Correlation Between Cognition, Imaging And Syndrome Factors In Cerebral Small Vessel Disease And Intervention Study Of Xuesetong Soft Capsul

Research Background:With the accelerated aging of Chinese society and the development of imaging technology,the early detection rate of small cerebrovascular disease has gradually increased.More and more studies have found that it is closely related to the progress of stroke,dementia,Parkinson’s disease and other serious neurological diseases,causing latent damage to patients’ cognitive function and quality of life.Therefore,individualized syndrome differentiation and early intervention are needed.Research objectives:In this study,cerebral small vessel disease(CSVD)patients were analyzed in cerebral small vessel disease patients with cerebral small vessel disease by cross-sectional comparison.The effects of Xuesaitong soft capsule on cognitive function,image manifestation and TCM syndrome elements of patients with cognitive impairment related to cerebral small vascular disease were discussed through the experimental method of before and after control.Research methods:From January 2022 to February 2023,general data collection,cognitive function assessment,head MRI examination and TCM syndrome factor score were conducted among the patients with small cerebral vascular disease admitted to the third Department of Encephalopathy,Dongzhimen Hospital of Beijing University of Chinese Medicine.A total of 100 patients with CSVD were included.Among them,41 patients with cognitive impairment received 24 weeks of traditional Chinese medicine Xuesaitong intervention,and a total of 30 patients finally completed the intervention.This study has been approved by the Medical Ethics Committee of Dongzhimen Hospital of Beijing University of Chinese Medicine.The collected data were input into Excel to establish a database,and SPSS25.0 was used for statistical analysis.P<0.05 was considered statistically significant.Research results:1 The comparison of age,overall cognitive level,and distribution of cognitive impairment field among different MRI total burden groups showed that the average age of mild and moderate MRI load group was lower than that of severe MRI total burden group(P=0.005).The incidence of cognitive impairment in the severe MRI total burden group was higher than that in the mild and moderate MRI total burden groups(P=0.000).The occurrence rate of delayed recall impairment in heavy MRI total burden group was higher(P=0.027).Patients with DST≤10 scores and TMT-A≥80s in the mild load group were significantly less than those in the severe load group(P=0.037,P=0.017),suggesting that severe nuclear magnetic load may impair the attention function of patients.Patients with mild load had fewer TMT-B≥200s than those with moderate and severe load(P=0.032),indicating that low nuclear magnetic load was associated with executive function retention.2.Comparison of the distribution of cognitive impairment between normal cognitive(NC)group and cognitive impairment(CI)group showed that:The incidence of AVLT-N5 ≤4 points,SDMT ≤21 points,DST ≤10 points and VFT≤30 points in CI group were higher than those in NC group(P=0.036,P=0.027,P=0.006,P=0.019).These results indicate that the cognitive impairment associated with small cerebral vascular disease is more likely to affect the long delayed memory,attention and speech.The results of SCWT comparison showed that CI group had higher times than NC group,and the correct number of C cards was lower than NC group(P=0.005,P=0.017,P=0.012,P=0.001).The time consuming/correct number of the three cards in CI group was higher than that in NC group(P=0.006,P=0.015,P=0.004),indicating that the executive function impairment in CI group was more serious than that in NC group.SIE time consuming,SIE correct number and SIE third correct number decline rate in CI group were higher than those in NC group(P=0.05,P=0.002,P=0.002),indicating that CI group had worse anti-interference ability than NC group.3.The distribution comparison of syndrome elements in different groups of gender,nuclear magnetic load and overall cognitive level showed that Qi-deficiency occurred more frequently in females than in males(P=0.002).The occurrence rate of blood stasis in severe nuclear magnetic load group was higher than that in mild to moderate load group(P=0.041).The occurrence rate of phlegm and dampness in severe load group was higher than that in moderate load group(P=0.044).The incidence of qi deficiency in mild load group was higher than that in moderate and severe load group(P=0.005).The incidence of blood stasis and internal fire in CI group was higher than that in NC group(P=0.000,P=0.028).The frequency of blood stasis syndrome in patients with AVLT-N5 ≤ 4 was higher than that in patients with normal scores(P=0.002).4 Comparison of imaging grading,cognitive assessment score and syndrome element score of CSVD-CI patients before and after Xuesaitong treatment showed that there was no significant difference in imaging findings before and after treatment.MMSE score after treatment was higher than that before treatment(P=0.013).The TMT-B time after treatment was less than that before treatment(P=0.043).After treatment,the time of card A and card B of Stroop color word test decreased compared with that before treatment(P=0.007,P=0.018).The integrals of blood stasis and phlegm-dampness syndrome were lower than those before treatment(P=0.035,P=0.012).Conclusion:1 Advanced age is associated with high nuclear magnetic load and cognitive impairment in CSVD patients.Qi-deficiency is more common in women than in men with CSVD.2 The cognitive impairment related to small cerebral vascular disease is more likely to involve executive,attention,memory and speech ability,and the incidence of blood stasis and internal fire is higher in the cognitive impairment group.3 High total nuclear magnetic load is an important factor leading to cognitive dysfunction in CSVD patients,especially the impairment of executive function,attention and memory.The occurrence rate of phlegm,dampness and blood stasis was higher in the severe load group,and the occurrence frequency of Qi deficiency was higher in the mild load group.4 Xuesaitong Soft capsule can improve the overall cognitive function and executive function of CSVD-CI patients,but has no significant changes in lacunar cerebral infarction,white matter high signal,brain atrophy and other imaging findings.