Objective To explore the elements of traditional Chinese medicine（TCM） syndromes of cognitive impairment after acute ischemic stroke

and to provide the basis for syndrome differentiation and treatment for early clinical intervention. Methods A total of 331 patients with cognitive impairment after acute ischemic stroke were collected by multi-center collaboration. The information of the four diagnosis methods was collected by using the Chinese Medicine Symptoms

Tongue and Pulse Observation Table

which included 40 clinical symptoms

20 tongue manifestations and 10 kinds of pulse. Factor analysis method was used to extract the syndrome elements from the 70 items of diagnosis information of the subjects

and the distribution characteristics of syndrome elements were counted. Results Among the 40 clinical symptoms

the top 5 of frequency of occurrence were fatigue（44.71%）

verbal astringency（41.99%）

insomnia（41.39%）

frequent nocturia at night（35.95%）

and spiritual fatigue（35.35%）. Among tongue manifestations

dark tongue is the largest frequency of tongue color

accounting for 53.47%; white tongue coating is most common tongue color accounting for 66.77%; the most common tongue quality is thin tongue coating

accounting for 48.94%. Stringy pulse is the most common pulse manifestation

accounting for 65.86%

followed by slippery pulse and deep pulse. After factor analysis

a total of 6 syndrome elements were obtained

of which the proportion of qi deficiency was the highest（43.20%）

followed by phlegm（23.56%）

blood stasis（16.31%）

fire（8.46%）

yin deficiency（5.44%）

and yang deficiency（3.02%）

the disease is more common in the kidney

the spleen and the liver. Conclusion The main TCM syndromes of cognitive impairment after acute ischemic stroke are qi deficiency. Deficiency of the kidney and the spleen and intermin-gled phlegm and blood stasis may be the important pathological factors of cognitive impairment in the acute stage of stroke.