Han Hui, Li Xin, Jiang Hai-Na, Xu Ke, Wang Ying
Department of Encephalopathy, Beichen Hospital of TCM Affiliate to Tianjin University of TCM, Tianjin 300400, China.
Department of Ultrasound, Beichen Hospital of TCM Affiliate to Tianjin University of TCM, Tianjin 300400, China.
Zhongguo Zhen Jiu. 2021 Sep 12;41(9):979-83. doi: 10.13703/j.0255-2930.20210117-k0008.
To observe the clinical efficacy of early acupuncture for vascular dementia (VD) after cerebral infarction, and explore its possible mechanism.
A total of 120 patients with VD after cerebral infarction were randomized into an acupuncture combined with medication group (60 cases, 1 case dropped off) and a western medication group (60 cases, 1 case dropped off). In the western medication group, oxiracetam capsules were given orally, 2 capsules each time, 3 times a day. On the basis of the treatment as the western medication group, acupuncture was applied at Baihui (GV 20), Sishencong (EXHN 1), Zhongwan (CV 12), Wailing (ST 26), Xiawan (CV 10), Qihai (CV 6), Guanyuan (CV 4), etc. in the acupuncture combined with medication group, 30 min each time, once a day, 5 days a week. The treatment was given 8 weeks in both groups. Before and after treatment，the scores of minimental state examination (MMSE), Alzheimer's disease assessment scale cognitive part (ADASCog), clock drawing test (CDT), Barthel index were observed, blood flow velocity of middle cerebral artery (MCA) was detected, and the clinical efficacy was evaluated in the two groups.
The total effective rate was 89.8% (53/59) in the acupuncture combined with medication group, which was superior to 76.3% (45/59) in the western medication group (<0.01). Compared before treatment, the subitem scores and total scores of MMSE, ADASCog score, CDT score and Barthel index score after treatment were improved in the two groups (<0.01, <0.05), and the scores in the acupuncture combined with medication group were superior to those in the western medication group (<0.05, <0.01). After treatment, the blood flow velocity of bilateral MCA was increased in the acupuncture combined with medication group (<0.05), which was faster than the western medication group (<0.05).
Early acupuncture could improve cognitive function and activities of daily living in patients with VD after cerebral infarction, its mechanism may be related to improving the blood flow velocity of MCA, promoting blood circulation, and improving cerebral perfusion.
观察早期针刺对脑梗死继发血管性痴呆（VD）的临床疗效，并探讨其可能机制。
将120例脑梗死继发VD患者随机分为针药结合组（60例，脱落1例）和西药组（60例，脱落1例）。西药组口服奥拉西坦胶囊，每次2粒，每日3次。针药结合组在西药组治疗基础上，针刺百会（GV 20）、四神聪（EXHN 1）、中脘（CV 12）、外陵（ST 26）、下脘（CV 10）、气海（CV 6）、关元（CV 4）等穴，每次30分钟，每日1次，每周5次。两组均治疗8周。观察两组治疗前后简易精神状态检查表（MMSE）、阿尔茨海默病评估量表认知部分（ADASCog）、画钟试验（CDT）、Barthel指数评分，检测大脑中动脉（MCA）血流速度，并评价临床疗效。
针药结合组总有效率为89.8%（53/59），优于西药组的76.3%（45/59）（P<0.01）。与治疗前比较，两组治疗后MMSE各分项评分及总分、ADASCog评分、CDT评分、Barthel指数评分均改善（P<0.01，P<0.05），且针药结合组评分优于西药组（P<0.05，P<0.01）。治疗后，针药结合组双侧MCA血流速度增快（P<0.05），快于西药组（P<0.05）。
早期针刺可改善脑梗死继发VD患者的认知功能和日常生活活动能力，其机制可能与提高MCA血流速度、促进血液循环、改善脑灌注有关。
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