Study On TCM Constitution Type And Early Postoperative Cognitive Dysfunction In Elderly Patients

ObjectiveStudy on correlation between elderly patients of POCD and TCM Constit ution,to search the rule from the characteristics of traditional Chinese medicine constitution,may have clinical significance as treatment guidel ines for the syndrome differentiation and treatment of elderly patients w ith POCD.Aiming at the type of physical constitution and the status of postoperative cognitive function in elderly patients,the influencing fac tors of cognitive function were explored to provide reference for the int ervention of traditional Chinese and Western medicine during the perioper ative period.MethodsUsing cross-sectional epidemiological survey,we collected from 60 to 90 years old patients who undergoing lower extremity surgery by general a nesthesia at Guangdong Provincial TCM Hospital.To finish the investigatio n of constitution in chinese medicine questionnaireand MoCA scale in the day before the operation.Record the patient’s hospitalization number,ge nder,age,body mass,standard of culture,blood pressure,heart rate,anamne sis,preoperative hemoglobin and preoperative hematokritbefore the operati on.Record the patient’s blood loss,operation time,duration of anesthesia and anesthetics,infused amount,blood loss,vol,operation types,postoperati ve hemoglobin,postoperative hematokrit at the day after operation.Once ag ain to complete the MoCA scale at the third day after operation.Finally,f ill in patients’ basic information and input them into the computer to es tablish a database.Descriptive analysis and inferential analysis(chi squa re test,t test,rank sum test and Logistic regression analysis)are carr ied out by using SPSS17.0 statistical software.ResultsPostoperative cognitive dysfunction belong to mild cognitive impairmen t.The number of the study in elderly patients with POCD was 21(12.7%).T he number of cases with cognitive decline were 75(45%).The elderly patie nts’ constitution distribution were Pinghe constitution59(35.5%),Yuxue c onstitution30(18.1%),Yangxu constitution30(18.1%)and other constitution 29(17.5%).The elderly patients’ main types of constitution were Pinghe c onstitution28(37.3%),Yuxue constitutionl7(22.7%),Yangxu constitutionl0(13.3%),Qixu constitutionl0(13.3%)and other constitutionl0(13.3%)who underg oing cognitive decline.Different gender had statistical differences in ag e and weight(P<0.05).The age and educational level on preoperative fun ction were abnormal before the occurrence of significant correlation was statistically significant(P<0.05).The age and educational level of abno rmal postoperative cognitive function has also had statistical correlatio n was statistically significant(P<0.05).The age and educational level be came the independent risk factors of POCD.There was a statistical correla tion between the type of operation and the incidence of cognitive decline(P<0.05).The chi square test showed statistics significance between preo perative cognitive function assessment results and postoperative cogniti ve function assessment results(P<0.001),Mackney Martha test showed that the difference was significant(P<0.05),that before and after the two co gnitive assessment results are consistent,Kappa=0.667 shows good consist ency between the evaluation results of preoperative cognitive and evaluat ion results of postoperative results.There was statistical correlation be tween the Yuxue constitution and the educational level(P<0.05).The diff erence in body weight between the patients with Yangxu constitution and t he patients with non Yangxu constitution was statistically significant(P<0.05).ConclusionIn this study,the distribution of the constitution types at elderly pa tients were Pinghe constitution,Yuxue constitution and Yangxu constitutio n.The elderly patients’ main types of constitution were Pinghe constitut ion,Yuxue constitution,Yangxu constitution and Qixu constitution who unde rgoing cognitive decline.The constitution center on Pinghe constitution a t the study.The evaluation results of preoperative cognitive and evaluati on results of postoperative results had a good consistency.The age and cu lture degree became independent factors of POCD.The type of operation was also an independent factor affecting the incidence of cognitive decline.Small sample size of this study,and not for a multi center study.Multi center study in the future can be implemented in large sample,providind more adequate basis and more reliable research results for the study betw een the TCM constitution type and the elderly on early postoperative cogn itive dysfunction.