Study Of Relevance Between TCM Syndromes With Phlegm,Constitution Types,ICAM-1and ApoE Gene Polymorphism Of AMCI

ObjectiveThis paper aims to amnestic mild cognitive impairment (aMCI) distribution of phlegmsyndromes，and the correlation between the syndrome types and type of constitution,neuropsychological indexes, laboratory indexes and ApoE gene polymorphism werediscussed to provide diagnostic basis for clinical diagnosis of aMCI and to preliminarilyreveal the modern pathophysiology of phlegm syndromes nature.MethodCollect376cases were recorded, TCM symptom scale, constitution of TCM scale,Mini-Mental State Examination (MMSE), clock drawing test (CDT), the Wechsler digitspan determination method of scoring, and blood routine, biochemical routine. In132aMCI patients record basic cognitive ability test scores. Selected81patients blood samplesfor leukocyte adhesion molecule (ICAM-1) detection and ApoE gene polymorphism.According to TCM symptom scale to judge each patient’s syndrome, and usingstatistical analysis method to analyze the correlation between the syndrome and constitutontypes, neuropsychological indexes, laboratory index and ApoE gene polymorphism.ResultSyndrome distribution:376cases of patients with aMCI syndrome were divided intofour types: syndrome of deficiency of both heart and spleen> syndrome of disharmonybetween heart and kidney> syndrome of deficiency of kidney yang> stagnation of liver Qi.Index of phlegm of deficiency of both heart and spleen syndrome group is significantlyhigher than other three,and that of the syndrome of deficiency of kidney yang issignificantly higher than that of liver qi stagnation group and syndrome of disharmonybetween heart and kidney (P<0.05).There is no significant difference between stagnation ofliver qi and syndrome of disharmony between heart and kidney.Physique type distribution and the relationship between physique type and phlegmsyndrome: liver qi stagnation see more Ping-he and Qi-xu type; syndrome of disharmony between heart and kidney see more Qi-xu and Shi-re;syndrome of deficiency of kidneyyang see more Q-xu and Yin-xu; syndrome of deficiency of both heart and spleen see moreQi-xu.The correlation between different syndrome types and neuropsychological indexes:MMSE score was negatively correlated with the syndrome of deficiency of both heartand spleen. The total score of MMSE of four groups:kidney yang deficiency>Liver qistagnation>disharmony between the heart and kidney> deficiency of both heart and spleen.In the directional and language between the four groups had no significant differences. Inlearning and memory: there were no significant difference between the immediate memory.In the calculation and attention, deficiency of both heart and spleen group was significantlylower than that in the other three groups. and the kidney yang deficiency syndrome groupwas significantly higher than the disharmony between heart and kidney.In delayed recallkidney-yang deficiency syndrome group and Liver qi stagnation group obviously strong inthe heart and spleen deficiency syndrome group.The "basic cognitive ability scale"scores: Qi stagnation has a negative correlation withperceptual speed; the heart and spleen deficiency syndrome there was a negative correlationwith efficiency of representation space; the deficiency of kidney yang has a negativecorrelation with memory recognition.The clock drawing test and syndrome: there is a significant negative correlationbetween the syndrome of disharmony between heart and kidney and heart and spleendeficiency syndrome.There is no difference between all types about Wechsler digit spantest score.Relationship between syndromes and laboratory indexes of aMCI:1.there was nosignificant correlation between aMCI syndrome and indexes of routine blood test;2.therewas no significant correlation between aMCI syndrome and biochemical routine indexes.The difference of expression of leukocyte adhesion molecule rate between varioussyndrome types of aMCI: ICAM-1of deficiency of both heart and spleen was significantlyhigher than that of disharmony between the heart and kidney (P<0.05), and higher than the stagnation of Liver-qi (P<0.01).No significant difference was found on ApoE gene frequency between the phlegmsyndrome groups and the control group, and each group of alleles ε2, ε4compared with thecontrol group with significant difference (p<0.01),while ε3no difference(p>0.05).Thisdenotes allele ε4is associated with phlegm syndromes of aMCI.There is no significantdifference between the syndrome groups on allele ε4.ConclusionThere are some relationships between syndrome and phlegm syndrome score andconstitution type,and there is some relationship between psychological indexes andsyndrome type of aMCI. Leukocyte adhesion molecule expression may contribute to thedisease and syndrome type judgment. Related syndromes of phlegm evil of aMCI mayoccur when ApoE ε4allele exist.This research lay the foundation for further study of thisdisease on combining Chinese and Western medicine treatment.