Study On Relationship Among Syndrome Differentiation Of TCM, Constitution Of TCM And Clinical Characteristics Of Vascular Cognitive Impairment (VCI)

ObjectivesOur study aimed to explore the clinical characteristics of vascular cog-nitive impairment (VCI) in different periods and different types, and to analyse the relationship among the VCI, syndrome differentiation of Traditional Chi-nese Medicine(TCM) and the constitution types of TCM, in order to provide clinical and theoretical evidences for VCI therapy and preventing.MethodsThe patients who diagnosed of ischemic stroke with the scores of Hacki-nski(HIS)≥7 were included.All the selected patients were separated into two group according to Mini-Mental State Examination(MMSE):the control group (MMSE score≥27) and the VCI group(MMSE score<27).And the VCI group were separated into vascular cognitive impairment not dementia(VCIND) group and vascular dementia group(VD) according to Clinical Dementia Rating(CDR) and the clinical dignosis. The cognitive state, capacity of daily living, the types of the syndrome differentiation of TCM and the constitution types of TCM of 47 patients with VCI and 34 control subjects were measured with Cognitive Rating Scale for clock draw text (Clox), Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-Cog), activity of Daily Living (ADL), the syndrome scale of TCM of VD and Classification and Determination of Constitution in TCM, respectively.The difference of all these five scales'score(MMSE, HIS, Clox, ADAS-Cog and ADL) among three groups were analysed by Analysis of Variance. Chi-square test was applied to analyse the diffenece among three groups in the types of the syndrome differentiation of TCM and the constitution types of TCM.Result1. When comparisons were carried out between VCIND group and control group, the scores of MMSE and CLOX1 in VCIND group were significantly lower than that of control group, and the scores of ADAS-cog were significantly higher in VCIND group than that of control group (P<0.01 or P<0.05). When comparisons were carried out among VD group, VCIND group and control group, the scores of MMSE, CL0X1,CLOX2 in VD group were significantly lower than that of VCIND group and control group, and the scores of HIS, ADAS-cog, ADL in VD group were signi-ficantly higher than that of VCIND group and control group (P<0.01 or P<0.05)2. The frequency of deficiency of spleen and kidney (DSK)and blood stagnant in cerebral venation syndrome (BSCVS) in VD group were 60.0%,30.0% res-pectively. The frequency of DSK and BSCVS in VCIND group were 59.3%,40.7% respectively. The frequency of DSK and BSCVS in control group were 52.9%,47.1% respectively. No significant difference in the syndrome differentiation of TCM were found among three groups. The scores of HIS in patients with DSK were significantly higher than that of patients with BSCVS in VCI patients (P<0.05). No significant variance were found in other scales between patients with DSK and patients with BSCVS.3. The frequency of neutral quality, Qi deficiency, Yang deficiency and blood stass were 5.0%,35.0%,15.0%,20.0% in VD group respectively. The frequency of neutral quality, Qi deficiency, Yang deficiency and blood stass were 25.9%,25.9%,14.8%,33.3% in VCIND group respectively. The frequency of neutral quality, Qi deficiency, Yang deficiency and blood stass were 20.6%,8.8%,17.6%,38.2% in control group respectively. But most of neutral quality tended to blood stass. No significant difference were found in the Constitution of TCM among three groups. When comparing neutral quality, Qi deficiency, Yang deficiency and blood stass, no significant difference for cognitive scales, HIS scales and ADL scales were revealed.ConclusionWhen compared with control subjects, the cognitive function of VCIND patients declined significantly. All domains of cognitive functions declined significantly in patients with VD, but executive function and memory defect were worse. The main syndromes differentiation of TCM in patients with VCI were deficiency of spleen and kidney(DSK)and blood stagnant in cerebral venation syndrome(BSCVS). The main constitution types of TCM in patients with VCI were neutral quality, Qi deficiency, Yang deficiency and blood stass. Therefore, we recommend that more attention should be paid to reinforce spleen and kidney function and activate blood circulation in VCI patients'therapy and to re-gulate Qi deficiency, Yang deficiency and blood stass in patients with VCIND.