Clinical Research Of Cognitive Impairment No Dementia Caused By Cerebral Small Vessel Disease Treated With “Kidney-Tonifying And Blood-Activating Therapy” Acupuncture

Objective Through clinical research of cognitive impairment no dementia caused by cerebral small vessel disease treated with “Kidney-tonifying and Blood-activating therapy” acupuncture,the changes of neuropsychological characteristics such as attention and executive ability were observed before and after treatment,Systematically evaluate the clinical effect of acupuncture treatment of this disease,improve it to be promoted and clinical application,in order to improve the development of acupuncture treatment of cognitive impairment no dementia caused by cerebral small vessel disease.Methods: 1.70 patients who met the diagnostic criteria and inclusion criteria for cerebral small vessel disease were randomly divided into 35 patients in the acupuncture group and 35 patients in the drug control group,control group: on the basis of platelet aggregation inhibitory,control of blood pressure,control of blood sugar,lipid regulation and plaque stabilization,oral Citicoline Sodium Capsules,0.2g 3 times/day,12 weeks of treatment.2.Acupuncture treatment group: Acupuncture treatment group: on the basis of the control group,add with "tonifying kidney and activating blood" acupuncture treatment.Basic syndrome type: kidney essence deficient deficiency,blood stasis collateral type Main symptom: the god is exhausted good forget,in a daze,action is slow,lumbar acid leg is soft,giddy tinnitus,after urination yu li is not clean,complexion is dull,skin is coarse not moist.Tongue appearance: the tongue is thin and pale,the sublingual vein is purple,moss is little or thin white Pulse: pulse sinking and fine string treatment principles: Kidney-tonifying and Blood-activating Brain-activating and Consciousness-regaining acupoint:(1)basic acupoint: Shenshu(double)Taixi(double)Xuanzhong(double)Geshu(double)Xuehai(double)Diji(double)Yintang Shenting Baihui Sishencong;(2)syndrome differentiation of acupoints: SDSVD scale was used to record the TCM symptoms and corresponding scores of patients. If syndrome of interior invaded by heat-toxicity with Quchi Hegu Waiguan(double);If the turbid phlegm blocking the clear orifices syndrome with Fenglong Yinlingquan Sanyinjiao Zusanli(double);If Qi-blood deficiency syndrome with Zhongwan Guanyuan Qihai Zusanli(double);If upper hyperactivity of liver yang syndrome with Taichong Sanyinjiao Yanglingquan Fengchi(double);(3)needle: disposable sterile acupuncture needle 0.25 * 40 mm,0.25 * 25mm(4)Operation: Put the patient in the sitting position,the twirling method is used for Shenshu Geshu Taixi Xuanzhong,the twist and purge method is used for Xuehai Diji,Yingtang: Pinch local skin,flat thorn,get gas for degree,Shenti Baihui Sishencong: Flat thorn,get gas for degree;Match acupoints according to the principle of virtual consolidation and diarrhea operation.Each point was rapidly twisted for 0.5 minute at a frequency of150-200 times/min after qi extraction by acupuncture.During the treatment,each needle was placed for 1 time at the time of acupuncture and before taking the needle,and the needle was retained for 25 minutes.The operator should be trained in acupoint positioning and acupuncture manipulation to reduce errors.(5)course of treatment: treatment once a day,continuous treatment for 5 days a week,rest for 2 day,a total of 12 weeks.3.Observation indicators: Before treatment assess the patient Hachinski、Mini Mental State Examination(MMSE)、Montreal Cognitive Assessment(MOCA)、Digit Span Test(DST)、Trail Making Test A and B(TMT A and B);After 12 weeks of treatment assess the patient MMSE、Mo CA、DST、TMT A and B;In this study,the recorded data will be counted and analyzed by SPSS26 software.Results:1.Before treatment,baseline data,MMSE,MOCA,DST and TMT of the two groups were compared,and no statistically significant differences were found between the two groups(P>0.05).2.After treatment,MMSE score and MOCA score were significantly increased in both groups(P<0.05),and the increase of MMSE score and MOCA score in the acupuncture group was significantly higher than that in the control group(P<0.05).3.After treatment,DST score in both groups were significantly improved(P<0.05).Among them,the DST score of acupuncture group increased significantly compared with that of control group(P<0.05).The results showed that the acupuncture group had better efficacy than the control group.4.After treatment,the TMT scores of the two groups were significantly reduced(P<0.05).The TMT score of acupuncture group decreased significantly compared with that of control group(P<0.05).The results showed that the acupuncture group had better efficacy than the control group.5.After treatment,SDSVD score of major syndromes(deficiency of kidney essence and obstruction of collaterals by blood stasis)in both groups was lower than that before treatment(P<0.05).The score of SDSVD in acupuncture group decreased significantly compared with that in control group(P<0.05).The total effective rate of acupuncture group was better than that of control group(P<0.05).Conclusion:1.The acupuncture method of "tonifying kidney and activating blood circulation" can improve the overall cognitive function,attention and executive ability of patients with cerebrovascular disease,and improve the score of TCM symptom scale,and the effect is better than that of the control group.2.The improvement of cognitive function of patients in the "kidney-tonifying and blood-activating" acupuncture group was better than that in the control group.It was speculated that the "kidney-tonifying and blood-activating" acupuncture group may improve the overall cognitive function of patients with cerebrovascular disease mainly by improving their attention and executive ability.