Study On The Correlation Between Early Cognitive Impairment And TCM Constitution And Syndrome Types In Patients With Acute Ischemic Stroke

Objective:To explore the distribution pattern of TCM constitution and syndrome types in patients with acute ischemic stroke(AIS)and the correlation between them and the early occurrence of post-stroke early cognitive impairment.In order to provide clinical basis for early intervention of stroke and post-stroke cognitive impairment from the perspective of TCM constitution.Method:193 hospitalized patients with AIS who met the inclusion criteria of this study were selected.On admission,the Classification and Determination Table of TCM Constitutions was used to determine the type of TCM constitutions,the Evaluation Criteria for TCM Diagnostic Efficacy of Stroke was used to determine the TCM syndromes,and the clinical data of the patients were registered with the epidemiological questionnaire.Montreal Cognitive Assessment Scale(MoCA)was used to assess the patients’ cognitive function at the onset of disease(14±2d),and the patients were divided into PSCI group and NCI group according to the MoCA scoring results.Database was established and statistical analysis was conducted to explore the correlation between early cognitive impairment in AIS patients and constitution and syndrome types of traditional Chinese medicine.Results:The TCM constitution of AIS patients were mainly consists of phlegm-dampness,qi deficiency,yin deficiency,and blood stasis.The constitution of wind-phlegm stasis syndrome mainly consists of phlegm-dampness,followed by peace,blood stasis,yang deficiency,qi deficiency,and qi depression,and without damp-heat.The constitution of qi deficiency and blood stasis syndrome mainly consists of qi deficiency,followed by blood stasis,peace,phlegm-dampness,yang deficiency,qi depression and yin deficiency,and without damp-heat.The constitution of yin deficiency and wind-movement syndrome consists of yin deficiency,followed by qi depression,phlegm-dampness,qi deficiency,and damp-heat,and without peace,blood stasis,and yang deficiency.The constitution of phlegm-heat and viscera syndrome mainly consists of damp-heat,followed by phlegm-dampness,yin deficiency,qi deficiency,qi depression,and without peace and blood stasis.The constitution of wind-phlegm and hyperactivity of fire syndrome mainly consists of phlegm dampness,damp-heat,and peace.And without qi deficiency,yin deficiency and blood stasis.There is a correlation between different TCM constitutions and syndromes,and there is a certain consistency(r=0.612,P=0.000).Among 193 AIS patients included in the study,109 cases(56.48%)had PSCI.The occurrence of early PSCI is correlated with the TCM constitution of AIS patients,including phlegm-dampness,qi deficiency and yin deficiency,but not with TCM syndrome types(P>0.05).Age,NIHSS score,homocysteinemia,phlegm-dampness,qi deficiency,yin deficiency and yang deficiency were correlated with the onset of early cognitive impairment in AIS patients(P<0.05).Among them,age,qi deficiency,phlegm-dampness,yin-deficiency and yang-deficiency are risk factors for cognitive impairment in AIS patients.Conclusion:The TCM constitution of AIS patients were mainly phlegm and dampness,followed by qi deficiency,peace,yin deficiency and blood stasis.There is a correlation between different TCM constitutions and syndromes,and there is a certain consistency(r=0.612,P=0.000).The incidence of early cognitive impairment in acute ischemic stroke is 56.48%.The occurrence of early cognitive impairment was correlated with the TCM constitution of AIS patients,but not with the TCM syndromes.Age,qi deficiency constitution,phlegm-dampness constitution,yin deficiency constitution and yang deficiency constitution are the risk factors for cognitive impairment in AIS patients.It can provide some reference basis for early intervention of post-stroke early cognitive impairment from the perspective of TCM constitution.