Analysis Of Risk Factors And TCM Syndrome Elements Of Post-ICU Syndrome Cognitive Impairment

Objective:By discussing the risk factors of cognitive impairment in patients with post-ICU syndrome and the distribution of TCM disease location and disease elements,it provides a theoretical basis for clinical medical staff to take intervention measures to prevent and reduce the occurrence of cognitive impairment in ICU survivors.Enrich the understanding of traditional Chinese medicine on post-ICU syndrome cognitive impairment.Methods:Selected 139 adult patients who were admitted to the ICU for more than 24 hours and had clear consciousness from September 2022 to March 2023 in Guang’anmen Hospital of China Academy of Chinese Medical Sciences,and recorded the demographics,diseases,treatment,and TCM information of the patients after signing the informed consent form.The relevant data and the cognitive function 7 days after being transferred out of the ICU.According to the cognitive score 7 days after being transferred out of the ICU,they were divided into cognitive impairment group and non-cognitive impairment group.The database was established through excel,and SPSS29.0 statistical software was used to process the data,and frequency statistics,chi-square test,Logistic regression analysis and other methods were used.The risk factors of cognitive impairment and the distribution of TCM syndrome elements were analyzed.Results:1 Post-ICU syndrome cognitive impairment in patients:A total of 139 patients were included in this study,71 patients had cognitive impairment,and the incidence of cognitive impairment was 51.1%.Univariate analysis of post-ICU cognitive impairment in patients with post-ICU syndrome:whether drinking alcohol,ICU length of stay,sepsis,after various surgical operations,use of sedative and analgesic drugs,delirium,and use of restraint belts had statistically significant differences(P<0.05),while gender,age,marital status,occupation,smoking,education level,other ICU diagnosis:(acute respiratory disease,acute heart disease,gastrointestinal disease,diabetes with severe complications,severe kidney disease,moderate severe liver disease,malignant tumor),and mechanical ventilation,there was no statistically significant difference(P>0.05);2 Analysis of risk factors for post-ICU syndrome cognitive impairment in patients;multivariate Logistic regression analysis showed that post-ICU syndrome cognitive impairment was statistically correlated with ICU length of stay,after various surgical operations,and restraint belt(physical restraint)factors learning meaning.ICU length of stay(OR=2.744,95%CI:1.172-6.428),after various surgical operations(OR=3.424,95%CI:1.192-9.836),restraint belt(body restraint)(OR=3.227,95%CI:1.372-7.590)ICU length of stay,after various surgical operations,restraint belt(body restraint)may be risk factors for post-ICU syndrome cognitive impairment.3 The total frequency of disease location syndrome elements in PICS-CI from high to low is as follows:lung 44 times(62.0%),mind(brain)39 times(55.0%),spleen 22 times(31.0%),heart 13 times(18.3%),kidney 7(9.9%),stomach 6(8.5%),bladder 5(7.0%),liver 3(4.2%),gallbladder 2(2.8%)and skin 1(1.4%)%).The proportion of patients with lung and mind(brain)occurrences is more than half.Except for the lung,the severity(grade 2 or 3)of other disease locations was less frequent.The total frequency of disease syndrome elements from high to low is qi deficiency 35 times(49.3%),heat 30 times(42.3%),yin deficiency 18 times(25.4%),phlegm 13 times(18.3%),water stagnation 8 times times(11.3%),yang deficiency 8 times(11.3%),wetness 8 times(11.3%),blood deficiency 4 times(5.6%),drink 4 times(5.6%),qi stagnation 4 times(5.6%),cold 3 times(4.2%),blood stasis 3 times(4.2%)and poison 2 times(2.8%).Among them,qi deficiency,heat,phlegm,stagnation of water,and stagnation of qi all appeared in a relatively serious degree(grade 3),while the frequency of occurrence of other disease syndrome elements(grade 2 or 3)was relatively low.In the distribution of disease syndrome elements,qi deficiency is the most,and other deficiency syndrome elements also account for a large proportion.The result of excess syndrome elements shows that the frequency of heat,phlegm,water retention,and dampness is relatively high,which are closely related to the disease.However,the occurrence frequency of solid diseases is quite different from that of deficiency syndromes.Combining with the clinical comprehensive view,PICS-CI is mostly deficiency syndromes,or syndromes of deficiency in origin and excess in excess(mixed with excess and deficiency).4 The common syndrome types of PICS-CI are syndrome of deficiency of origin(deficiency of heart and spleen,lack of nourishment of mind and spirit),syndrome of deficiency of origin and excess of superficial syndrome(phlegm-heat obstructing lung,disturbing mind).Conclusion:1 Studies have shown that alcohol consumption,ICU length of stay,sepsis,after various surgical operations,use of sedative and analgesic drugs,delirium,and use of restraint belts are related to the occurrence of PICS-CI in patients.The incidence rate of PICS-CI is 51.1%;2 ICU length of stay,after various surgical operations,restraint belt(body restraint)may be risk factors for post-ICU syndrome cognitive impairment3 The distribution of syndrome elements in PICS-CI is mainly lung,followed by mind(brain),spleen,heart,kidney,stomach,bladder,liver,gallbladder,and skin.The proportion of patients with lung and mind(brain)occurrences is more than half.The frequency of severe(grade 2 or 3)lesions in the lungs is high.The disease distribution is mainly based on qi deficiency,followed by heat,yin deficiency,phlegm,water retention,yang deficiency,dampness,blood deficiency,drinking,stagnation of qi,cold,blood stasis,and poison.Among them,qi deficiency,heat,phlegm,stagnation of water,and stagnation of qi all appeared in a relatively serious degree(grade 3),while the frequency of occurrence of other disease syndrome elements(grade 2 or 3)was relatively low.In the distribution of deficiency syndrome elements,qi deficiency is the most,and other deficiency syndrome elements also account for a large proportion,while the frequency of solid syndrome is much higher than that of deficiency syndrome elements.Combining with clinical comprehensive view,PICS-CI is mostly deficiency syndrome,or the evidence of falsehood and superficiality(mixture of virtuality and reality).4 The common syndrome types of PICS-CI are syndrome of deficiency of origin(deficiency of heart and spleen,lack of nourishment of mind and spirit),syndrome of deficiency of origin and excess of superficial syndrome(phlegm-heat obstructing lung,disturbing mind).