Clinical Study Of TCM Syndromes Distribution In VCI Patients And Mechanism Of Naosuikang Treatment

ObjectiveThis study will focus on " Phlegm,Deficiency,Blood stasis”to explore the distribution of TCM syndromes in patients with vascular cognitive impairment(VCI)and effects of age,different vascular risk factors and cerebrovascular disease on the distribution of TCM syndromes.The effect and mechanism of Naosuikang capsule on learning,memory and activity of tMCAo mice were explored in the experimental research.MethodsClinical study:332 VCI patients in five Chinese hospitals in Guangdong from December 2016 to January 2019 are incorporated into the study.Through the collection of general data,the score of SDSVD,vascular risk factors,cerebrovascular history and other data,the method of Logistic regression analysis was used to explore the relationship between different vascular factors and the distribution of TCM syndromes in VCI patients.Experimental research:The modeling method of mice in the VCI model used the tMCAo method,and a week of drug treatment after surgery,each group of mice evaluated their learning memory and activity through fear conditioning test and rota-rod test,immunofluorescent staining of TNF a and microglia in the hippocampus CA1 region of the brain,the ELISA kit measure the levels of IL-6 and IL-10 in mice serum,and recorded spiking frequency by in vivo multi-channel recording.ResultsClinical study:The distribution frequency of TCM syndromes in VCI patients from high to low in order:kidney-jing deficiency,phlegm obstruction,qi and blood deficiency,Blood stasis syndrome.Older than 60 years of age has a higher risk of kidney-jing deficiency in VCI patients(OR=2.418,95%CI=1.289,4.536).VCI patients have a higher risk of phlegm syndrome in combined smoking history(OR=2.153,95%CI=1.013,4.578),patients combined with hyperlipidemia have a lower risk of qi and blood deficiency than patients without hyperlipidemia(OR=0.611,95%CI=0.379,0.984),with combined cerebral infarction have a higher risk of Blood stasis syndrome(OR=2.362,95%CI=1.355,4.119)and kidney-jing deficiency(OR=1.407,95%CI=1.020,1.951).Experimental research:Mice in the high dose group of Naosuikang can better distinguish fear and safety signals;the motor ability improved significantly in the residual drug-taking group except control group.The level of TNF a in the high dose group of Naosuikang was significantly lower than that of control group and nimodipine group,microglia and the level of IL-6 were significantly lower than nimodipine group;the level of IL-10 were significantly higher than nimodipine group;the high concentration group of Naosuikang and nimodipine group can improve the firing rate with considerable effect.ConclusionClinical study:The TCM syndromes in VCI patients was the most common in the distribution of kidney-jing deficiency,and its age,vascular risk factors,cerebrovascular disease affected the patient’s TCM syndromes.VCI-related vascular risk factors have good predictive and analytical value for the patient’s TCM syndromes.Experimental research:The effect of Naosuikang on improving learning memory and activity in tMCAo mice is remarkable,and the mechanism of this drug on nerve protection may be related to controlling immune cell expression,inhibiting inflammatory response and promoting neuronal action potential.