The Study On Syndromes Cluster Analysis And Related Factors Of Cerebral Small Vessel Diseases Complicated With Depression

Objective1.Exploring the distribution of Traditional Chinese Medicine(TCM)syndromes of cerebral small vessel diseases complicated with depression.2.In order to provide basis for the early prevention and treatment of cerebral small vessel diseases complicated with depression,analyzing the relationship between syndrome types and related factors preliminarily.MethodsThe cases were all from the outpatients and inpatients in the neurology department of Hubei Provincial Hospital of TCM,during July 2016 to September 2017.The MRI results of patients'brain were consistent with the diagnostic criteria of CSVD.Using the Patient Health Questionnaire-9(PHQ-9)in early screening,and estimating the degree of depression for patients by using the Hamilton Depression rating Scale(HAMD)to confirm that the patients meet the diagnostic criteria.Extracting common TCM symptoms associated with the cerebral small vessel diseases complicated with depression through the retrieval of the literature.According to the results,we made the TCM syndrome questionnaire.After obtaining the consent of the patient,the members of the study group should explain the meaning of the TCM syndrome in the questionnaire to the patient and complete the investigation.We made a descriptive statistics of the frequency by SPSS 22.0 software,according to the information of the questionnaire and related risk factors.Then using cluster analysis to process the data in the Wald method.Finally,differentiating and concluding the TCM syndrome elements of the 98 patients on the basis of the clustering results,by comparing and analyzing related risk factors and the character of TCM syndrome.Result1.In patients with cerebral small vessel diseases complicated with depression,the proportion of women was higher than that of men,and the ratio is about 1.2 to 1.Among the 98 patients,the greatest occurrence of the disease was in the age group from 70 to 79 years old.The degree of depression which was different in the sexes was associated with age and education.Past medical history of the statistical results showed that related factors of the proportion including hypertension,diabetes,hyperlipidemia,etc.The highest percentage of its imaging performance was the lacunar infarction(76.5%),followed by the white matter lesions(30.6%).2.In this study,there were 56 cases of TCM symptoms except"affective depression",among which the highest frequency was low interest(29.6%).According to the result of cluster analysis and the book named Zheng Su BianZhengXue,the study concluded five kinds of syndrome types.The proportion of syndromes in the following order was:fire derived from stagnation of liver-qi,dampness stagnancy due to spleen deficiency,heart and spleen deficiency,heart yang deficiency due to blood stasis,yin deficiency and blood asthenia of liver-kidney.3.The fasting blood glucose and LDL-C level of the patients with dampness stagnancy due to spleen deficiency syndrome were higher than that of the heart yang deficiency due to blood stasis syndrome,fire derived from stagnation of liver-qi syndrome,heart and spleen deficiency syndrome,(P<0.05).The fasting blood glucose of the patients with yin deficiency and blood asthenia of liver-kidney syndrome was higher than that of the patients who belong to one of the three syndrome types,(P<0.05).4.The HAMD score of patients with dampness stagnancy due to spleen deficiency syndrome and yin deficiency and blood asthenia of liver-kidney syndrome was higher than that of other syndromes.The HAMD score and fasting blood glucose(r_s=0.641,P<0.05)were positively correlated.The HAMD score and the low density lipoprotein cholesterol(r_s=0.724,P<0.05)were also positively correlated.Conclusion1.This disease is related to organs such as liver,spleen,brain,kidney and heart.The nature of disease was divided into asthenia syndrom and excess syndrome.The asthenia syndrom included heart and spleen deficiency syndrome and yin deficiency and blood asthenia of liver-kidney syndrome.The asthenia syndrom intermingled with dampness and stasis included dampness stagnancy due to spleen deficiency syndrome and heart yang deficiency due to blood stasis syndrome.The excess syndrome was more common in fire derived from stagnation of liver-qi syndrome.The high HAMD score of patients who belong to dampness stagnancy due to spleen deficiency syndrome or yin deficiency and blood asthenia of liver-kidney syndrome may be related to their high fasting blood glucose and LDL-C level.2.This study provides a certain reference for the TCM in the aspects of the syndrome differentiation and treatment and of the disease.By discussing the syndrome distribution of the disease and the relationship between TCM syndrome type and related risk factors preliminarily.Because the study in the whole sample size and the crowd scope is limited,the reference which related to vascular depression,post stroke depression and other disease,have a certain extent effects on the result of the research.There still need multicenter,large sample research and comprehensive statistical method to clear and specify the diagnosis and treatment of the disease as an independent disease.