Cognitive Function And TCM Syndromes In Middle-Aged And Elderly Patients With Hypertension And Diabetes

Objective: To study cognitive function and related risk factors in middleaged and elderly patients with hypertension complicated with diabetes mellitus(DH),and to provide evidence for early clinical intervention of cognitive dysfunction(MCI).The distribution characteristics of TCM syndromes in middle-aged and elderly patients with DH were analyzed to provide ideas for syndrome differentiation and symptom improvement.Methods: A total of 122 middle-aged and elderly DH patients who met the inclusion criteria were selected from the Department of Cardiology and Endocrinology in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine as data sources.With the consent of the patients,scores of the Daily Living Ability Scale(ADL)and Montreal Cognitive Assessment Scale(MoCA)were performed,and the patients were grouped according to the scores of the MoCA scale.General data,relevant laboratory data,TCM syndromes and other clinical information were collected.Excel 2021 and SPSS 26.0 were used to analyze the general data,laboratory data and TCM syndrome composition ratio of the two groups of patients,and to summarize the TCM syndrome distribution of middle-aged and elderly patients with DH.Results: 1.General data characteristics: A total of 122 effective cases were included in this study,including 69 cases in the cognitive dysfunction group and 53 cases in the normal cognitive function group.There were significant differences in age,sex,years of education,body mass index(BMI)and ADL score between the two groups(P<0.05).2.Clinical data characteristics:(1)The longer the course of hypertension and diabetes,the higher the incidence of MCI.(2)There were significant differences in triglyceride,total cholesterol and low density lipoprotein levels between the two groups(P < 0.05),high density lipoprotein,glycosylated hemoglobin,serum creatinine and serum uric acid had no significant statistical significance(P>0.05).3.Impaired cognitive function: MCI patients had different degrees of impairment in various cognitive domains on the MOCA scale,and the two groups of patients had significant differences in visual space and executive ability,naming,attention,abstraction,delayed recall,and language scores(P<0.05),no significant difference in orientation(P>0.05).4.MCI group syndrome type distribution: The incidence of renal essence deficiency syndrome,Qi and blood deficiency syndrome MCI in middle-aged and elderly DH patients was compared with other syndrome types,and the difference was statistically significant(P<0.05).5.Syndrome distribution: There were 67 cases of both syndrome types in middle-aged and elderly patients with DH,and 55 cases of single and independent syndrome.The total frequency of syndrome of blood stasis blocking collagals was the most,followed by syndrome of phlegm turbidness and deficiency of kidney essence.The most common tongue image was red(47.5%),thin white(24.6%),and the most common pulse image was thin pulse(13.1%).The top 5 symptoms were fatigue(77.9%),dizziness(74.6%),dry mouth(56.6%),exhaustion and amnesia(53.3%),blurred vision(48.4%).Conclusion: 1.Age is an irreversible factor in DH patients with MCI.Course of disease,BMI index and education level are independent risk factors.The prevalence of MCI is higher in women than in men.2.The impairment of cognitive function in DH patients is correlated with blood lipid levels.The higher the level of blood lipid,the more severe the impairment of cognitive function.3.Middle-aged and elderly patients with DH and MCI have significantly impaired cognitive function in visuospatial and executive function,naming,attention,abstraction,delayed recall,and language.4.MCI is more likely to occur in middle-aged and elderly patients with DH syndrome of deficiency of kidney essence and deficiency of Qi and blood.5.Middle-aged and elderly patients with DH often witness the deficiency of kidney essence,phlegm turbidness,blood stasis blocking collaterals.