Study On TCM Syndrome Characteristics Of Forgetting Mild Cognitive Impairment

BackgroundThe amnestic mild cognition impairment is the most common subcyte of mild cognition impairment. Undoubtedly, The studies on the syndromes of mild cognition impairment have achieved a lot over the past decades, but there are also many deficiencies. Through the combination of literature research and clinical research, we will study the characteristics of syndromes of the amnestic mild cognitive impairment, and provide scientific basis for clinical syndrome differentiation of amnestic mild cognitive impairment.ObjectiveBy exploring the characteristics of syndromes of amnestic mild cognitive impairment, the study will provide scientific basis for clinical syndrome differentiation of amnestic mild cognitive impairment.Method(1) Literature study retrieves 3 bibliographic databases including Chinese HowNet, Wanfang Data and VIP. Setting literature selection criteria and exclusion criteria, a total of 25 articles were included in the sudy. Symptoms, syndromes and syndrome elements will be extracted. The relationship between symptoms and syndrome elements will be studied. After standardizing terminology of symptoms, syndromes and syndrome elements, descriptive statistics method describes characteristics of them and hierarchical clustering method studies the relationship between symptoms and syndrome elements. (2) Descriptive statistics method describes characteristics of demographic data for clinical patients. Frequency dominance method screens symptoms. Factor analysis and system clustering extracts the syndrome elements. (3) Descriptive statistics method and Non parametric test describes characteristics of demographic data for clinical patients. Two Classification Logistic regression analyses the relationship between symptoms and disease, the relationship between symptoms and syndrome elements and the relationship between syndrome elements and disease.ResultModern literature research:(1) subjective symptoms (Frequency>5) include amnesia, coma, fatigue, addicted to lying, fatigue, insomnia, fatigue, insomnia, less gas, dizziness, headache, heavy head, tinnitus, deafness, lassitude of the loins and knees, limbs not warm, palpitations, chest tightness, loss of appetite, abdominal fullness, constipation; Objective symptoms (Frequency>5) include lips cyanosis, sallow complexion, loose stools, moss white, red tongue, greasy moss, pale red tongue, ecchymosis tongue, fat tongue, yellow moss, thin moss, thready pulse, taut pulse, fast pulse, deep pulse, slippery pulse, weak pulse, unsmooth pulse. (2) 24 types of syndrome(>1%):kidney essence deficiency (10.5%), turbid phlegm syndrome of orifices (10.5%), qi and blood deficiency syndrome (10.5%) and heat toxin flourishing syndrome (10.5%), the others are as follows:the viscera stagnation and turbid leaving certificate (8.9%), blood stasis in cerebral collaterals (8.9%), liver yang hyperactivity (6.5%), yin deficiency and yang hyperactivity (4.85%), phlegm (4.03%). (3) 15 syndrome elements.5 syndrome elements of disease location:kidney (29.89%), brain (27.59%), liver (13.79%), spleen (9.2%), heart (6.9%); 9 syndrome elements of disease type:qi deficiency (16.44%), the others followed by phlegm (11.84%), blood stasis (11.84%), blood deficiency (11.18%), yang hyperactivity (9.21%), essence deficiency (8.55%), heat (8.55%), yin deficiency (7.89%), xcess of Fu-organ (7.24%) and turbidity (7.24%). (4) The relationship between symptoms and syndrome elements:kidney:deafness, tinnitus, lassitude of the loins and knees, deep pulse; brain:amnesia, coma, dizziness, headache; heart palpitation, chest tightness, dreaminess; liver:dizziness, headache, tinnitus, string pulse; spleen:fatigue, weakness, cold limbs, sallow complexion, fat tongue, loss of appetite, loose stools; qi deficiency:less gas, fatigue, weakness, fatigue, weak pulse, thin fur, fat tongue; blood deficiency:sallow complexion, palpitation, dizziness, fine pulse; essence deficiency:deafness, tinnitus, lassitude of the loins and knees; yin deficiency:tinnitus, fine pulse; yang deficiency: cold limbs, loose stool, white fur; phlegm:addicted to lying, greasy fur, slippery pulse, fat tongue, heavy head, dizziness; constipation:abdominal fullness, greasy fur, loss of appetite; blood stasis:purple lips, ecchymosis tongue, astringent pulse; yang hyperactivity:dizziness, headache, tinnitus, string pulse; heat toxin; yellow fur,fast pulse, red tongue.Clinical research:(1) study on the distribution characteristics of syndrome elements:The total frequency of syndrome elements of disease location appeared 714 times. According to the frequency from high to low order are brain 165 times (23.1%); renal 165 times (23.1%); spleen 152 times (21.3%); heart 126 times (17.6%); liver 106 times (14.8%).The total frequency of syndrome elements of disease type appeared 1342 times. According to the frequency from high to low order are phlegm 166 times (12.4%); blood deficiency 160 times (11.9%); essence deficiency 158 times (11.8%); blood stasis 155 times (11.5%); heat toxin 145 times (10.8%); yin deficiency 137 times (10.2%); yang hyperactivity 127 times (9.5%); yang deficiency 127 times (9.5%); qi deficiency 123 times (9.2%); fu real 109 times (8.1%); qi stagnation 62 times (4.6%)(2) Study on the relationship among disease, syndrome element and symptom: Associated with amnestic mild cognitive impairment subjective symptoms include Chills, shortness of breath, anxiety, irritability, dizziness, tinnitus, acid and weight lower limb; Associated with amnestic mild cognitive impairment objective symptoms include phlegm, white sputum, weak lip, bad breath, purple eyelid, sallow complexion, limb tremor, pale nails, purple tongue, white fur, deep pulse, slow pulse, fast pulse, slippery pulse, empty pulse, string pulse. The relationship between syndrome factor and symptom:kidney:loss of teeth, lumbago, backache;brain:dizziness, headache; liver:irritability, anxiety, pain, tinnitus, string pulse; spleen:fatigue, fatigue, limbs cold, pale tongue, fat tongue; heart:upset, insomnia, palpitation; Qi deficiency:fatigue, shortness of breath; blood:vertigo, sallow complexion; essence deficiency:tinnitus, loss of teeth; yang deficiency:fear of cold, cold limbs, loose stool, hi hot drinks; yin deficiency:dry mouth, dry throat, tinnitus, dry eyes, vertigo; phlegm:cough, thick fur, greasy fur, slow, fat tongue, slippery pulse; blood stasis:petechia and ecchymosis, purple lips, dark tongue; heat toxin:yellow fur, dry mouth and bad breath; fu organ sthenia:dry mouth and bad breath, abdominal distension; yang hyperactivity:dizziness, headache, dizziness; qi stagnation:anxiety, depressed mood, indifferent expression. Syndrome elements associated with amnestic mild cognitive impairment include the kidney(P=0.028),the phlegm(P=0.010) and yin deficiency (P=0.004).ConclusionThe main syndromes in aMCI are kidney essence vacuity, deficiency of blood and qi and tu rbid phlegm blocking upper orifice.The main syndromes elements of disease location in aMCI are the brain and the kidney; The main syndrome elements of disease type in aMCI are phlegm turbidity, blood deficiency, blood stasis, essence deficiency and Yin deficiency.The relationship between syndrome elements and symptoms remains to be further studied.