| Objective:Modern medicine thinks vascular cognitive impairment-no dementia as the early stage of vascular dementia, is a subtype of vascular cognitive impairment in this disease more common, the disease in patients with impaired cognitive function to a lesser degree, and the progress of the disease was reversible to some extent; along with the acceleration of China’s population aging process, clinical incidence of the disease is increasing rapidly, at an alarming rate so, actively develop and explore effective treatment measures of prevention and control of the disease, not only for the patients to relieve the pain of their disease, but also to reduce patient family economic pressure and social burden of medical care are of great significance.Because the etiology and pathological mechanism of the disease is still unclearly, auxiliary examination means no deterministic, current clinical no targeted treatment measures, in addition to control the primary disease, the basic use of the drug in the treatment of vascular dementia, and limited efficacy; and this disease belongs to "consciousness" the scope of the disease in traditional Chinese medicine, on the this kind of disease has a systematic and detailed exposition, the clinical effect of traditional Chinese medicine, acupuncture and moxibustion by, or combination of acupuncture and medicine and other treatment measures significantly.Clinical application and experimental study of acupuncture has been confirmed in cerebrovascular disease and vascular dementia in effectiveness and the mechanism of action of a certain; As one of the classic traditional therapy, auricular needle has the advantages of simple operation, little side effects, reports of its clinical application in cerebrovascular diseases have more, and the curative effect is good, but the investigations and reports about the application of auricular acupuncture for treatment of less cognitive impairment is too little.Therefore, this research adopts combined auricular acupuncture with Jin’s three needle acupuncture therapy applied in vascular cognitive impairment-no dementia, not only to explore the treatment method is simple and effective and safe for the disease, but also to further explore the clinical application values of auricular acupuncture has important significance.Methods:The topics chosen small sample parallel randomized controlled trials, as a prospective study at the same time, the study chose 2013 March to 2014 December visit to the rehabilitation center of the First Affiliated Hospital of Guangzhou University of Chinese Medicine of outpatient and inpatient department of 100 patients with vascular cognitive impairment-no dementia in patients with the inclusion criteria. The diagnosis of western medicine with 《expert consensus of vascular cognitive impairment》 in 2007, the diagnosis of TCM with 1990 years of Chinese society of Chinese medicine of《the elderly stay disease diagnosis, and curative effect evaluation standard));and using the method of random number table according to the ratio of 1:1 to the patients were randomly divided into treatment group and control group,50 cases in each group; Two groups of patients in the basic treatment of neural Department of internal medicine respectively receive different treatments, the treatment group treated by Acupuncture of auricular acupuncture combined with acupuncture, while the control group only with acupuncture, four weeks as a period of treatment; this study adopts MMSE scale, MoCA scale, FAQ scale and ADL scale as the evaluation index, the study used in the process of observation of analysts blind method, all the patients were performed before treatment, at the end of the two week and 4 weeks after treatment evaluation scale, evaluation indicators by specialized personnel carefully check and detailed records, data collected by the unified management to establish a database using SPSS17.0 statistical software for analysis of relevant statistics, to the clinical efficacy and safety of the objective and accurate evaluation of auricular acupuncture combined with acupuncture.Results:The study enrolled 100 patients who accorded with the diagnostic standard, but there are three people in the process of treatment for personal reasons failed to complete the study, patients with final 49 cases in the treatment group, control group of 48 cases. Results show:the two group patients before treatment of traditional Chinese medicine in age, gender, duration, type, level of education and other aspects of difference has no statistical significance (P > 0.05), suggesting that two groups of patients in these aspects of the fundamental equilibrium, the smaller possibility of results by the above factors; Two groups of patients before treatment respectively using MMSE scale, MoCA scale, FAQ rating scale and ADL scale four scale, the results show two groups of patients in the four rating scale total score and corresponding scale sub item scores were no statistically significant differences, suggesting that two groups of patients before treatment basic consistent and comparable.Treatment for two weeks when the four rating scale results:MMSE scale scores show that the treatment group patients in the total score and the directional force, immediate memory, attention, and computing power, memory, naming, three-step instruction and drawing has a certain improvement before the treatment (P<0.05), the control group patients in the total score and the two aspects of attention and computing power, memory improvement before the treatment (P<0.05); After two weeks of treatment compared with pre-treatment score difference was found after two weeks of treatment, the treatment group in total score and attention and calculation, memory, three-step instructions and graphics aspects score improvement than the control group difference was statistically significance; MoCA rating scale results show two groups of patients in the total score and the delayed memory, attention, visual space and execution ability, orientation ability, named five items were improved than before treatment (P<0.05), the treatment group compared with control group in the total score and delayed memory, attention, visual space and execution ability three aspects difference obvious (P< 0.05),it means the effect of the treatment group super to the contro group; FAQ scale score of treatment group in account management, ability to work, shopping, prepare the meals, serve them to participate in the discussion, six child go out alone, projects to improve before the treatment (P<0.05), the control group in account the total score and management, shopping, and three aspects to go out alone before the treatment improved significantly (P<0.05), compared the two groups treatment group than the control group in the FAQ scores improved significantly (P<0.05), the others each subproject no statistical difference (P> 0.05); ADL scale score results show two groups of patients in the basic ability of daily life and instrumental daily was to improve the significantly (P<0.01), the treatment group compared with controls in instrumental daily ability and ADL scores improved more significantly (P<0.05).Treatment of four weeks after statistical results show that the MMSE scale score in treatment group patients was in the rating scale according to the patients in treatment group orientation, immediate memory, attention and calculation of forces, memories, naming, drawing and the total score on improved (P< 0.01), the three-step instruction (P<0.05), four weeks after scoring two weeks when the relative treatment than in orientation, immediate memory, attention and calculation of forces, recall three aspects to improve (P<0.01), the control group after treatment around scores compared with before treatment and two weeks later in the total score and the directional force, immediate memory, attention, and computing power, memory, repetition, drawing on improved (P< 0.01), two groups of patients four weeks after the MMSE score in the total score and immediate memory, attention, and computing power, memory, graphics four children differ significantly(P< 0.05); MoCA rating scale before treatment group in the treatment of four weeks after the treatment in delayed memory, attention, visual space and execution ability, orientation ability, language, naming, abstract seven sub item and total score were significantly improved (P < 0.01), treatment group around the treatment in two weeks delay memory, attention, visual space and execution ability, orientation ability, naming, abstract aspect to improve (P<0.05), language to improve the control treatment of four weeks after than before treatment in the total score and delayed memory, attention, visual space and execution ability, orientation ability, language, named improved (P< 0.01), abstract aspect to improve (P<0.05), the control group treatment around the treatment in two weeks the total score and delay memory, attention, visual space and executive ability improved (P<0.01), the two aspects of language and abstract improve (P<0.05), in the two groups after treatment around delay memory, attention, visual space and execution ability, naming significant difference (P<0.05); FAQ rating scale compared with the control group after treatment around two weeks treatment in account management, ability to work, shopping, prepare meals and being alone much better, while the treatment group in account management, ability to work, shopping, prepare the meals and keep track of current events and the total score improved more significantly; FAQ rating scale compared with the control group after treatment around before treatment in account management, ability to work, shopping, prepare meals, being alone and the total score much better (P<0.01), while the treatment group in account the total score and management, ability to work, shopping, prepare the meals, serve them to participate in the discussion, to go out alone on improved (P< 0.01), and keep track of current events (P< 0.05), compared the two groups treatment group in this subproject accounts management and FAQ scores than the control group significant difference (P< 0.05), the sub-project of the other differences between the two groups have no obvious statistical significance (P> 0.05); ADL rating scale according to four weeks after treatment in both groups in the total score and two components was obviously improved compared with the two weeks and before treatment (P< 0.01), all round the contrast between the two groups after treatment the treatment group than the control group improved more significantly in the total score and the aspect of IADL (P<0.01).In terms of security, adverse reactions of the two groups of patients were not found obvious associated with treatment.Conclusion:Whether treatment with acupuncture alone, or combined auricular acupuncture with acupuncture of vascular cognitive impairment-no dementia, to improve patients cognitive dysfunction and certain effect of daily life ability were safe, and no obvious adverse reaction; auricular acupuncture combined with Jin’s three needle treatment program than single use acupuncture treatment scheme can quickly improve the ability of daily living and cognitive function in patients with along with the extension, and the therapeutic effect of the treatment time is more significant, and no significant adverse reactions, showing the effectiveness of auricular acupuncture combined with acupuncture treatment program for clinical, acupuncture combined with usage patterns used in clinical treatment of vascular cognitive impairment-no dementia, its specific mechanism remains to be further research. |
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