Study On Syndromes Cluster Analysis And Related Factors Of Cerebral Small Vessel Diseases Complicated With Cognitive Impairment

Object:By collecting hubei provincial hospital of Traditional Chinese medicine the clinical data of patients with cerebral vascular disease complicated with cognitive impairment,and analyze its related factors,main clinical symptoms,tongue and pulse condition statistical induction,using the system cluster analysis to extract the main syndrome factors of the disease,for the traditional Chinese medicine dialectical of CSVD complicated with cognitive impairment clinical disease provides the basis.It also discusses the correlation between different syndromes,and provides help for the combination of Chinese and western medicine.Method:This research through to hubei provincial hospital of Traditional Chinese medicine in July 2016 to September 2017 encephalopathy patients with CSVD complicated with cognitive impairment by clinical questionnaire investigation,filled the related information in the?Patients with cerebral small vessel information questionnaire?(table 3).The research needed to use Excel 2010 to establish the database,and SPSS 22.0 statistical software to describe and relate parameters test.At the same time,we accumulated constitute more than 95%of the clinical symptoms of pulse and tongue as the main variables to finish system cluster analysis.In the end,according to the clustering results we used the related theory of traditional Chinese medicine knowledge to induce factors of CSVD complicated with cognitive impairment's syndromes which can be combinated as the main syndrome.At the same time,according to the clustering results,we divided the patients into different syndromes and studied the correlation of various indicators between different syndromes and finally reached the conclusion.Result:This study included 109 patients with CSVD complicated with cognitive impairment.According to the statistica l description,the female patients accounted for 51.4%.The age was in normal distribution,with an average age of 70.12 years,and the majority of people aged 60 and above accounted for 80.7%.There was a large difference in the number of men and women between the ages of 70to 79 years old,but after the independent sample t test,P=0.508>0.05,indicating that there was no significant difference in age between the sexes.In the case of education,the number of patients with secondary education and above was about 76.1%,and the degree of education was statistically significant.By the normal distribution test(K-S test,P=0.022<0.05),BMI doesn't fit the normal distribution.So we need to use interquartile range(Q=P75-P25)to describe the variation of the skewness distribution data.P25,P50,P75 were 21.75 kg/m~2,24.4 kg/m~2 and 26.0 kg/m~2,the average of BMI was 23.867 kg/m~2,Q was 4.25 kg/m~2.In the history of previous diseases,hypertension accounted for 78.9%,and the number of patients with cerebral infarction,diabetes and hyperlipidemia was close to 46%,and the male smokers were significantly more than the drinkers.The Montreal cognitive assessment scale(MoCA)scores of patients with different level of education have bigger difference.Illiterate patients'MoCA averaged 14.33 points,patients with primary school on average 17.65 points and 19.98 points in high school or above education.There was a significant difference in the Pvalue of kruskal-wallis test,indicating that different education degree could affect MoCA score.On the other hand,because of TCM symptoms'dispersion,we of refer to the symptoms whose cumulative constituent ratio reached 95%as the main symptoms of patients with CSVD complicated with cognitive impairment.By system cluster analysis,we concluded seven classes of the main symptoms,pulse and tongue.According to the cluster analysis result we concluded seven combinations:spleen and kidney Yang deficiency syndrome,spleen wet phlegm obstruction,essence of liver Yang,qi and blood stasis,qi and blood deficiency,liver and kidney Yin deficiency and kidney essence deficiency.The distribution of the syndromes is mainly:kidney deficiency syndrome>qi deficiency syndrome>qi stagnation blood stasis syndrome>spleen wet sputum obstruction syndrome,the number of false witnesses is significantly more than the empirical evidence.There were differences in Mo CA score,BMI,fasting blood glucose and low density lipoprotein cholesterol in different syndromes.MoCA score significantly lower than the empirical deficiency syndrome,spleen wet phlegm obstruction of BMI and low density lipoprotein cholesterol significantly higher than other syndromes,fasting blood glucose levels of liver and kidney Yin deficiency syndrome was obviously higher than that of other syndromes.MoCA scores were associated with low density lipoprotein cholesterol.Coclusion:Patients with cerebral vascular disease complicated with cognitive impairment's onset age concentrated in over 60 years of age,the related influencing factors can be divided into non-interference factors(e.g.age,level of education)and interference factors(mainly for hypertension),other such as gender,medical history except hypertension,personal history remains to be further research.The disease is asthenia in origin and asthenia in superficiality,in which spleen wet sputum obstruction,liver Yang hyperactivity and qi stagnation blood stasis were excess syndromes and the spleen and kidney Yang deficiency,qi and blood deficiency,liver and kidney Yin deficiency and kidney essence deficiency were deficiency syndromes.There were differences in MoCA score,BMI,fasting blood glucose and low density lipoprotein cholesterol in different syndromes.It provides certain basis for the combination of Chinese and western medicine to guide clinical syndrome differentiation and medication,but It remained to be further studied.