Study On TCM Syndrome Characteristics And Low Frequency Amplitude Of BOLD-fMRI In Patients With Type 2 Diabetes Mellitus With Cognitive Impairment

[Objective]This study aims to explore the characteristics of TCM syndromes in patients with Type 2 Diabetes Mellitus(T2DM)combined with Cognitive Impairment(CI),and to provide a reference for clinical diagnosis and treatment of TCM.Use resting state BOLD-fMRI technology to detect and analyze the brain areas of patients with T2DM and CI,and combine with the cognitive function scale to find the diseased brain areas and impaired cognitive functions of patients with T2DM and CI,and to explore the function The value of sex MRI in the evaluation of this disease provides objective evidence for clinical diagnosis.[Methods]In this study,165 T2DM patients were enrolled from the inpatients of the Department of Endocrinology,Dongfang Hospital,Beijing University of Traditional Chinese Medicine.The MOCA scale,MMSE scale,and other mental cognitive status evaluation scales were used to evaluate the cognitive status of patients and their Grouping,T2DM patients without CI are in the T2DM-N group,with a total of 83 people,and T2DM patients with CI in the T2DM-CI group,with a total of 82 people.The patients in the T2DM-CI group are divided into the T2DM-CI group based on the score of the MOCA scale In the three degree cognitive impairment groups,mild,moderate,and severe,all patients were collected with information on general conditions,four-diagnostics of traditional Chinese medicine,and laboratory objective indicators.Sixteen patients were selected in the T2DM-N group and 26 patients in the T2DMCI group.After ensuring that the baseline levels of the two groups of patients were consistent in general conditions and laboratory safety indicators,the two groups were subject to resting blood oxygen level dependence.Functional magnetic resonance imaging(Blood Oxygen Level Dependent Functional Magnetic Resonance Imaging,BOLD-fMRI)low-frequency amplitude(The Amplitude of Low-frequency Fluctuations,ALFF)examination,collect brain area images and use the imaging statistical software Statistical Parametric Mapping(SPM)to The ALFF values of the two groups of patients were significantly different in brain regions for analysis and processing.Establish a basic database,use SPSS 22.0 to process clinical data,and use factor analysis to summarize the characteristics of TCM syndromes.[Results]1.The general condition of patients in the T2DM-N group and T2DM-CI group.Results:The age of patients in the T2DM-CI group is significantly higher than that of the T2DM-N group,and the years of education and education are significantly lower than those in the T2DMN group,combined with hypertension and coronary heart disease.The number of people was significantly higher than that of the T2DM-N group,the number of people with fatty liver was significantly lower than that of the T2DM-N group,the number of people with lacunar infarction and peripheral neuropathy was higher than that of the T2DM-N group,and the BMI and diastolic blood pressure were lower than those of T2DM-N groups.There were no significant differences between the two groups in terms of gender,history of tobacco and alcohol,family history,diabetic nephropathy,diabetic retinopathy,hyperlipidemia,heart rate and systolic blood pressure.2.Laboratory index results of patients in T2DM-N group and T2DM-CI group:There was no significant difference in the laboratory tests of blood glucose and blood lipids of the two groups of patients.3.Results of risk factors of T2DM complicated with CI:T2DM complicated with CI is related to the length of education and HbA1 c level.The length of education is a negative factor,and HbAlc is a positive factor.4.General conditions and laboratory results of patients with different degrees of cognitive impairment:There is no significant difference in general conditions and laboratory indicators in patients with mild,moderate,and severe CI,but in terms of gender distribution,patients with severe CI are all female,suggesting females It may be a susceptible group of T2DM with CI.5.TCM syndrome characteristics analysis results:the main syndromes of the T2DM-CI group are qi deficiency and blood stasis,followed by yin deficiency,the disease is mainly in the kidneys,mind(brain),and the heart and spleen are also involved.The main symptom of the T2DM-N group is yin deficiency,followed by fire and qi deficiency.The disease is mainly in the liver and spleen,and it also affects the stomach,gallbladder,large intestine,kidney,heart and mind.(Brain),heart.6.Results of correlation between cognitive function scores and TCM syndrome types:cognitive function scores are correlated with blood stasis brain pulse syndrome and heart pulse stasis syndrome,the lower the cognitive function score,the occurrence of blood stasis brain pulse syndrome and heart pulse stasis The higher the probability of blocking.7.Cognitive function and BOLD-fMRI results:The two groups of patients included in the NMR study had no difference in general conditions and laboratory safety indicators,and the baseline levels were matched.In the CI-B group,the BOLD-fMRI low-frequency amplitude ALFF value in the resting state of the bilateral posterior cerebellar,inferior frontal gyrus,and inferior temporal gyrus were significantly lower than those in the NB group.The NB group and the CI-B group There are significant differences in the language,memory,naming,abstraction,spatial execution,and directional cognitive scores of the patients in the problem brain area.The cognitive scores of the CI-B group are significantly lower than those of the NB group.[Conclusion]1.Patients with T2DM combined with CI have Qi deficiency and blood stasis as their main syndromes.The disease is mainly in the kidneys,heart and mind(brain),and also involves the heart and spleen.The disease is mainly a mixture of deficiency and excess,and blood stasis is the process of disease.Important pathological products are also important pathological factors.2.The main damaged brain areas in patients with T2DM and CI are bilateral posterior cerebellum,inferior frontal gyrus and inferior temporal gyrus.The impairment of cognitive ability involves language,memory,naming,abstraction,spatial execution and orientation.