Research On Relevance Between TCM Syndrome Elements And Biomarkers Of Patients With Alzheimer’s Disease

ObjectiveTo explore the distribution of TCM syndrome elements of patients of Alzheimer’s disease（AD）with different cognitive levels and the correlation between each syndrome elements element and common biomarkers of AD,so as to provide a potential basis for the objectification of TCM syndrome elements in AD and the identification of AD high-risk groups and patients.MethodsIn this study,A total of 37 patients diagnosed with AD who were hospitalized in the Department of Neurology of Wuhan First Hospital from November 2018 to October 2020 were collected and assessed for cognitive impairment and disease severity using neuropsychological examination,combined with clinical syndrome,nervous imaging,and laboratory tests,and screened for mild cognitive impairment（MCI）group,dementia group,and then 18 inpatients with normal cognition were screened.（1）Eleven types of syndrome elements,including kidney deficiency,spleen deficiency,hyperactivity,toxicity,and phlegm,were typed and quantified according to the TCM four diagnostic Syndromes and Dementia Syndrome elements Element Scale（PES-D-11）.（2）Imaging examinations were performed on subjects in each group separately.（3）In the patient group,cerebrospinal fluid was retained and sent for examination of Aβ_1-42.（4）To compare the distribution pattern of TCM syndrome elements and the differences in syndrome elements scores,clinical signs of disease,imaging markers,and cerebrospinal fluid biomarkers among the groups,and to analyze the data of statistically significant differences using Spearman correlation analysis and other methods with SPSS23.0 software.The correlation between the TCM syndrome elements score and the clinical signs of the disease,imaging markers,cerebrospinal fluid biomarkers Aβ_1-42,p-tau protein,t-tau protein content and Aβ_1-42/Aβ_1-40ratio was analyzed.Results（1）A total of 55 eligible subjects were included in this research,including 18 cases in the normal cognitive group,16 cases in the MCI group,and 21 cases in the dementia group.（2）The results of the TCM syndrome elements analysis showed that there was a significant difference between the three groups in the distribution ratios of kidney deficiency syndrome elements,hyperthermia syndrome elements and phlegm syndrome elements（P<0.05）,and there was a statistically significant difference between the three groups in the syndrome elements scores of spleen deficiency syndrome elements,kidney deficiency syndrome elements,phlegm syndrome elements and hyperthermia syndrome elements.（3）The scores of kidney deficiency and heat toxicity were negatively correlated with MMSE scores（P<0.05）,and the scores of heat toxicity and hyperactivity were positively correlated with CDR,ADL and NPI scores（P<0.05）.（4）The scores of hyperactivity and heat toxicity were positively correlated with MTA scores（P<0.05）,and the scores of kidney deficiency were positively correlated with Fazekas scores（P<0.05）.5)The points of renal deficiency were negatively correlated with Aβ_1-42content（P<0.05）,the points of medulla hypertension were negatively correlated with Aβ_1-42/Aβ_1-40ratio（P<0.05）,and the points of heat toxicity were positively correlated with T-tau protein content（P<0.05）.Conclusion（1）The overall syndrome elements of Alzheimer’s disease in this study was dominated by kidney deficiency syndrome elements,phlegmatic syndrome elements,and hyperactive syndrome elements.（2）The TCM syndrome elements of Alzheimer’s disease was related to clinical signs,and the cognitive impairment of patients was more severe when kidney deficiency,hyperactive yang,and toxic evil were evident;and with the aggravation of hyperactive yang and toxic evil syndrome elements,the ability of daily life and mental behavior abnormalities of AD patients might be affected.（3）There are correlations with imaging markers,hyper-yang and toxicity are associated with temporal lobe and hippocampal atrophy and even whole brain volume loss,and kidney deficiency syndrome elements is associated with cerebral white matter high signal.（4）Chinese medical syndrome elements of Alzheimer’s disease has some correlation with cerebrospinal fluid biomarkers,kidney deficiency syndrome elements and medullary subtraction syndrome elements are associated with amyloidosis,and heat toxicity syndrome elements is associated with neurodegenerative impairment.