The Correlation Between Traditional Chinese Medicine Syndrome Differentiation Typing And Cognitive Function In Patients With Schizophrenia

BackgroundAs a disease mostly happens in young adults, schizophrenia is one kind of chronic diseases featuring prolonged course, high disability and recurrent rates. The are mainly three symptoms in schizophrenia, namely, negative symptoms, positive symptoms and cognitive function damage, in which cognitive function is closely related to the prognosis of patients and social functional recovery. Traditional Chinese medicine (TCM) has categorized this mental disease as depressive or mad psychosis. The TCM treatment of mental illness emphasizes holistic view and dialectical treatment. It is beneficial to treatment of schizophrenia to combine the diagnosis with western diagnostic criteria and the treatment with TCM syndrome differentiation.Objective1.Though analyzes the characteristics of traditional Chinese medicine syndrome differentiation of schizophrenia, psychiatric symptoms and cognitive function, to discuss the correlation between TCM syndrome differentiation typing of schizophrenia and psychiatric symptoms.2. Though explores the correlation between TCM syndrome differentiation and cognitive function, so as to provide new ideas and theoretical basis for fine clinical treatment.MethodsAccording to the traditional Chinese medicine syndrome differentiation,538 schizophrenic patients in February 2016 to July 2016 in Henan province psychiatric hospital were divided into seven groups, namely, pyrophlegm internal disturbance type, phlegm resistance type, qi-blood stagnation type, yin deficiency with fire hyperactivity type, Yang deficiency type, heart-spleen deficiency type, liver stagnation with spleen deficiency type. The Cognitive function of schizophrenic patients were assessed by Wisconsion Card Sorting Test(WCST), MATRICS Consensus Cognitive in Schizophrenia(MCCB) including Trail Making Test (TMT-A), Symbol Coding(SC), Hopkins Verbal Learning Test Revised (HVLT-R), Brief Visuospafial Memory Test-revised (BVMT-R), Stroop Test, Continious Performance Test-Identical Pair(CPT-IP); the psychiatric symptoms were assessed by Positive and Negative Syndrome Scale (PANSS); The differences of cognitive function and psychiatric symptoms in each group were compared. All the statistic analysis were conducted with SPSS20.0 software.Results1. The age, gender, education background and course of disease in each group were not significantly different (P> 0.05).2. The phlegm resistance pyrophlegm type, internal disturbance type, yin deficiency with fire hyperactivity, heart-spleen deficiency type, liver depression with qi stagnation, Yang deficiency loss, were significantly different (P<0.05).The general pathological scores were not significantly different in each type(P>0.05). The PANSS score in liver stagnation with spleen deficiency and Yang deficiency loss group was not significantly different from those in phlegm resistance type, pyrophlegm internal disturbance group and yin deficiency with fire hyperactivity group(P<0.05).3. The WCST test results indicated that continual errors, the number of correct responses, the number of wrong answers and the number of completed categories, in phlegm resistance type, pyrophlegm internal disturbance group and yin deficiency with fire hyperactivity were significantly different from those in liver stagnation with spleen deficiency group, heart-spleen deficiency type, qi stagnation group and Yang deficiency type (P<0.01);4. The MCCB test results indicated that in TMTA test, phlegm resistance group, yin deficiency with fire hyperactivity group, Yang deficiency type (P<0.01). SC test pyrophlegm internal disturbance group was significantly different with liver stagnation with spleen deficiency group, heart-spleen deficiency group, Qi-stagnation and blood stasis group, Yang deficiency type (P<0.05). phlegm resistance type, yin deficiency with fire hyperactivity type were significantly different with liver stagnation with spleen deficiency group, heart-spleen deficiency group, Qi-stagnation and blood stasis group, Yang deficiency group. HVLT-R test, phlegm resistance group, yin deficiency with fire hyperactivity group, yin deficiency with fire hyperactivity type were significantly different with liver stagnation with spleen deficiency type, Yang deficiency type. BVMT-R test, phlegm resistance type, pyrophlegm internal disturbance type yin deficiency with fire hyperactivity type were significantly different with liver stagnation with spleen deficiency group, Qi-stagnation and blood stasis group (P<0.01); the CPT-IP test results indicated that there were significant differences among liver stagnation with spleen deficiency type, phlegm resistance type, pyrophlegm internal disturbance type, yin deficiency with fire hyperactivity group were significantly different with heart-spleen deficiency type, Qi-stagnation and blood stasis type, Yang deficiency type (P<0.01). The Stroop color words test results in phlegm resistance type, pyrophlegm internal disturbance group, yin deficiency with fire hyperactivity type were significantly different from those in liver stagnation with spleen deficiency type, heart-spleen deficiency type, Qi-stagnation and blood stasis group and Yang deficiency type (P<0.01).5. The correlation analysis of impact factors on cognitive function in schizophrenia suggested that the onset age, course of disease and positive syndrome were not correlated to cognitive function; the negative syndrome was negatively correlated to TMTA, SC, HVLT-R and continual errors (P<0.01); the educational backgroud was positively correlated to SC, HVLT-R, number of correct answers and completed categories (P<0.01).Conclusions1. The distribution of patients with schizophrenia from TCM syndrome type are different, the distribution of pyrophlegm internal disturbance type is most, liver stagnation with spleen deficiency type is minimum.2. There are extensive cognitive function damages in schizophrenic patients from TCM point of view. The negative syndrome and positive educational background were correlated to cognitive function in schizophrenic patients.3. The schizophrenic patients with pyrophlegm internal disturbance, phlegm resistance, yin deficiency with fire hyperactivity are characterized by positive syndrome, and had less impaired cognitive function. The schizophrenic patients with liver stagnation with spleen deficiency type, heart-spleen deficiency group, Yang deficiency are characterized by negative syndrome, and have more impaired cognitive function.