| The spectrum of cerebrovascular disease that can cause Vascular Cognitive Impairment (VCI) includes full-blown strokes, and transient ischemic attacks (TIAs), which involve a brief loss of blood flow to the brain. VCI includes Vascular mild cognitive impairment, Vascular dementia and Mixed Dementia.Vascular Mild Cognitive Impairment (VMCI) is a condition associated with impairments in understanding and memory not severe enough to be diagnosed as dementia affecting activities of daily livings but more pronounced than those associated with normal aging. About10%～15%people with VMCI develop Alzheimer’s Disease (AD)annually, hence people with this condition do have a significantly increased risk of dementia compared to the rest of the population. The underlying vascular risk factors of VMCI are differentiated by heterology including hypertension, diabetes,cerebral infarct, cerebral hemorrhage, atherosclerotic stenosis, leukoaraiosis, etc.VMCI is curable and preventable. The earlier the discovery, diagnosis and prevention being made, the better the prevention and prognosis of VMCI.Prevention of VMCI is crucial in lowering the onset of the disease and it is an important aspect economically, socially and medically.There is no "Vascular Mild Cognitive Impairment" recorded in the ancient Chinese medicine literature but its description can been seen within absent-mindedness, forgetfulness and amnesia. Contemporary research suggests that kidney essence deficiency, phlegm and blood stagnation are the root causes for VMCI in Chinese medicine. Among many Chinese medicine practitioners, acupuncture is a well-known and effective treatment with many benifits and few side-effects. Blood stagnation and phlegm are unwanted products and can worsen the condition; hence tonifying bone marrow and the brain while clearing phlegm and invigorating blood are the main remedy. Electro-thermal acupuncture is developed from both The Medical Classic of the Yellow Emperor(Huang Di Nei Jing) and modern scientific technology, it uses as acupuncture is benifits while adding a warm, tonifying quality to restore harmony of Qi and Blood. Chinese medicine diagnostics and the Montreal cognitive assessment (MoCA) provide objective evidences for the effectiveness of electro-thermal acupuncture.This project is composed of two parts, a literature review and a clinical study. There are two literature reviews. The first one is the analysis of ancient acupuncture. The later one is the review of VMCI research in the recent decade and its assessment tools.Clinical StudyObjectiveTo verify and conclude the therapeutic effect of electro-thermal acupuncture treating vascular mild cognitive impairment. In order to compare its therapeutic value to usual acupuncture, Chinese medicine diagnostics and Montreal cognitive assessment (MoCA) are used as assessment tools.Method58patients diagnosed with VMCI were randomly divided into a treatment group and a control group. The treatment group of30cases were treated with electro-thermal acupuncture at2groups of acupoints simultaneously:①Baihui (DU20), Yamen (DU15), Shenshu(BL23), Zusanli(ST36) and②Benshen(GB13), Sanyinjiao(SP6), Fenglong(ST40). The control group of28cases were treated by simple acupuncture with the same acupoints. The two groups were given a30-day treatment. After the treatment, therapeutic effects of both groups were compared.ResultsNo significant difference in sex, age,career, disease past history,activites and MMSE scores hence the two groups are comparable (P>0.05). The electro-thermal acupuncture group showed better effect in treating headache, dizziness, neck stiffness, coughing phlegm, tiredness, blotted stomach and cold limbs in the total effective rate (P<0.05). The average MoCA score of the treatment group is much better than the control group especially in the aspect of visuospatial/executive ability, attention/calculating ability and delayed recall ability in the total effective rate(P<0.05).Significant difference shown in tongue manifestations and pulse presentations before and after treatment (P<0.05).Both two groups show improvements in MoCa score and chinese medicine clinical symptoms (P<0.01).Significant statistical difference shown between two groups(P<0.05) where the electro-thermal acupuncture group shows better VMCI improvement in MoCa score and chinese medicine clinical symptoms than the acupuncture group. No adverse effects shown during research, neither before nor after the treatment.ConclusionElectro-thermal acupuncture is a safe and effective treatment and it has a better clinical therapeutic effect on vascular mild cognitive impairment than ordinary acupuncture. |
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