Study On The Correlation Between The Degree Of Cognitive Impairment After Ischemic Stroke And The Constitution Classification Of Traditional Chinese Medicine

Objective To study the correlation between different severity of post of stroke cognitive impairment(PSCI)and TCM constitution and its related risk factors,and to find out the susceptible constitution and related risk factors of different degrees of ischemic PSCI,so as to carry out early intervention,prevent the occurrence and development of ischemic PSCI,and guide clinical individualized treatment of constitution.Methods Following the inclusion and exclusion criteria,287 ischemic PSCI patients who visited the outpatient and inpatient departments of Inner Mongolia Hospital of Traditional Chinese Medicine from November 2021 to November 2022 were selected.The general data and related examination results of the patients were recorded by two doctors in the department of encephalopathy and above through questionnaire survey.According to the Montreal Cognitive Assessment(MoCA),the patients were divided into three grades(mild,moderate and severe PSCI of ischemic stroke),and the TCM constitution of the patients was determined by referring to the ’TCM constitution classification and determination table’.The collected data were statistically analyzed through the observation and study of patients with ischemic PSCI.To analyze the correlation between PSCI patients with different severity of ischemic stroke and TCM constitution and its risk factors.Results 1.A total of 287 patients with ischemic PSCI were included in this study,with an average age and standard deviation of(62.17 ± 7.21)years.Among them,108 patients were>65 years old,with an average age and standard deviation of(69.01 ± 3.01),and 179 patients were ≤ 65 years old,with an average age and standard deviation of(58.07 ± 5.71).The degree of ischemic PSCI in patients aged>65 years was more severe than that in patients aged ≤65 years(P>0.05).The proportion of males with moderate and severe ischemic PSCI<65 years old was higher than that of females(P<0.05).2.The distribution of ischemic PSCI patients in TCM constitution was as follows:phlegm-dampness constitution 79 cases(27.5%)>blood stasis constitution 43 cases(15.0%)>qi deficiency constitution 42 cases(14.6%)>yang deficiency constitution 38 cases(13.2%)>damp-heat constitution 26 cases(9.1%)>gentleness constitution 21 cases(7.3%)>yin deficiency constitution 19 cases(6.6%)>qi stagnation constitution 15 cases(5.2%)>special constitution 4 cases(1.4%).3.Patients with mild,moderate and severe ischemic PSCI accounted for 68.3%,27.5%and 4.2%,respectively.In the analysis of the degree of ischemic PSCI and the distribution of TCM constitution,the constitution distribution types of patients with mild PSCI in ischemic stroke were mainly 42 cases(21.4%)of phlegm-dampness constitution>35 cases(17.9%)of qi deficiency constitution>32 cases(16.3%)of yang deficiency constitution>21 cases(10.7%)of blood stasis constitution.The constitution distribution types of patients with moderate PSCI in ischemic stroke were mainly 31 cases(39.2%)of phlegm-dampness constitution>20 cases(25.3%)of blood stasis constitution>6 cases(7.6%)of qi deficiency constitution=6 cases(7.6%)of damp-heat constitution.There were 6 cases(50%)of phlegm-dampness constitution in patients with severe PSCI of ischemic stroke.4.Analysis of different degrees of ischemic PSCI and related risk factors showed that ischemic PSCI patients with hypertension,diabetes,hyperuricemia,and hyperhomocysteinemia had more severe cognitive impairment(P>0.05).There was no difference between hyperlipidemia and different degrees of ischemic PSCI(P<0.05).The more severe ischemic PSCI occurred in the cortex and subcortex of the anterior circulation blood supply range.Conclusion1.Patients with ischemic PSCI who are over 65 years old have a higher incidence of ischemic PSCI.Men aged ≤65 years have a higher degree of ischemic PSCI.2.The 9 types of TCM constitution in patients with ischemic PSCI are mainly phlegm dampness,blood stasis,qi deficiency and yang deficiency.3.The main constitution types of patients with different degrees of ischemic PSCI are different:mild to phlegm dampness,qi deficiency,yang deficiency,blood stasis;moderate to phlegm dampness,blood stasis,qi deficiency,damp heat;severe mainly phlegm dampness.4.Hypertension,diabetes,hyperuricemia,hyperhomocysteinemia,and anterior circulation of stroke are risk factors for cognitive dysfunction in patients with ischemic PSCI.