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基于肠脑轴的针刺治疗遗忘型轻度认知障碍的临床观察及机制:一项随机对照试验的研究方案

Clinical observation and mechanism of acupuncture on amnestic mild cognitive impairment based on the gut-brain axis: study protocol for a randomized controlled trial.

作者信息

Bao Qiongnan, Liu Yiwei, Zhang Xinyue, Li Yaqin, Wang Ziqi, Ye Fang, He Xia, Xia Manze, Chen Zhenghong, Yao Jin, Zhong Wanqi, Wu Kexin, Wang Ziwen, Sun Mingsheng, Chen Jiao, Hong Xiaojuan, Zhao Ling, Yin Zihan, Liang Fanrong

机构信息

School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China.

出版信息

Front Med (Lausanne). 2023 Jun 21;10:1198579. doi: 10.3389/fmed.2023.1198579. eCollection 2023.

Abstract

BACKGROUND

Amnestic mild cognitive impairment (aMCI) is a pre-dementia condition associated with declined cognitive function dominated by memory impairment. The occurrence of aMCI is associated with the gut-brain axis. Previous studies have shown cognitive improvements in MCI after acupuncture treatment. This study evaluates whether acupuncture can produce a therapeutic effect in patients with aMCI by modulating the gut-brain axis.

METHODS AND DESIGN

This is a prospective, parallel, multicenter randomized controlled trial. A total of 40 patients with aMCI will be randomly assigned to an acupuncture group (AG) or a waiting-list group (WG), participants in both groups will receive health education on improving cognitive function at each visit, and acupuncture will be conducted twice a week for 12 weeks in the AG. Another 20 matched healthy volunteers will be enrolled as normal control. The primary outcome will be the change in Alzheimer's Disease Assessment Scale-cognitive scale score before and after treatment. Additionally, functional magnetic resonance imaging data, faeces, and blood will be collected from each participant to characterize the brain function, gut microbiota, and inflammatory cytokines, respectively. The differences between patients with aMCI and healthy participants, and the changes in the AG and WG groups before and after treatment will be observed. Ultimately, the correlation among brain function, gut microbiota, inflammatory cytokines, and clinical efficacy evaluation in patients with aMCI will be analyzed.

DISCUSSION

This study will identify the efficacy and provide preliminary data on the possible mechanism of acupuncture in treating aMCI. Furthermore, it will also identify biomarkers of the gut microbiota, inflammatory cytokines, and brain function correlated with therapeutic effects. The results of this study will be published in peer-reviewed journals.

CLINICAL TRIAL REGISTRATION

http://www.chictr.org.cn, identifier ChiCTR2200062084.

摘要

背景

遗忘型轻度认知障碍(aMCI)是一种痴呆前状态,与以记忆障碍为主的认知功能下降相关。aMCI的发生与肠-脑轴有关。既往研究表明针刺治疗后MCI患者的认知功能有所改善。本研究旨在评估针刺是否能通过调节肠-脑轴对aMCI患者产生治疗作用。

方法与设计

这是一项前瞻性、平行、多中心随机对照试验。总共40例aMCI患者将被随机分配至针刺组(AG)或等待名单组(WG),两组参与者每次就诊时均接受改善认知功能的健康教育,AG组将每周进行2次针刺,共12周。另外20名匹配的健康志愿者将作为正常对照纳入。主要结局指标为治疗前后阿尔茨海默病评估量表-认知分量表评分的变化。此外,将从每位参与者收集功能磁共振成像数据、粪便和血液,分别用于表征脑功能、肠道微生物群和炎性细胞因子。观察aMCI患者与健康参与者之间的差异,以及AG组和WG组治疗前后的变化。最终,分析aMCI患者脑功能、肠道微生物群、炎性细胞因子与临床疗效评估之间的相关性。

讨论

本研究将确定针刺治疗aMCI的疗效,并提供其可能机制的初步数据。此外,还将确定与治疗效果相关的肠道微生物群、炎性细胞因子和脑功能的生物标志物。本研究结果将发表在同行评审期刊上。

临床试验注册

http://www.chictr.org.cn,标识符ChiCTR2200062084

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45ae/10321407/cc9608d84a45/fmed-10-1198579-g001.jpg

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