constitution are all biased constitution,there is no single body constitution,biased constitution all with composite health is given priority to,the primary physical distribution in composite constitution,phlegmy wet mass of 88 cases(29.5%),blood stasis,mass in 76 cases(25.5%),qi depression,74 cases(24.8%),Yang deficiency quality,and the 21 cases(7%),Yin deficiency,quality,and the 21 cases(7%),and the rest of the body are less than 15 cases(compound constitution scored the highest is the main physical).5.Among 298 patients with CSVD complicated with depression,TCM depression syndrome classification mainly included spittoon stagnation(78 cases),liver stagnation(78cases),deficiency of heart and spleen(46 cases),qi stagnation of fire(40 cases),deficiency of liver and kidney Yin(27 cases),and loss of mental health(27 cases).Conclusion:1.The MRI findings of CSVD patients complicated with depression are mostly lacunar infarction.The lesions are mainly located in basal ganglia and lateral ventricle,and there is no obvious correlation between the constitution type of traditional Chinese medicine and imaging manifestations and the distribution of lesions2.The TCM constitution types of 2.CSVD patients complicated with depression are all complex constitutions.Among the main constitution types,phlegm dampness(29.5%),blood stasis(25.5%)and qi stagnation(24.8%)are obviously more than other constitutions,followed by yang deficiency,yin deficiency,damp heat,qi deficiency,disharmony and special constitution.3.The TCM syndromes of CSVD patients with depression are mainly phlegm-qi stagnation and liver-qi stagnation,followed by deficiency of both heart and spleen,stagnation of qi and fire,yin deficiency of liver and kidney and mental dystrophy.4.Among the constitution types and syndromes distribution of patients with CSVD complicated with depression,the TCM syndromes were phlegm dampness and blood stasis in patients with cuspidor stagnation,and qi stagnation and blood stasis in patients with liver-qi stagnation.The traditional Chinese medicine constitutions of patients with heart and spleen deficiency are mainly composed of Yang deficiency and qi stagnation;those of patients with qi stagnation fire are composed of Yin deficiency and blood stasis;those of patients with liver and kidney Yin deficiency are composed of blood stasis and Yin deficiency.