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Journal of Chinese Integrative Medicine ›› 2011, Vol. 9 ›› Issue (10): 1075-1082.doi: 10.3736/jcim20111007

Special Issue: Traditional Chinese Medicine

• Original Clinical Research • Previous Articles     Next Articles

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

Jing Shi, Ming-qing Wei, Fu-yun Ma, Ying-chun Miao, Jin-zhou Tian()   

  1. Department of Geriatric Diseases, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
  • Received:2011-05-12 Accepted:2011-07-12 Online:2011-10-20 Published:2011-10-15
  • Contact: Tian Jin-zhou E-mail:jztian@hotmail.com

Objective: To investigate the correlation between cognitive function and the Chinese medicine syndrome characteristics of vascular cognitive impairment (VCI).

Methods: A total of 774 subjects (age from 41 to 87 years old) from Beijing of China accepted neuropsychological assessments and differentiation of Chinese medicine syndromes. The mini-mental state examination (MMSE) and clinic dementia rating (CDR) were used to access the global cognitive function; the Hachinski ischemia scale (HIS) and the Hamilton depression scale (HAMD) were used for differential diagnosis; the ability of daily living (ADL) scale was used to assess the ability of daily living; the clock drawing test was used to access the executive function; the investigation of syndrome manifestations and the syndrome differentiation scale of vascular dementia (SDSVD) were used for diagnosis of syndrome manifestations. According to the diagnostic criteria of vascular cognitive impairment, subjects were subgrouped as normal cognition (NC) group and VCI group, and then the correlation between the cognitive functions and Chinese medicine syndromes was analyzed.

Results: The correlation between cognitive scales and Chinese medical syndrome: in the VCI group, the syndrome of phlegm turbid blocking upper orifices showed negative correlation with the scores of MMSE and CDT (r=–0.525, r=–0.321, P=0.000, P=0.001), and the ADL demonstrated positive correlation to the syndrome (r=0.424, P=0.000). The correlation between cognitive function and Chinese medical syndrome: the phlegm turbid blocking upper orifices was closely correlated with the total orientation, time orientation and place orientation (r=–0.451, r=–0.448, r=–0.392, P=0.001, P=0.000, P=0.004); instant word recall and delayed word recall were closely correlated with the syndrome of phlegm turbid blocking upper orifices (r=–0.355, r=–0.225, P=0.000, P=0.021); calculation/attention, language function and executive function had negative correlation to the syndrome of phlegm turbid blocking upper orifices (r=–0.379, r=–0.448, r=–0.321, P=0.000, P=0.000, P=0.013). The scores of orientation, calculation/attention, delayed word recall and language function in the patients with phlegm turbid blocking upper orifices were significantly lower than the patients with non-phlegm turbid blocking upper orifices (P<0.05).

Conclusion: The syndrome of phlegm turbid blocking upper orifices is significantly correlated to the scores of MMSE and ADL, indicating that the phlegm turbid blocking upper orifices is related to the cognitive function and ability of daily living in the VCI patients. Treatment of the phlegm is important in the cognitive impairment in VCI patients.

Key words: vascular cognitive impairment, traditional Chinese medical syndrome, cognitive function

Table 1

Demographic characteristics of normal cognition and VCI groups"

Demographic characteristic Normal cognition group (n=251) VCI group (n=107) Z/χ2 P value
Age ($\overline{x}$±s, years) 61.64±8.72 68.12±9.45 39 574.50 0.000
Education ($\overline{x}$±s, years) 10.93±4.21 8.57±4.36 14 094.00 0.000
SexFemale (n, %) 159 (63.3%) 49 (45.8%) 9.49 0.002
Male (n, %) 92 (36.7%) 58 (54.2%)
Race Han (n, %) 40 (97.6%) 101 (94.4%) 0.66 0.416
Others (n, %) 1 (2.4%) 6 (5.6%)
MMSE score ($\overline{x}$±s) 28.16±1.29 21.56±6.13 1 340.00 0.000

Table 2

Scores of Chinese medical syndromes of normal cognition group and VCI group"

Syndrome Score ($\overline{x}$±s) Z value Pvalue
Normal cognition group (n=251) VCI group (n=107)
Kidney essence deficiency 7.09±4.62 8.57±4.63 42 438.000 0.003
Phlegm turbid blocking upper orifices 3.35±3.59 5.17±4.79 42 486.500 0.004
Blood stasis obstructing brain collaterals 5.30±3.06 9.02±4.38 38 006.000 0.000
Hyperactivity of yang due to yin deficiency 4.02±4.52 3.23±3.46 18 283.500 0.295
Excess of toxic heat 3.48±3.19 1.49±2.16 12 772.500 0.000
Viscera stagnation and turbid left 1.76±2.69 2.64±3.19 43 305.500 0.039
Blood and qi deficiency 2.85±3.05 1.43±2.48 14 487.500 0.000

Table 3

Distribution of Chinese medical syndromes in normal cognition group and VCI group"

Syndrome Percent (n, %) Zvalue Pvalue
Normal cognition group (n=251) VCI group (n=107)
Kidney essence deficiency 130 (51.8%) 73 (67.6%) 7.671 0.006
Phlegm turbid blocking upper orifices 46 (18.3%) 41 (38.0%) 15.857 0.000
Blood stasis obstructing brain collaterals 75 (29.9%) 84 (77.8%) 70.208 0.000
Hyperactivity of yang due to yin deficiency 75 (29.9%) 23 (21.3%) 2.804 0.094
Excess of toxic heat 32 (12.7%) 5 (4.6%) 5.385 0.020
Viscera stagnation and turbid left 16 (6.4%) 18 (16.7%) 9.329 0.002
Blood and qi deficiency 49 (19.5%) 8 (7.4%) 8.297 0.004

Table 4

Partial correlation coefficients between scores of cognitive scales and TCM syndromes in VCI patients"

Syndrome n Correlation coefficient
MMSE CDT ADL
Kidney essence deficiency 107 –0.187 –0.060 0.216*
Phlegm turbid blocking upper orifices 107 –0.525** –0.321** 0.424**
Blood stasis obstructing brain collaterals 107 0.186 0.196 –0.143
Hyperactivity of yang due to yin deficiency 107 0.104 0.000 –0.037
Excess of toxic heat 107 0.180 0.032 –0.009
Viscera stagnation and turbid left 107 –0.022 0.017 0.148
Blood and qi deficiency 107 0.145 0.002 –0.109

Table 5

Partial correlation coefficients between cognitive functions and TCM syndromes in VCI patients"

Cognitive function Correlation coefficient
Kidney essence
deficiency
Phlegm turbid
blocking upper
orifices
Blood stasis
obstructing
brain collaterals
Hyperactivity
of yang due
to yin
deficiency
Excess of
heat toxin
Viscera
stagnation
and turbid left
Blood and
qi deficiency
Total orientation (MMSE) –0.12 –0.45** 0.19 0.03 0.12 –0.05 0.12
Attention/calculation –0.15 –0.38** 0.14 0.09 0.10 0.01 0.06
Memory (MMSE)
IWR –0.17 –0.36** 0.10 0.15 0.17 –0.03 0.09
DWR –0.06 –0.23* 0.01 0.16 0.29 0.13 0.01
Total language (MMSE) –0.15 –0.45** 0.17 0.10 0.08 –0.10 0.19
Executive function (CDT) –0.06 –0.32** 0.20 0.00 0.03 0.02 0.00
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