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Journal of Chinese Integrative Medicine ›› 2009, Vol. 7 ›› Issue (3): 205-211.doi: 10.3736/jcim20090302

Special Issue: Traditional Chinese Medicine

• Original Clinical Research • Previous Articles     Next Articles

Correlation between cognitive functions and syndromes of traditional Chinese medicine in amnestic mild cognitive impairment

 Ying-chun Miaoa, Jin-zhou Tiana, Jing Shia, Min Maoa, Xiao-dong Zhaoa, Li-yan Fangb, Chui-you Zenga, Jian-ping Liuc, Zhi-liang Wangd, Xiao-bin Lid   

  1. a Department of Geriatric Disease, Dongzhimen Hospital, Beijing University of Chinese Medcine, Beijing 100700, China
    b Department of Traditional Chinese Medicine, China Rehabilitation Research Center, Beijing Boai Hospital, Beijing 100068, China
    c Center for Evidence-Based Medicine,Beijing University of Chinese Medicine, Beijing 100029, China
    d North China Pharmaceutical Group Formulation Company Limited, Shijiazhuang 050015, Hebei Province, China
  • Received:2008-09-11 Accepted:2008-12-08 Online:2009-03-20 Published:2009-03-15

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Objective

To explore the correlation between the cognitive functions and syndromes of traditional Chinese medicine (TCM) in amnestic mild cognitive impairment (aMCI), and to provide evidence for clinical syndrome differentiation treatment.
Methods

Six hundred subjects from Dongzhimen Hospital and seven communities in Beijing, aged between 40 and 85 years, accepted neuropsychological assessments, imaging and biochemical examinations, and syndrome differentiation, from whom 159 aMCI patients, 213 normal control (NC) subjects and 171 Alzheimer’s dementia (AD) patients were screened out. Correlation between the cognitive functions and TCM syndromes in aMCI patients was analyzed.
Results

Mini-Mental State Examination (MMSE) score in aMCI patients was closely correlated with kidney essence vacuity and deficiency of blood and qi (r=–0.11, r=–0.11; P=0.003, P=0.015). Delayed Word Recall (DWR) score was correlated with kidney essence vacuity (r=–0.20, P=0.020). Instant Story Recall (ISR) and Delayed Story Recall (DSR) scores were respectively correlated with turbid phlegm blocking upper orifices (r=–0.11, r=–0.27; P=0.021, P=0.000). Language function was correlated with kidney essence vacuity and deficiency of blood and qi (r=–0.11, r=–0.13; P=0.042, P=0.007). Attention/calculation was also closely correlated with kidney essence vacuity and deficiency of blood and qi (r=–0.10, r=–0.21; P=0.039, P=0.010). Attention score of aMCI patients was correlated with excess of heat toxin syndrome (r=–0.29, P=0.026).
Conclusion

The memory decline of aMCI is correlated with kidney essence vacuity and turbid phlegm blocking upper orifices. Furthermore, turbid phlegm blocking upper orifices is correlated with episodic memory decline, which is closely related to AD. The aMCI patients with phlegm have the risk to progress into AD. Although other cognitive functions of aMCI remain relatively intact, the patients’ language function, attention/calculation and the whole cognitive function may be worsen as the aggravation of kidney essence vacuity, deficiency of blood and qi, phlegm and heat toxin, and may eventually lead to multiple cognitive domains impairment, even dementia.

Key words: Amnestic mild cognitive impairment, Cognitive functions, Syndromes in traditional Chinese modicion, Corrolation

"

Syndrome TCM syndrome score
NC group (n=213) aMCI group (n=159) AD group (n=171)
Kidney essence vacuity 10.60±3.24 11.61±2.65* 12.78±3.40**△
Turbid phlegm blocking upper orifices 10.18±3.35 11.94±2.90** 12.23±3.18**
Blood stasis obstructing brain collaterals 8.95±1.93 9.88±2.73* 10.30±1.94*
Hyperactivity of yang due to yin deficiency 9.88±2.73 9.22±2.34 9.96±2.42
Deficiency of blood and qi 8.67±1.63 9.55±2.68 8.92±2.51
Excess of heat toxin 9.41±3.70 9.50±3.31 9.14±2.91
Viscera stagnation and turbid left 9.14±2.91 9.40±3.06 10.43±2.87

"

Syndrome n Correlation coefficient
MMSE ISR DSR MoCA HVLT CDT
Kidney essence vacuity 159 –0.11** –0.14 –0.06 –0.08 –0.19 0.02
Turbid phlegm blocking upper orifices 159 –0.06 –0.11* –0.27** 0.23 0.03 –0.01
Blood stasis obstructing brain collaterals 159 –0.01 –0.10 –0.05 –0.01 –0.12 –0.11
Hyperactivity of yang due to yin deficiency 159 0.19 –0.02 0.03 –0.20 –0.03 0.03
Deficiency of blood and qi 159 –0.04* –0.09 –0.03 –0.05 –0.10 0.07
Excess of heat toxin 159 –0.02 –0.02 –0.10 –0.04 –0.09 0.11
Viscera stagnation and turbid left 159 –0.11 –0.01 –0.10 –0.13 –0.03 –0.08

"

Syndrome n Correlation coefficient
IWR (MMSE) DWR (MMSE) DWR (MoCA) HVLT
TKidney essence vacuity 159 –0.09 –0.10 –0.20* –0.19
Turbid phlegm blocking upper orifices 159 0.01 –0.08 0.10 0.03
Blood stasis obstructing brain collaterals 159 0.07 –0.02 –0.18 –0.12
Hyperactivity of yang due to yin deficiency 159 –0.02 0.09 –0.24 –0.03
Deficiency of blood and qi 159 0.02 –0.04 –0.13 –0.10
Excess of heat toxin 159 0.03 0.02 –0.14 –0.09
Viscera stagnation and turbid left 159 0.05 –0.12 –0.03 –0.03

"

Syndrome Correlation coefficient
n ISR DSR
Kidney essence vacuity 159 –0.14 –0.06
Turbid phlegm blocking upper orifices 159 –0.11* –0.27**
Blood stasis obstructing brain collaterals 159 –0.10 –0.05
Hyperactivity of yang due to yin deficiency 159 –0.02 0.03
Deficiency of blood and qi 159 0.09 –0.03
Excess of heat toxin 159 –0.02 –0.10
Viscera stagnation and turbid left 159 –0.01 –0.10

"

Cognitive function Correlation coefficient
Kidney
essence vacuity		 Turbid phlegm
blocking upper
orifices		 Blood stasis
obstructing
brain collaterals		 Hyperactivity
of yang due to
yin deficiency		 Deficiency of
blood and qi		 Excess of
heat toxin		 Viscera
stagnation and
turbid left
Language
MMSE –0.11* –0.02 0.11 0.10 –0.13** –0.04 0.11
MoCA –0.06 0.21 0.13 –0.08 –0.06 –0.13 –0.05
Attention/calculation
MMSE –0.10* 0.01 0.03 0.03 –0.21* 0.02 –0.09
MoCA –0.09 0.22 0.09 –0.10 –0.19 –0.29* –0.09
Abstraction
MoCA 0.14 0.01 0.03 0.08 –0.04 0.03 –0.02
Visuospatial and executive function
MoCA 0.02 0.08 0.13 –0.15 –0.06 –0.08 –0.07
CDT 0.02 –0.01 –0.11 0.03 –0.08 0.07 0.11
Orientation
Time –0.12 0.03 0.02 0.15 –0.05 –0.02 0.07
Place 0.03 0.11 0.01 –0.03 0.01 –0.13 –0.08
Total 0.08 0.08 0.05 0.07 –0.06 0.13 –0.01
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