Analysis Of The Chinese Medical Evidence Of Cerebral Small Vessel Disease And The Efficacy Of Kaixin San Plus Flavor On Its Cognitive Impairment

Objective:To gather clinical information from cerebral small vessel disease patients,to identify risk factors for the condition,to research the prevalence of cerebral small vessel disease and the cognitive impairment it causes in Chinese medicine,as well as the clinical effectiveness of Kaixin San plus flavor in treating phlegm-stasis type cognitive impairment.Methods:1.Using questionnaires,a randomly selected group of 160 CSVD patients were asked about their general characteristics,current health state,past medical history,and knowledge of the four Chinese medical diagnoses.The Cerebral Small Vessel Disease Risk Factor Questionnaire was used to statistically analyze the risk factors.The Diagnostic Scale of Ischemic Chinese Medicine Evidence Elements was used to explore the characteristics of the distribution of Chinese medicine evidence for CSVD and CSVCI,and common evidence types were derived.2.100 CSVCI patients were randomly assigned to the treatment group(the group of Kaixin San plus flavor)and the control group after meeting the criteria(Idebenone group).Prior to,during,and after treatment,patients’ cognitive improvement and functional capacity were assessed using the Chinese Medicine Evidence Score Scale,MMSE,Mo CA,and ADL score scales,respectively.Additionally,the efficacy of the treatment was determined as well as the intra-group and inter-group differences between the treatment and control groups.Results1.The risk factors for cerebral small vessel disease,patterns of evidence for cerebral small vessel disease,and the symptomatology of cognitive impairment were all determined by statistical analysis.1.1 The distribution of these risk variables in the sample size is as follows: Hypertension,diabetes,coronary heart disease,smoking,and alcohol misuse are the main risk factors for cerebral small vessel disease.Diabetes(9.38%),coronary heart disease(21.25%),smoking(36.25%),alcohol misuse(31.88%),and hypertension(72.5%)are among the other health issues.1.2 Independent risk factors in the serum that influence the development and exacerbation of CSVD are glycated haemoglobin,homocysteine,low-density lipoprotein and fibrinogen.1.3 Distribution of CSVD symptoms: Chinese medical evidence often appeared together in CSVD patients,with three evidence concurrent(28.13%)and four evidence concurrent(28.13%)being the most frequent,followed by two evidence concurrent(21.86%),single evidence(13.13%)and five evidence concurrent(8.75%).The most frequent concurrence of three symptoms was Qi deficiency + Blood stasis + Phlegm and Dampness,accounting for 15.56% of the cases.1.4 Distribution of CSVCI symptoms: Chinese medical evidence in CSVCI patients is mainly phlegm-dampness evidence,followed by yin-deficiency evidence,blood-stasis evidence,qi-deficiency evidence,internal fire evidence and internal wind evidence,with the most frequent combination of the three symptoms(31.25%)and the symptoms are often concurrent and complex.1.5 Evidential characteristics of CSVD:The main evidence is Qi deficiency,with concurrent evidence of Yin deficiency and blood stasis;the main evidence is phlegm-dampness,with concurrent evidence of blood stasis and internal fire;the main evidence is internal wind,with concurrent evidence of phlegm-dampness.1.6 Evidential characteristics of CSVCI:The main evidence is Qi deficiency,with concurrent evidence of phlegm-dampness and blood stasis;the main evidence is Yin deficiency,with concurrent evidence of Qi deficiency and blood stasis;the main evidence is internal fire,with concurrent evidence of phlegm-dampness.1.7 Cognitive impairment due to CSVD is closely related to phlegmdampness evidence2.91 cases were eventually included,46 in the treatment group and45 in the control group,with a total of 9 cases shed.2.1 After analyzing the baseline data,we found that there was no significant difference in the comparison of baseline information.After 4weeks of treatment,after 12 weeks,all scale scores and related indexes in the treatment and control groups were improved to a certain extent,with statistical significance,P < 0.05,and there was a difference.The results of the study showed that the study group was better than the control group in terms of their overall.In terms of ADL,the comparison between the two groups was not significant,P > 0.05.2.2 Comparing within groups,the scales and all related indexes were statistically tested and P < 0.05.Both Chinese and Western medicines could improve the clinical efficacy of patients with phlegm-stasis blocked orifice type CSVCI.And the longer the time,the more significant the effect.2.3 The Mo CA scores of both groups were higher than those before treatment,P < 0.05,which was statistically significant,and the results of the study group were better than those of the control group.0 of cases were clinically cured,6 of cases were effective,34 of cases were effective,6 of cases were ineffective and 0 cases were deteriorated in the study group,while 0 cases were clinically cured,4 cases were effective,21 cases were effective,20 cases were ineffective and 0 cases were deteriorated in the control group.The total effective rate of the treatment group was 87.0%,which was better than that of the control group(55.6%),indicating that the effect of Kaixin San plus flavor on the total effective rate of treatment of the disease was significant.Conclusion1.CSVD Chinese medicine evidence pattern1.1 The most common symptomatic elements in Chinese medicine in CSVD are phlegm-dampness evidence,followed by blood stasis evidence,internal fire evidence,qi deficiency evidence,internal wind evidence and yin deficiency evidence,and often appear in combination with each other.The symptoms of CSVCI are characterised by three main points: Qi deficiency evidence is the main symptom,together with Yin deficiency and blood stasis evidence;phlegm and dampness evidence is the main symptom,together with blood stasis and internal fire evidence;and internal wind evidence is the main symptom,together with phlegm and dampness evidence.The CSVCI syndromes are mainly characterised by Qi deficiency evidence as the main symptom,together with evidence of phlegm and dampness and blood stasis;Yin deficiency evidence as the main symptom,together with evidence of Qi deficiency and blood stasis;and internal fire evidence as the main symptom,together with evidence of phlegm and dampness.2.2 Chronic hypertensive disease is associated with the TCM evidence of internal wind and yin deficiency;diabetes mellitus is associated with the evidence of phlegm-dampness and blood stasis;coronary heart disease is associated with the evidence of yin deficiency,and smoking is associated with the evidence of internal fire;hypertensive disease,diabetes mellitus and smoking are independent risk factors for CSVD.2.Kaixin San Plus can successfully treat cerebral small vessel disease’s cognitive impairment.2.1 Kaixin San Plus can effectively improve neurofunctional cognitive impairment,enhance patients’ daily life functions and reduce family and social burdens.2.2 Kaixin San Plus can improve the TCM evidence score,cognitive score and life ability score of phlegm-stasis blocking CSVCI.2.3 Kaixin San Plus can reduce the serum levels of Hcy,LDL-C and DD in patients.The mechanism may be related to the active ingredients of the drug contained to prevent atherosclerosis and Aβ deposition through antioxidation,inhibition of inflammatory response,anti-apoptosis and protection of endothelial cells,thus improving cognitive function.2.4 Kaixin San Plus has a certain safety profile and can act clinically.