Study On The Etiology,Pathogenesis And Syndrome Rules Of Cerebral Small Vessel Disease

Objective: Study the etiology,pathogenesis and syndrome laws of CSVD in Chinese medicine,and provide scientific data support and theoretical basis for the standardized dialectical treatment of CSVD prevention and treatment by Chinese medicine.Methods: Include 200 inpatient and outpatient patients in Henan Provincial Hospital of Traditional Chinese Medicine.who meet the CSVD diagnostic criteria,and include the patient’s general information,past disease history,personal history,and four-diagnosis information of traditional Chinese medicine into the clinical database of traditional Chinese medicine;according to the "Ischemic Stroke Syndrome Elements" "Diagnostic Scale" to judge the syndrome elements of CSVD,and at the same time,two encephalopathy associate directors and above-title physicians combined with rich clinical experience to dialect the syndromes of CSVD.Through MMSE,MOCA,TMT,HAMD,NIHSS and other scores,the main clinical manifestations of CSVD patients are evaluated.Through the total CSVD score,assess the severity of the patient’s condition.Results:1.Etiology: diet: those who are addicted to eating fat and sweet(62.5%),those who are greedy for cold drinks(29.5%);emotions: irritability(37.5%),thinking(35.5%);exercise: those who like quietness and less movement(92 %).Risk factors: followed by hypertension(72%),diabetes(50.5%),alcoholism(48.5%),hyperlipidemia(46%),and smoking(36.5%).2.The main clinical manifestations: in order of cognitive dysfunction(66.5%),motor balance disorder(59%),affective disorder(55%),and feces disorder(25.5%).3.Syndrome elements: the combination of syndrome elements has two certificates concurrently(58%)as the most,followed by one certificate and single issuer(23%),three certificates concurrently(17%),four certificates concurrently(2 %).Among them,the most complicated cases of two certificates are internal fire syndrome + phlegm-dampness syndrome(22.4%),and the most frequent one is Qi deficiency syndrome(37%).4.Syndromes: in turn are phlegm-fire obstruction syndrome(22.4%),phlegm turbidity and blood stasis syndrome(15.5%),qi deficiency and blood stasis syndrome(11%),wind phlegm entering collaterals syndrome(5.2%),yin deficiency and blood stasis Certificate(1.7%).5.CSVD patients with a history of hypertension(72%),the proportion of Yin deficiency syndrome is higher than that of CSVD patients without a history of hypertension(P<0.05);CSVD patients with a history of hyperlipidemia(46%),The proportion of blood stasis syndrome was significantly higher(P<0.05);CSVD patients with a history of coronary heart disease(22%),the proportion of blood stasis syndrome was significantly higher(P<0.05);CSVD patients with a history of smoking(36.5%)The proportion of internal fire syndrome was higher than that of CSVD patients without a history of smoking(P<0.05);the proportion of CSVD patients with a history of alcoholism(48.5%)was higher than that of CSVD patients without a history of alcoholism(P<0.05));CSVD patients with cognitive impairment(66.5%),the proportion of Qi-deficiency syndrome is higher than that of CSVD patients without cognitive impairment(P<0.05);CSVD patients with affective disorder(55%)have a significantly higher proportion of Yin-deficiency(P <0.05);the incidence of phlegm-dampness syndrome and blood stasis syndrome increased significantly with the aggravation of the disease(P<0.05).Conclusion:1.The main causes of CSVD include old age and physical weakness,improper diet,emotional imbalance,and exercise disorders.The main risk factors include hypertension,diabetes,hyperlipidemia,smoking,alcoholism,etc.2.The main clinical manifestations of CSVD are cognitive dysfunction,motor balance disorder,affective disorder,and two stool disorders.3.The frequency of occurrence of CSVD syndrome elements from high to low is phlegm-dampness syndrome,internal fire syndrome,qi deficiency syndrome,blood stasis syndrome,yin deficiency syndrome,and internal wind syndrome.The combination of syndrome elements has the most concurrent two certificates.4.The syndromes of CSVD are mainly syndromes of wind phlegm entering collaterals,phlegm-fire obstruction syndrome,phlegm turbidity and blood stasis syndrome,qi deficiency and blood stasis syndrome,yin deficiency and blood stasis syndrome.5.The risk factors,main clinical manifestations,and severity of CSVD are closely related to its syndrome elements.