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麦粒灸疗法对轻度认知障碍患者认知功能及脑代谢变化的影响:一项初步的氢质子磁共振波谱研究

Effects of Moxa Cone Moxibustion Therapy on Cognitive Function and Brain Metabolic Changes in MCI Patients: A Pilot H-MRS Study.

作者信息

Mai Wei, Zhang Aizhen, Liu Qiang, Tang Liying, Wei Yichen, Su Jiahui, Duan Gaoxiong, Teng Jinlong, Nong Xiucheng, Yu Bihan, Li Chong, Shao Lijuan, Deng Demao, Chen Shangjie, Zhao Lihua

机构信息

Guangxi University of Chinese Medicine, Nanning, China.

Department of Traditional Chinese Medicine, Guangxi Tumour Hospital, Nanning, China.

出版信息

Front Aging Neurosci. 2022 May 26;14:773687. doi: 10.3389/fnagi.2022.773687. eCollection 2022.

Abstract

OBJECTIVE

To explore the effect of moxa cone moxibustion on -acetyl aspartate/total creatinine (NAA/tCr) and choline/total creatinine (Cho/tCr) in the bilateral hippocampus (HIP) and bilateral posterior cingulate gyrus (PCG) in patients with mild cognitive impairment (MCI) using hydrogen proton magnetic resonance spectroscopy (H-MRS) and to provide imaging basis for moxa cone moxibustion treatment for MCI.

METHODS

One hundred eight patients with MCI were served as the MCI group, and 67 age-matched subjects were enrolled as the normal control group. The MCI group was randomized and allocated into acupoint group, drug group, and sham acupoint group, with 36 cases in each group. Some patients in each group withdrew. Finally, 25 cases were included in the acupoint group, 24 cases in the drug group, and 20 cases in the sham acupoint group. The drug group was treated with oral donepezil hydrochloride. The acupoint group and sham acupoint group received moxa cone moxibustion treatment. Mini-mental state exam (MMSE) and Montreal cognitive assessment (MoCA) scores were recorded before intervention, at the end of the first and the second months of intervention, and in the 5th month of follow-up. The NAA/tCr and Cho/tCr ratios in the HIP and PCG were bilaterally measured by H-MRS before and after intervention.

RESULTS

Before intervention, compared with the normal control group, the MMSE and MoCA scores, the Cho/tCr ratio in the right HIP, the NAA/tCr ratio in the bilateral HIP, and the NAA/tCr ratio in the left PCG in the three treatment groups decreased significantly (both < 0.01), and the NAA/tCr ratio in the right PCG significantly reduced in the acupoint and drug groups ( < 0.05). After two months of treatment, compared with the normal control group, there were no differences in the MoCA scores, the NAA/tCr, and Cho/tCr ratios in the bilateral PCG and bilateral HIP in the three treatment groups ( > 0.05). However, the MMSE scores in the drug group decreased when compared with the acupoint group and normal control group ( < 0.05, < 0.01). The scores of MMSE and MoCA in the acupoint group and sham acupoint group at all time points were better than those in the drug group, which were similar to those in the normal control group.

CONCLUSION

Our findings suggest that moxibustion could improve the cognitive function of patients with MCI. The mechanism may be related to the improvement of abnormal brain metabolism in HIP and PCG.

摘要

目的

采用氢质子磁共振波谱(H-MRS)探讨麦粒灸对轻度认知障碍(MCI)患者双侧海马(HIP)及双侧后扣带回(PCG)中 N-乙酰天门冬氨酸/总肌酐(NAA/tCr)和胆碱/总肌酐(Cho/tCr)的影响,为麦粒灸治疗 MCI 提供影像学依据。

方法

将 108 例 MCI 患者作为 MCI 组,选取 67 例年龄匹配的健康受试者作为正常对照组。将 MCI 组随机分为穴位组、药物组和假穴位组,每组 36 例。每组部分患者退出。最终,穴位组纳入 25 例,药物组纳入 24 例,假穴位组纳入 20 例。药物组口服盐酸多奈哌齐治疗。穴位组和假穴位组接受麦粒灸治疗。在干预前、干预第 1 个月末、第 2 个月末及随访第 5 个月时记录简易精神状态检查表(MMSE)和蒙特利尔认知评估量表(MoCA)评分。干预前后采用 H-MRS 双侧测量 HIP 和 PCG 中的 NAA/tCr 及 Cho/tCr 比值。

结果

干预前,与正常对照组相比,三个治疗组的 MMSE 和 MoCA 评分、右侧 HIP 中的 Cho/tCr 比值、双侧 HIP 中的 NAA/tCr 比值以及左侧 PCG 中的 NAA/tCr 比值均显著降低(均 P<0.01),穴位组和药物组右侧 PCG 中的 NAA/tCr 比值显著降低(P<0.05)。治疗两个月后,与正常对照组相比,三个治疗组的 MoCA 评分、双侧 PCG 和双侧 HIP 中的 NAA/tCr 及 Cho/tCr 比值均无差异(P>0.05)。然而,与穴位组和正常对照组相比,药物组的 MMSE 评分降低(P<0.05,P<0.01)。穴位组和假穴位组在各时间点的 MMSE 和 MoCA 评分均优于药物组,与正常对照组相似。

结论

研究结果表明,艾灸可改善 MCI 患者的认知功能。其机制可能与改善 HIP 和 PCG 中异常的脑代谢有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cb7/9204283/bdfae2f9e132/fnagi-14-773687-g001.jpg

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