Relationship between cognition and typology of syndrome differentiation of primary hypertension

Yujin ZHANG; Wenzhi ZHANG

ABSTRACT

BACKGROUND:

Primary hypertension is in the category of "dizziness"and "dementia" in Chinese medicine. It is discovered in recent years that vascular dangerous factors, like hypertension affect the risk constitution of Alzheimer disease.

OBJECTIVE:

To probe into relationship between cognition and syndrome differentiation of primary hypertension.

DESIGN:

Case-control analysis was designed.

SETTING:

Jiangsu Staff University of Medical Science and Yangzhou Wenhe Hospital.

PARTICIPANTS:

Totally 90 cases of primary hypertension were employed from May to June 2000. They were from some city in the north of Jiangsu province, graduated from middle school and cooperated with the investigation. Totally 30 cases were collected from physical-check group and taken in the control.

METHODS:

The cases of primary hypertension were differentiated as excess-syndrome group (excessive phlegm and damp and hyperactivity of liver yang), deficiency-syndrome group (yin deficiency of liver and kidney and deficiency of yin and yang), excess within deficiency group (complicated with blood stasis and with turbid phlegm) and the control group. Neuropsychological method was used to evaluate the cognition.MAIN OUTCOME

MEASURES:

Indexes of neuropsychology Fuld object-memory Evaluation (FOM), rapid verbal retrieve (RVR), block design WISE (BD), digit span WISE (DS), Hachinski ischemic score (HACH), mini-mental state examination (MMSE) and activity of daily living scale among groups.

RESULTS:

The data of 90 cases of primary hypertension and 30 cases in physical-check group entered result analysis. Compared with the control group, significant difference was not indicated in every statistical index in excess-syndrome group (P ＞ 0.05). In deficiency-syndrome group, except MMSE and ADL, the rest observed indexes indicated statistical difference.In excess within deficiency group, statistical difference presented in every observed index (P ＜ 0.01), in which the results in the complication of turbid phlegm was worse than blood stasis (FOM was 11.3±3.7,13.5±2.5 respectively; DS was 6.4±3.9,8.3±3.5, respectively)

CONCLUSION:

Primary hypertension affects mental state of patient, in which, cognition is declined mildly in deficiency-syndrome group. Dementia symptoms present in excess within deficiency group which is severe in phlegm type compared with blood stasis type. Differentiation of syndromes in Chinese medicine integrated with neuropsychological assessment benefits early discovery and diagnosis of dementia.