Standardization On Syndrome Differentiation Of Mild Cognitive Impairment And Its Correlative Research With Cognition Level

Objective:①to research on normalized TCM syndrome factors and TCM syndromes of Mild Cognitive Impairment (MCI) and develop The diagnostic scoring scale of TCM syndrome factors of Mild Cognitive Impairment.②to research on the correlations between TCM Syndrome factors and cognition level [Mini-Mental State Examination (MMSE), Montreal cognitive assessment(MoCA), Auditory Verbal Learning Test(AVLT), Clock Drawing Test(CDT)], as well as TCM Syndromes and cognition level (MMSE, MoCA, AVLT, CDT) regarding to MCI.Method:with the clinical scoring questionnaire about information of TCM four examinations in Mild Cognitive Impairment, the score of the information of TCM four examinations in458MCI patients were collected. These data were calculated by Cluster Analysis and Factor Analysis in order to research on TCM syndrome factors and TCM syndromes, to obtain the weight coefficients of the information of TCM four examinations belong to the corresponding TCM syndrome factors or TCM syndromes, to get the primary and secondary symptoms of TCM syndrome factors and TCM syndromes, and then set up the integral models of TCM syndrome factors or TCM syndromes about MCI. Based on these research results, The diagnostic scoring scale of TCM syndrome factors of Mild Cognitive Impairment were preliminarily developed. At the same time, The cognitive function of458MCI patients were evaluated by MMSE, MoCA, AVLT, CDT (4points scoring method) and CDT(30points scoring method). At last, make the partial correlation analysis respectively between the score of TCM syndrome factors and TCM syndromes and the score of MMSE, MoCA, AVLT, CDT (4points scoring method), CDT(30points scoring method) and their subtests from458MCI patients.Results:①Based on the research, there were9common syndrome factors of MCI being observed, such as kidney, heart, liver, qi deficiency, blood deficiency, yin deficiency, yang deficiency, phlegm, blood stasis. The major syndrome factors of disease locations is kidney (89.30%;97.42%), heart (78.17%;75.77%), liver (67.69%;84.54%); The major syndrome factors of disease nature is phlegm (55.46%;75.77%), blood stasis (44.98%;59.28%), qi deficiency (51.75%;41.24%); From the research, the weight coefficients of the symptoms and the primary and secondary symptoms belong to the corresponding TCM syndrome factors were obtained(See Table31).②Based on these research results of the TCM syndrome factors about MCI, and their weight coefficients of the symptoms and their primary and secondary symptoms, the integral models of TCM syndrome factors about MCI were set up, The diagnostic scoring scale of TCM syndrome factors of Mild Cognitive Impairment were preliminarily developed(See Table31).③Among458MCI patients, there were16syndrome factors of MCI being observed, Such as Kidney Essence Deficiency Syndrome, Kidney-Qi Deficiency Syndrome, Kidney-Yin Deficiency Syndrome, Kidney-Yang Deficiency Syndrome, Heart-Qi Deficiency Syndrome, Heart-Blood Deficiency Syndrome, Heart-Yin Deficiency Syndrome, Heart-Yang Deficiency Syndrome, blood stasis in Heart vessels Syndrome, phlegm obstructing the pericardium Syndrome, Stagnation of Liver-Qi Syndrome, kidney deficiency and blood stasis Syndrome, kidney deficiency and phlegm turbidness Syndrome, Phlegm-Stagnancy Obstruction Syndrome, Heart-Blood and Heart-Qi Deficiency Syndrome, Imbalance between Heart-Yang and Kidney-Yin Syndrome. The common syndromes of MCI were Kidney Essence Deficiency Syndrome (89.30%;97.42%), phlegm obstructing the pericardium Syndrome (52.84%;66.49%), Heart-Qi Deficiency Syndrome (42.36%;43.81%), blood stasis in Heart vessels Syndrome (42.36%;45.88%), Phlegm-Stagnancy Obstruction Syndrome (39.96%;59.79%). From the research, the weight coefficients of the symptoms and the primary and secondary symptoms belong to the corresponding TCM syndromes were obtained(See research result2.2.3), and the integral models of TCM syndromes about MCI were set up.④There was a negative correlation between the score of MoCA and the score of TCM syndrome factor yin (r=-0.262, P=0.047),and There were negative correlations in its subtests between the score of naming functionality and the score of TCM syndrome factor kidney (r=-0.149,P=0.041), yin deficiency (r=-0.357, P=0.006), as well as between the score of attention function and the score of TCM syndrome factor kidney (r=-0.189, P=0.009), liver (r=-0.277, P=0.000), yin deficiency (r=-0.331, P=0.011); linguistic functionality and TCM syndrome factor qi deficiency (r=-0.344, P=0.002); abstract thinking and TCM syndrome factor yang deficiency (r=-0.489, P=0.010). There was no significant correlation between the score of visual-spatial and executing skill, delayed recall, orientation and the score of every TCM syndrome factor about MCI (P>0.05). There was a negative correlation between the score of AVLT and the score of TCM syndrome factor qi deficiency (r=-0.252, P=0.025), and There were negative correlations in its subtests between the score of short-delayed recall and the score of TCM syndrome factor heart (r=-0.219, P=0.052), as well as the score of long-delayed recall and the score of TCM syndrome factor qi deficiency (r=-0.306, P=0.006). There was no significant correlation between the score of short-term memory and the score of every TCM syndrome factor about MCI (P>0.05). There was a negative correlation between the score of CDT(30points scoring method) and the score of TCM syndrome factor yin deficiency (r=-0.272, P=0.039). There was no significant correlation between the score of CDT30-A、CDT30-C and the score of every TCM syndrome factor about MCI (P>0.05). There was a negative correlation between the score of CDT (4points scoring method) and the score of TCM syndrome factor yang deficiency (r=-0.395, P=0.041). There was no significant correlation between the score of MMSE and the score of every TCM syndrome factor about MCI (P>0.05)⑤There were negative correlations between the score of MOCA and the score of Heart-Blood and Heart-Qi Deficiency Syndrome (r=-0.611, P=0.016), Stagnation of Liver-Qi Syndrome (r=-0.305, P=0.030). There were negative correlations in its subtests between the score of naming functionality and the score of Heart-Yin Deficiency Syndrome (r=-0.351, P=0.018) Stagnation of Liver-Qi Syndrome (r=-0.352, P=0.011), as well as between the score of attention function and the score of Kidney-Qi Deficiency Syndrome (r=-0.276, P=0.040), Kidney-Yang Deficiency Syndrome (r=-0.464, P=0.017),Kidney-Qi Deficiency Syndrome (r=-0.247, P=0.035), kidney deficiency and blood stasis Syndrome (r=-0.310, P=0.025),kidney deficiency and phlegm turbidness Syndrome (r=-0.290, P=0.021), Heart-Yin Deficiency Syndrome (r=-0.405, P=0.006), Imbalance between Heart-Yang and Kidney-Yin Syndrome (r=-0.482, P=0.001), Stagnation of Liver-Qi Syndrome (r=-0.300, P=0.033);linguistic functionality and Heart-Qi Deficiency Syndrome (r=-0.267, P=0.045); delayed recall and Heart-Blood and Heart-Qi Deficiency Syndrome (r=-0.656, P=0.008). There was no significant correlation between the score of visual-spatial and executing skill, linguistic functionality, orientation and the score of every TCM syndrome about MCI (P>0.05).There was a negative correlation between the score of AVLT and the score of Heart-Yang Deficiency Syndrome (r=-0.500, P=0.018), and There were negative correlations in its subtests between the score of short-delayed recall and the score of Heart-Yang Deficiency Syndrome (r=-0.527, P=0.012), as well as the score of long-delayed recall and the score of Heart-Yang Deficiency Syndrome (r=-0.409, P=0.058). There was no significant correlation between the score of short-term memory and the score of every TCM syndrome about MCI (P>0.05). There was a negative correlation between the score of CDT(30points scoring method) and the score of Heart-Yin Deficiency Syndrome (r=-0.345, P=0.020), as well as the score of CDT30-C and the score of Heart-Yin Deficiency Syndrome (r=-0.349, P=0.019).There was no significant correlation between the score of CDT30-A and the score of every TCM syndrome about MCI (P>0.05). There were negative correlations between the score of CDT (4points scoring method) and the score of Heart-Blood and Heart-Qi Deficiency Syndrome (r=-0.537, P=0.039). There was a significant correlation between the score of MMSE and the score of Stagnation of Liver-Qi Syndrome (r=-0.239, P=0.008)Conclusions:①There were9syndrome factors of MCI, such as kidney, heart, liver, qi deficiency, blood deficiency, yin deficiency, yang deficiency, phlegm, blood stasis. The major syndrome factors of disease locations is kidney, heart, liver, the major syndrome factors of disease nature is phlegm, blood stasis, qi deficiency. The syndrome factors of MCI were obtained, and the common syndromes of MCI were Kidney Essence Deficiency Syndrome, phlegm obstructing the pericardium Syndrome, Heart-Qi Deficiency Syndrome, blood stasis in Heart vessels Syndrome, Phlegm-Stagnancy Obstruction Syndrome. From the research, the weight coefficients of the symptoms and the primary and secondary symptoms belong to the corresponding TCM syndrome factors and TCM syndromes were obtained.②To MCI patients, there were negative correlations between most of TCM syndrome factors (such as kidney, liver, heart, yin deficiency, yang deficiency and so on) and cognition level (MMSE, MoCA, AVLT, CDT),as well as between most of TCM syndromes (such as Kidney Essence Deficiency, Stagnation of Liver-Qi Syndrome, Heart-Yin Deficiency, Heart-Blood and Heart-Qi Deficiency Syndrome and so on) and cognition level (MMSE, MoCA, AVLT, CDT).