Clinical Study Of Jiannao Decoction On The Syndrome Of Spleen And Kidney Deficiency Of Mild Cognitive Impairement After Lacunar Infarction

Objective:To explore the clinical efficacy evaluation of Jiannao Decoction in the treatment of Mild Cognitive Impairment(MCI)after lacunar infarction,which is a syndrome of spleen and kidney deficiency,summarize the clinical experience of Professor Liu Shichang,and expand the scope of clinical application of Jiannao Decoction.It provides a new way of differentiation and treatment for cognitive dysfunction after lacunar infarction.Methods:Collected patients with lacunar infarction diagnosed by menstrual imaging from October 2020 to March 2021 in the outpatient and inpatient department of the First Affiliated Hospital of Guangzhou University of TCM.The CDR scale and GDS scale were collected within 6 months of onset.Combined with(or)Mo CA scores to evaluate the diagnosis as mild cognitive impairment,according to the random number table,they were divided into control group and experimental group with 32 cases.Before treatment,the two groups of patients were evaluated by MMSE scores,Mo CA scores,SES-9 scores,and the amplitude and latency of event-related potential P300 were detected.After 3 weeks of treatment,the MMSE scores,Mo CA scores,SES-9 scores,the amplitude and latency of P300 in the two groups were retested.The data were collected for statistical analysis.Results:Before treatment,there was no significant difference between the two groups of patients in gender,age,course of disease,education level,first symptoms,location and number of imaging lesions,risk factors and other baselines(P>0.05).The MMSE scores,Mo CA scores and the amplitude and latency of P300 before and after treatment were significantly different between the two groups(P<0.01);there were significant differences in SES-9 scores in the experimental group before and after treatment(P <0.01),the control group was not statistically significant(P>0.05).In comparison between the groups,there were no significant differences in the SES-9 scores,MMSE scores,Mo CA scores,and the amplitude and latency of P300 between the two groups before treatment(P>0.05).After treatment,the SES-9 scores,MMSE scores,Mo CA scores,and the amplitude and latency of P300 were significantly different(P<0.01);based on the scores of the sub-items of the Mo CA scale,compared with the control group,the experimental group has a significant difference in the improvement of visual space execution ability(P<0.01),the improvement in abstraction and memory capabilities were statistically significant(P<0.05).In terms of the efficacy of TCM,the total effective rate of the experimental group was 53.13%,which was higher than the total effective rate of 12.50% in the control group,with a significant difference(P<0.01).In the Pearson correlation analysis,before treatment,the P300 latency was moderately negatively correlated with the MMSE scores,and was highly negatively correlated with the Mo CA scores,the differences were statistically significant(P<0.01);the P300 amplitude was low-positively correlated with MMSE scores,the difference was statistically significant(P<0.05).There was no significant correlation between P300 amplitude with the Mo CA scores(P>0.05).P300 latency and amplitude were not significantly correlated with SES-9 scores(P>0.05).After treatment,the P300 latency was moderately negatively correlated with the MMSE scores and extremely highly negatively correlated with the Mo CA scores,the differences were statistically significant(P<0.01).There was no significant correlation between the P300 latency with the SES-9 scores(P>0.05).P300 amplitude was moderately positively correlated with the MMSE scores and the Mo CA scores,the differences were statistically significant(P<0.01).P300 amplitude was low-negatively correlated with SES-9 scores,the difference was statistically significant(P<0.05).Conclusion:By comparing the conventional treatment of neurology,Jiannao Decoction has the effect of invigorating the spleen Qi,nourishing the kidney Jing,and has definite therapeutic effect and high safety in the treatmeny of mild cognitive impairment after lacunar infarction;especially in improving TCM syndromes,enhancing visual space execution ability,abstraction and memory capabilities.The P300 latency has a relatively stable correlation with MMSE and Mo CA scale scores.The P300 latency can be used as a reference index for clinical evaluation of MCI after lacunar infarction.