TCM Syndrome Research And Clinical Research On Chronic Cerebral Insufficiency Associated With Intracranial Artery Stenosis

CCCI is a clinical common disease,because its underlying disease name in the World Health Organization-related documents and the classification of cerebrovascular diseases has been canceled,diagnosis of this disease is low,and clinical attention is less,but its incidence is high.CCCI is the important process of stroke,vascular dementia,Alzheimer's disease and other major cerebrovascular disease occurs,its diagnosis and treatment can be effective in preventing and delaying major cerebrovascular events.The name and diagnostic criteria of CCCI is not recognized by the international and domestic stage,and treatment of modern medicine has no really effective way,but the treatment of Chinese medicine for this disease has a better therapeutic effect in its multi-target and multi-channel.From the relevant literature and clinical studies of chronic cerebral circulation insufficiency,this study discusses the distribution of TCM syndromes of chronic cerebral circulation insufficiency and clinical efficacy of medical treatment,so as to explore new ideas for the treatment of chronic cerebral circulation insufficiency,and specify the direction for the prevention and treatment of Chinese medicine to CCCI,to delay and prevent the occurrence of major cerebrovascular diseases.Section 1:A study of Chinese medicine syndromes of chronic cerebral circulation insufficiency about modern literatureObjective:Searching literature about CCCI,then extract relevant information to analyze the syndromes distribution of chronic cerebral circulation insufficiency.Methods:Retrieve literature about CCCI syndromes learning in Chinese Journal Full-text Database(CNKI)January 2000-December 2013,summarize the clinical characterized symptoms,syndrome elements,syndrome types and other information related to chronic cerebral circulation insufficiency to conduct entry and analysis.Results:(1)GENERAL INFORMATION:met the inclusion criteria were screened out literature 26,included patients with 2,452 cases,14 syndromes types,16 syndrome elements and 515 characterized symptoms are summarized.(2)Analysis of characterized symptoms:in 515 symptoms,there are 320 general characterized symptoms,of which 11 common characterized symptoms appear in the literature frequency more than 25%,including dizziness,headache,insomnia,tinnitus,forgetfulness,soreness and weakness of waist and knees,fatigue,chest tightness,heavy head,weary,dreams.There are 83 pulse symptoms,in which veinlets,taut pulse,deep pulse have the highest frequency.Tongue characterized symptoms of 112,of which the common tongue color is pale tongue,red tongue,the most common tongue fur include thin fur,white fur and yellow fur.(3)Analysis of syndrome elements:In 16 syndrome elements,including 4 disease-bit syndrome elements,12 disease resistance syndrome elements.Common syndrome elements of disease location as liver,kidney and brain.Common syndrome elements of disease types include deficiency of vital energy,blood stasis,deficiency of yin,phlegm,essence deficiency,Qi stagnation and blood deficiency.(4)Analysis of TCM syndrome:All of 14 syndrome types,the most common syndrome types include kidney essence deficiency syndrome,Qi deficiency and blood stasis syndrome,syndrome of yin deficiency of liver and kidney,hyperactive of liver-yang syndrome and phlegm turbidity of resistance.Section 2:Clinical Research of Syndrome about CCCIObjective:By review the law of TCM syndromes,provide the theoretical foundation for diagnosis and treatment of chronic cerebral circulation insufficiency.Methods:Collect syndromes information with chronic cerebral circulation insufficiency to observe the syndromes law of CCCI,entry data and analysis to discuss TCM syndrome distribution of CCCI,and compare the results with the literature.Results:(1)76 cases of patients with chronic cerebral circulation insufficiency,male 45 cases(59%)and 31 females(41%).Age of 60-79 years old with a maximum of 55 cases(72.3%).Underlying diseases combined maximum of hypertension,65 patients(85.5%),followed by hyperlipemia(68.4%)and diabetes(53.9%),coronary heart disease(19.7%);in them who with two or more underlying diseases accounted for 80%of the total.(2)Distribution of TCM syndrome elements:76 cases of patients with chronic cerebral circulation insufficiency summed 9 disease types syndrome elements and five syndrome elements of disease location,common syndrome elements of disease resistance include marrow deficiency syndrome,phlegm syndrome,blood deficiency syndrome,qi deficiency and blood stasis.Common syndrome elements of disease location brain,kidney and liver.Among all patients with chronic cerebral circulation insufficiency,simply combined one syndrome only four cases,two to four certificates of merger occurred by 65(85.5%).Pure deficiency syndrome of which 29 cases(38.2%),pure sthenic syndrome only one case(1.3%),the situation mixed 46 cases(60.5%).(3)Cluster analysis of syndromes:the 9 sorts of illness syndrome elements of cluster analysis,to gather into two categories,the phlegm and marrow deficiency syndrome together as one class,the other seven cards together as a class.(4)Correlation analysis of TCM syndrome elements with the underlying disease situation:the results show that blood stasis syndrome and hyperlipidemia is positively correlated(P<0.05);phlegm syndrome and hypertension is positively correlated(P<0.05).(5)Difference of TCM syndrome between literature survey and clinical observation:In literature,Qi deficiency syndrome,blood stasis syndrome,syndrome of yin deficiency and phlegm turbidity of resistance is most common syndrome,and clinical observation to marrow deficiency syndrome,phlegm syndrome,blood deficiency syndrome,qi deficiency syndrome and blood stasis syndrome is most common.Section 3:Efficacy research of the Chinese medicine meridians Huoluoyinao.Objective:By TCM and modern medicine scales and evaluation of brain perfusion e interest in the efficacy of chronic cerebral circulation insufficiency,to provide an objective basis on treating chronic cerebral circulation insufficiency.Methods:(1)All 76 cases of chronic cerebral circulation insufficiency taking the medicine for three months or more,Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),Hamilton depression Scale(HAMD),Hamilton anxiety Scale(HAMA)and the Pittsburgh Sleep Quality scale(PSQI)and TCM symptomatology scale,scores were performed to interest in the efficacy of chronic cerebral circulation insufficiency before and after treatment.(2)Among 76 cases of patients with chronic cerebral circulation insufficiency,31 of them did SPECT examination to measure of cerebral blood flow perfusion,with the cerebral infarction group and normal rCBF comparing observed CCCI patients with cerebral blood flow characteristics.(3)Part of patients who did SPECT before treatment did it again after treatment to evaluation of its regional cerebral blood flow changes,to evaluate brain active interest in the treatment of chronic cerebral circulation insufficiency side effect.Results:(1)Analysis of CCCI patients with cerebral artery stenosis:76 cases of patients of chronic cerebral circulation insufficiency with single artery stenosis is 33 patients(43.4%),multiple in 43 cases(56.6%);involved 182 narrow arteries,intracranial arterial stenosis 135(74.2%),extracranial artery stenosis 47(25.8%),intracranial arteries more than extracranial;which the anterior circulation 135(74.2%),posterior cerebral circulation 47(25.8%),more than the anterior circulation.(2)Analysis of variety scale situations:after treatment HAMA,HAMD,MoCA,MMSE,PSQI and TCM symptomatology scale were different significantly with prior treatment(P<0.01).(3)Regional cerebral blood flow(rCBF)distribution of CCCI:CCCI group rCBF values higher than patients with cerebral infarction,and lower than the normal group,and the results were statistically significant(P<0.01).(4)Before and after treatment of cerebral blood flow was evaluated:6 cases of chronic cerebral circulation insufficiency patients improved significantly after treatment than before(P<0.01).Conclusion:Through literature and clinical studies to explore the CCCI TCM Syndrome Distribution and treating chronic cerebral circulation insufficiency efficacy.The results showed that chronic cerebral circulation insufficiency is a kind of syndrome of intermingled deficiency and excess,which baced on qi deficiency,blood deficiency and marrow deficiency,that phlegm,blood stasis is standard;marrow deficiency among the chronic cerebral circulation insufficiency with main artery stenosis is more obvious compared to no large artery stenosis.Patients with chronic cerebral circulation insufficiency is often accompanied by anxiety,depression,sleep disorders and cognitive level,that were improved by Chinese herb of Huoluoyinao,and cerebral blood flow of patients with CCCI can be significantly improved,too.