Department of Acupuncture-Moxibustion, Second TCM Hospital of Guangdong Province, Guangzhou 510095, China.
Department of Acupuncture-Moxibustion, TCM Hospital of Lianzhou City.
Zhongguo Zhen Jiu. 2024 Mar 12;44(3):255-260. doi: 10.13703/j.0255-2930.20230725-k0002.
To compare the effects of pressing moxibustion at Baihui (GV 20) and Guanyuan (CV 4) combined with donepezil hydrochloride tablets and donepezil hydrochloride tablets alone on cognitive impairment in patients with mild to moderate Alzheimer's disease(AD), and to explore the mechanism of pressing moxibustion in the treatment of mild to moderate AD from the serum levels of β-amyloid 1-42 (Aβ), microtubule-associated protein tau and phosphorylated tau (P-tau).
A total of 76 patients with mild to moderate AD were randomly divided into an observation group (38 cases, 4 cases dropped out) and a control group (38 cases, 2 cases dropped out). Patients in the control group were given oral donepezil hydrochloride tablets (5 mg each time, once a day). On the basis of the control group, patients in the observation group were treated with pressing moxibustion at Baihui (GV 20) and Guanyuan (CV 4), 5 cones per acupoint, once every other day, three times a week. Both groups were treated for 8 weeks. The scores of mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were compared between the two groups before treatment, after treatment and after 4 and 12 weeks of treatment completion. The serum levels of Aβ, tau and P-tau were detected before and after treatment in the two groups, and the safety was evaluated.
At each time point after treatment, the MMSE and MoCA scores of the two groups were higher than those before treatment (<0.05), and the scores in the observation group were higher than those in the control group (<0.05). After treatment, the serum levels of Aβ, tau and P-tau in the two groups were lower than those before treatment (<0.05), and above indexes in the observation group were lower than those in the control group (<0.05). There was no significant difference in the safety level between the two groups (>0.05).
The short-term and long-term effect of pressing moxibustion at Baihui (GV 20) and Guanyuan (CV 4) combined with donepezil hydrochloride tablets in improving cognitive impairment in mild to moderate AD is better than that of donepezil hydrochloride tablets alone, and can reduce serum levels of Aβ, tau and P-tau, which may be one of the mechanisms of pressing moxibustion to improve cognitive impairment.
比较艾灸百会穴、关元穴联合多奈哌齐片与单纯多奈哌齐片治疗轻中度阿尔茨海默病（AD）患者认知障碍的疗效，从血清β-淀粉样蛋白 1-42（Aβ）、微管相关蛋白 tau 和磷酸化 tau（P-tau）水平探讨艾灸治疗轻中度 AD 的作用机制。
将 76 例轻中度 AD 患者随机分为观察组（38 例，脱落 4 例）和对照组（38 例，脱落 2 例）。对照组患者给予多奈哌齐片口服（每次 5 mg，每日 1 次），观察组在此基础上联合艾灸百会穴、关元穴治疗，每穴 5 壮，隔日 1 次，每周 3 次。两组均治疗 8 周。比较两组患者治疗前后及疗程结束后 4 周、12 周的简易精神状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）评分，检测两组患者治疗前后血清 Aβ、tau、P-tau 水平，并评价安全性。
治疗后各时间点，两组患者 MMSE、MoCA 评分均高于治疗前（<0.05），观察组高于对照组（<0.05）。治疗后，两组患者血清 Aβ、tau、P-tau 水平均低于治疗前（<0.05），观察组低于对照组（<0.05）。两组安全性分级比较，差异无统计学意义（>0.05）。
艾灸百会穴、关元穴联合多奈哌齐片治疗轻中度 AD 患者认知障碍的短期及长期疗效优于单纯多奈哌齐片，能降低血清 Aβ、tau、P-tau 水平，这可能是艾灸改善认知障碍的作用机制之一。
