Analysis Of TCM Syndrome Type And Its Related Factors In Type 2 Diabetics Patients With Mild Cognitive Impairment

Objective:We aim to study the Association between TCM Syndrome Type and its related factors in Type 2 Diabetics Patients with mild cognitive impairment.Methods:Diagnosis of DM was based on criteria published by the WHO in 1999 and MCI was based on MCI Working Group of the European Consortium on Alzheimers Disease in 2006^[1],Montreal Cognitive Assessment(MoCA)(Beijing Version) was chosed as cognition assessment implement.Current neuropsychological assessment commonly depends on Mini-Mental State Examination(MMSE).However,it could not clearly distinguish the normal cognition from MCI and early-stage Alzheimer disease(AD) in elderly subjects because of the low sensitivity and specificity.Recently MoCA has been applied to assess the cognitive function and it has higher sensitivity and specificity when compared with MMSE in the early diagnosis of MCI.We chose 58 type 2 diabetes mellitus with mild cognitive impairment patients as research group and 30 type 2 diabetes mellitus with normal cognitive function patients as control group.Then according to 2002 "Chinese Native Medicine New Medicine Clinical Research Guiding Principle" gerontic dementia diagnosis standard,58 type 2 diabetes mellitus with mild cognitive impairment patients were divided into kidney deficiency syndrome group,deficiency of YIN of both the heart and liver group,type of deficiency of both the heart and spleen group,turbid phlegm blocking the clear orifices group and qi-stagnancy and blood stasis;stagnation of vital energy and blood stasis group.The MCI group including 31 males,27 females;age from 51-75 years old.The average age was 64.38±6.05 years old.The control group including 16 males,14 females;age from 55-75 years old.The average age was 65.33±5.65 years old.All subjects were analyzed by rating scales of MoCA,MMSE,CDR,ADL,HIS,HADS and HbA1c,blood lipid,ALT,AST, Cr,urine microalbumin was measured.We analyzed the association between TCM Syndrome Type and its related factors in Type 2 Diabetics Patients with mild cognitive impairment.Results:1.Kidney asthenia syndrome of TCM was specially common in MCI(30,51.72%),the following is turbid phlegm blocking the clear orifices syndrome(15,25.86%),deficiency of YIN of both the heart and liver syndrome,deficiency of both the heart and spleen syndrome,qi-stagnancy and blood stasis syndrome were rare.2.Compare Kidney asthenia syndrome and turbid phlegm blocking the clear orifices syndrome with control group:There were significant differences in pathogenesis of DM,complication,BMI,abdominal perimeter,cholesterol(CHOL),low density lipoprotein (LDL-C ),urine microalbumin(P＜0.05).There were no significant differences in glycosylated hemoglobin(HbAlc),Triglyceride(TG),high density lipoproteins(HDL-C),high density lipoproteins(ALT),glutamic-oxalacetic transaminase(AST),creatinine (CREA).Conclusion:1.The kidney asthenia syndrome and turbid phlegm blocking the clear orifices syndrome were especially common in MCI caused by T₂DM.It implies that the kidney asthenia and turbid phlegm blocking the clear orifices were the basic pathogenesis of MCI.2.The risk factors such as longer pathogenesis,more DM-related complications,obesity and high level of blood fat contribute to the development of cognitive impairment and may even aggravate it.so reduction of complication and body weight,control of blood fat may help to improve the cognitive function.3.Taking advantage of TCM,early intervention and treatment were applied for the corresponding syndrome.You can begin with the syndrome of kidney asthenia,heart blood deficiency,spleen qi deficiency,Sputum and turbid,blood stasis.Kidney asthenia,sputum and turbid syndrome were especially the basic pathogenesis.They were the important steps to prevent aggravation and interrupt the development of dementia.