Abstract:Objective To analyze the TCM syndrome differentiation and imaging characteristics of hypertensive patients with cerebral microbleeds (CMB), as well as their correlation with cognitive dysfunction. Methods A total of 225 hypertensive patients who were treated in Jiangsu Province Hospital of Chinese Medicine from January 2019 to December 2021 were assessed for CMB by sensitivity weighted imaging (SWI), and they were divided into CMB group (n=108) and non-CMB group (n=117). The two groups of patients were analyzed by TCM syndrome differentiation, CMB lesions characteristics, and the cognitive function was assessed by the simple mental state scale (MMSE) and the Montreal cognitive scale (MoCA). The occurrence of cognitive impairment between the two groups was compared, and the characteristics of TCM syndrome types of patients with cognitive impairment were analyzed. Results In 225 hypertensive patients, 108 cases (48.0%) had CMB, which was mainly located in the deep and infratentorial. The type of liver-fire flaring-up was the most common syndrome type in patients with CMB, followed by the type of hyperactivity of yang due to yin deficiency. The incidence of cognitive dysfunction in CMB group (58.3%) was significantly higher than that in non-CMB group (21.4%), and type of liver-fire flaring-up was the most common syndrome type in patients with cognitive impairment. Conclusion Liver-fire flaring-up and hyperactivity of yang due to yin deficiency are the main syndrome types of hypertensive CMB. The incidence of cognitive impairment in patients with hypertensive CMB is significantly higher, and the type of liver-fire flaring-up is the main syndrome type of patients with cognitive impairment.