Correlation Analysis Of TCM Syndromes Of Vascular Cognitive Impairment With MoCA Cognitive Domains And Risk Factors Based On Logistic Regression

Objective:To explore the correlation of cognitive domains and risk factors in TCM syndrome differentiation of vascular cognitive impairment(VCI).Methods:All patients with cerebrovascular disease who were admitted to the Affiliated Hospital of Nanjing University Of Chinese Medicine from May 2011 to October 2018 were collected by the cross-sectional study method.The patients were evaluated their cognitive function by the Montreal Cognitive Assessment(MoCA),the quantitative assessment of ischemia was performed by Hachinski Ischemic Score(HIS),the quantitative assessment of self-care ability was performed by Activities of Daily Living(ADL),and the quantitative assessment on the severity and diagnose of patient was performed by Clinical Dementia Rating(CDR)scale.According to National Institute of Neurological Disorders and Stroke and the Association Internationalepour la Recherche et l’ Enseignement en Neurosciences(NINDS-AIREN),patients with vascular cognitive impairment were selected according to the criteria,and those who met the inclusion criteria were included in the group.The patients were divided their syndrome differentiation of TCM by vascular dementia TCM syndrome differentiation scale(SDSVD),and the risk factors of patient were recorded through an epidemiological survey.EpiDate 3.02 software was used to establish a database,the questionnaire data was entered and organized,SPSS 22.0 software was used for statistical analysis,measurement data were performed by the normality test and variance homogeneity analysis,the consistency was performed by one-way-ANOVA analysis,the non-consistency was performed by Kruskal-Wallis H test,the counting data were performed by x2 tests;TCM syndrome differentiation was regarded as the dependent variable,MoCA various cognitive domains and risk factors were regarded as independent variables,it was analyzed by multinomial logistic regression.If P<0.05,it should be considered as the statistically significance.Results:1.Analysis of TCM Syndromes:the frequency of appearance on the syndromes is ranged in descending order as following:blood stasis obstructing the collaterals(53.8%)>phlegm turbidity and obstruction(45.2%)>kidney essence deficiency(44.6%)>stagnation turbidity of inside organs(21.2%)>Hyperactivity liver Yang(19.1%)>Qi and blood deficiency(15.3%).The frequency of single syndromes was 11.6%;only one combination of kidney essence deficiency+phlegm turbidity and obstruction+blood stasis obstructing the collaterals was found in this study(9.1%);no other syndrome could be seen;a total of 12 types were found in the combination of the two syndrome types,the most frequent of which are phlegm turbidity and obstruction+blood stasis obstructing the collaterals(12.4%),kidney essence deficiency+blood stasis obstructing the collaterals(9.9%),kidney essence deficiency+phlegm turbidity and obstruction(8.3%)and blood stasis obstructing the collaterals+Qi and blood deficiency(8.3%);2.Distribution characteristics on MOCA,HIS,ADL,and CDR of VCI TCM syndromes:the scores of kidney essence deficiency in MoCA and ADL scores were counted as 12.18±3.50 scores and 17.90±7.81 scores in order,which was the lowest score in groups(P<0.05);In the score of CDR,the kidney essence deficiency was the highest score as 1.85 ± 0.57 in groups(P<0.05),and the HIS scale score in the syndrome of blood stasis obstructing the collaterals was 14.59±1.91,which was the lowest in groups(P<0.05);3.Multivariate logistic regression results were shown that kidney essence deficiency syndrome was associated with visual space(P=0.001,OR=0.391),attention(P=0.001,OR=0.422),delayed recall(P=0.000,OR=0.421),and orientation(P=0.002,OR=0.432)and age(P=0.001,OR=1.109);the phlegm obstruction syndrome was associated with language ability(P=0.024,OR=0.511),delayed recall(P=0.000,OR=0.522),BMI(P=0.014,OR=1.230)and smoking(P=0.041,OR=3.574);the stagnant blood obstructing collaterals syndrome was associated with directional force(P=0.003,OR=0.501),BMI(P=0.016,OR=1.230),hypertension(P=0.000,OR=12.778),diabetes(P=0.003,OR=4.624)and smoking(P=0.005,OR=6.091);hyperactivity of liver Yang syndrome was associated with abstract ability(P=0.000,OR=0.065),delayed recall(P=0.017,OR=0.580),age(P=0.007,OR=1.110),hypertension(P=0.026,OR=4.652),smoking(P=0.001,OR=9.784)and sleep quality(P=0.015,OR=0.150);the retention and stagnation syndrome of viscera was associated with naming ability(P=0.014,OR=0.039)and attention(P=0.045,OR=0.232).Conclusions:There are different types of cognitive impairment and related risk factor characteristics in various TCM syndromes of VCI,which can provide a basis for early diagnosis and intervention of dementia.