Study On The Characteristics Of Cognitive Impairment Caused By Carotid Artery Stenosis And Its Correlation With TCM Constitution

Object ive: To explore the clinical features of VCIled by CAS,and observe and analyze the relevance of the patients with different degrees of CAS cognitive impairment with TCM constitution.It provides a new idea for the early prevention and treatment of CAS cognitive impairment.Method : Ninety patients with CAS cognitive impairment admitted to the Department of Encephalopathy,the Second Affiliated Hospital of Shandong University of Chinese Medicine from December 1,2021 to January 1,2023 were selected as the observation group,based on the results of cervical angiography and head and neck angiography(CTA results were used when there was a big difference between the results of cervical angiography and head and neck CTA).According to NASCET’s classification criteria for CAS,the observation group was divided into mild group(n=28),moderate group(n=35),severe group(n=27),and the control group was 60 normal people who had no CAS confirmed by physical examination in our hospital during the same period.Neuropsychological evaluation was performed on the included cases,and the overall cognitive ability was assessed by Mo CA scale.Furthermore,the four core cognitive domains of visual space,attention/ executive function,memory and language were reevaluated by using the detailed scale,and the relationship between CAS and VCI was discussed.The TCM Constitution Evaluation Table was used to evaluate 9 types of constitution,and the distribution and characteristics of TCM constitution of patients with different degrees of CAS were discussed.Results : 1.Compared with the control group: 1)The mild group had statistically significant differences in Mo CA score and memory(long-term memory assessment);2)The moderate group had statistically significant differences in Mo CA total score,memory(immediate memory,delayed recognition,long-term memory evaluation),attention and executive power(TPT-A time,TPT-B time,TPT-B error evaluation),and executive power(CDT evaluation)scores;3)The severe group had statistically significant differences in total score of Mo CA,memory(immediate memory,delayed recognition,long-term memory evaluation),attention and executive ability(TPT-A time,TPT-A errors,TPT-B time,TPT-B errors evaluation),language function(BNT-2 evaluation)and executive ability(CDT evaluation).2.Compared with the mild group: 1)the moderate group had no statistically significant differences in memory(long-term memory assessment),attention and executive ability(TPT-A time and TPT-A errors assessment),and language function(BNT-2 assessment),but had statistically significant differences in other test scores;2)Mo CA total score,memory(immediate memory,delayed recognition,long-term memory evaluation),attention and executive ability(TPT-A time,TPT-A errors,TPT-B time,TPT-B errors evaluation),language function(BNT-2 evaluation),executive ability(CDT evaluation)were statistically significant in the severe group.3.Compared with the moderate group,The severe group had statistically significant differences in Mo CA total score,memory(immediate memory,delayed recognition,long-term memory evaluation),attention and executive ability(TPT-A time,TPT-A errors,TPT-B time,TPT-B errors evaluation),language function(BNT-2 evaluation)and executive ability(CDT evaluation).4.There were statistically significant differences between the control group and the observation group in the distribution of peace quality,bias quality and physical bias.The control group was dominated by peace quality,while the observation group was dominated by bias quality.In the distribution of biased constitution,Qi deficiency and Yang deficiency were dominant in the control group,while blood stasis and phlegm-dampness were dominant in the observation group.5.There was no significant difference in the distribution of biased constitution between moderate and severe groups.Compared with the mild group,there were statistical differences in the distribution of biased constitution between the moderate group and the recombination group,among which the moderate group and the severe group were dominated by blood stasis and phlegm-dampness,while the mild group was dominated by qi deficiency and Yang deficiency.Conclus ions : 1.CAS can impair multiple cognitive domains,resulting in mild stenosis(< 3 0 %)the impairment of cognitive function was mainly in long-term memory;Moderate stenosis(30%-69%)mainly showed impairment of memory,attention and executive ability,visuospatial ability,and no significant decline in language function.Severe stenosis(70%-99%)showed extensive cognitive impairment,especially in memory and executive function.Both short-term and long-term memory functions were affected.2.Compared with the control group,CAS patients generally had physical bias,mainly characterized by blood stasis,phlegm-dampness,qi deficiency and Yang deficiency.The mild group mainly had qi deficiency and Yang deficiency,while the moderate and severe patients mainly had blood stasis and phlegm-dampness.