| Objective:Through the observation of the clinical effect of Dihuangyinzi combined with the acupuncture method of invigorating the kidney and eliminating phlegm and opening the orifices on mild cognitive impairment(MCI)after cerebral infarction,the effective treatment and possible mechanism of MCI after cerebral infarction were preliminarily discussed.Methods:According to the inclusion and exclusion criteria,114 patients with kidney deficiency and phlegm obstruction type were selected from January 2018 to July 2019 in the Department of encephalopathy rehabilitation of Tai’an traditional Chinese medicine hospital.Randomly divided into three groups:Acupuncture and medicine combined group(referred to as acupuncture and medicine group),control group and acupuncture group;42 cases in acupuncture and medicine group and control group,30 cases in acupuncture group.The general information of patients:gender,age,course of disease were compared statistically to make it comparable.All patients were.treated with routine medicine and general support.On this basis,the acupuncture group was treated with Dihuangyinzi,250ml in the morning and 250ml in the evening,1 dose in the day,combined with the acupuncture method of invigorating the kidney,eliminating phlegm and opening the orifices,once a day;the control group was treated with the acupuncture method of invigorating the kidney,eliminating phlegm and opening the orifices,30mg(1 piece)in three times a day,after meals;the acupuncture group was treated with the acupuncture method of invigorating the kidney,eliminating phlegm and opening the orifices.The above treatment is a course of treatment every 6 weeks,with 3 days’ rest between courses for 2 consecutive courses.Before and after treatment,the patients in the three groups were assessed with MMSE,MoCA(Beijing version),HAMD(17 items),modified Barthel Index(MBI),TCD(transcranial Doppler)and blood lipid before and after treatment for one course and two courses.After treatment,the clinical efficacy was assessed。Result:1.Due to the individual factors of the patients,one patient in the acupuncture group and one patient in the control group quit respectively.Finally,41 cases in the acupuncture group,41 cases in the control group and 30 cases in the acupuncture group were completed.2.MMSE score:there was no significant difference among the three groups before treatment.After treatment,MMSE score of the three groups was higher than that before treatment,with significant difference(P<0.05);compared with one course,the score of the two courses had an increasing trend,with significant difference(P<0.05).Compared with the control group and the acupuncture group,the score of the acupuncture and medicine group increased significantly,and was higher than that of the control group and the acupuncture group,with a significant difference(P<0.05);compared with the acupuncture group,the score of the acupuncture group after treatment was higher than that of the control group.3.MoCA score:there was no significant difference among the three groups before treatment.After treatment,MoCA score of the three groups was higher than that before treatment,with a significant difference(P<0.05);compared with one course,the score of the two courses had an increasing trend,with a significant difference(P<0.05).Compared with the control group and the acupuncture group,the score of the acupuncture and medicine group increased significantly,and was higher than that of the control group and the acupuncture group,with a significant difference(P<0.05);compared with the acupuncture group,the score of the acupuncture group after treatment was higher than that of the control group.4.Hamd17 items:there was no significant difference in the scores of three groups before treatment.After treatment,the scores of hamd17 items in three groups decreased significantly compared with that before treatment(P<0.05);compared with one course,the scores of two courses decreased,with significant difference(P<0.05).Compared with the control group and the acupuncture group,the score of the acupuncture and drug group decreased significantly,and was lower than that of the control group and the acupuncture group,with a significant difference(P<0.05);compared with the acupuncture group,the score of the acupuncture group after treatment was lower than that of the control group.5.MBI score:before treatment,there was no significant difference among the three groups.After treatment,the MBI score of the three groups was significantly higher than that before treatment(P<0.05);compared with one course,the score of the two courses had an increasing trend,with a significant difference(P<0.05).Compared with the control group and the acupuncture group,the score of the acupuncture and medicine group increased significantly,and was higher than that of the control group and the acupuncture group,with a significant difference(P<0.05);compared with the acupuncture group,the score of the acupuncture group after treatment was higher than that of the control group.6.TCD examination:before and after treatment,there was no significant difference between the three groups in systolic peak velocity(VS),end diastolic velocity(VD),resistance index(RI)and pulsation index(PI)(P>0.05).However,after two courses of treatment,the values of VS and VD in the three groups were higher than before treatment,and RI and PI were lower than before treatment.7.Blood lipid:there was no significant difference in total cholesterol(TC),triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)between the three groups before and after treatment;TC,TG and LDL-C in the three groups after two courses of treatment were all lower than before treatment,with significant difference(P<0.05).Compared with the control group and the acupuncture group,the score of the acupuncture and drug group decreased significantly,and was lower than that of the control group and the acupuncture group,with a significant difference(P<0.05);compared with the acupuncture group,the score of the acupuncture group after treatment was lower than that of the control group.8.Clinical effect:after two courses of treatment,the total effective rate of acupuncture and medicine group was 90.5%,that of control group was 71.4%,and that of acupuncture group was 76.7%.There was a significant difference among the three groups(P<0.05).Conclusion:1.Dihuangyinzi combined with acupuncture method of invigorating the kidney eliminating phlegm and opening the orifices can effectively treat MCI after cerebral infarction,improve the cognitive and daily life ability of patients,and the effect is better than that of idebenone and acupuncture alone,and has a certain timeliness.2.The mechanism of Dihuangyinzi combined with acupuncture method of invigorating the kidney eliminating phlegm and opening the orifices in the treatment of MCI after cerebral infarction may be related to the reduction of blood lipid viscosity and the improvement of circulation. |
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