To Explore The Effect Of Exercise Acupuncture On Clinical Efficacy Of Vascular Dementia And Synaptic Plasticity

Objective: To understand the clinical effect of exercise acupuncture on VD through clinical observation,and then through basic experiments to explore the mechanism of exercise acupuncture on VD,so as to explore an effective therapeutic schedule for this disease.Methods:1.This study was divided into two parts: clinical observation and animal research.The clinical observation took VD patients as subjects.According to the study protocol design,a total of 60 VD subjects were included,randomly divided into 30 subjects in the control group and the observation group,The control group were treated with routine therapy plus nimodipine,and the observation group were treated with exercise acupuncture on the basis of the control group for a period of 4 weeks.Before and after the intervention,MMSE,HDS and ADL scores were scored in the two groups,and the changes of MMSE,HDS and ADL scores were compared.According to Nimodipine formula,the effective rate of the two groups was calculated after treatment.2.VD rat model was made by repeated occlusion and reperfusion combined with intraperitoneal injection of sodium nitroprusside.In the sham operation group,bilateral common carotid arteries were separated and sutured without clamping and intraperitoneal injection of sodium nitroprusside.Fifty rats were randomly divided into sham operation group(8 rats),and 42 rats were made VD models.The failed rats were eliminated by Morris experiment.The successful VD rats were randomly divided into model group(8 rats),exercise group(8 rats),acupuncture group(8 rats)and exercise acupuncture group(8 rats).The sham operation group and model group were fed normally without any intervention.The exercise group were treated with forced swimming and running wheel training.The acupuncture group were treated with acupuncture,and the selected acupoints were Baihui and Sishencon.The exercise acupuncture group were treated with forced swimming and running wheel training after acupuncture at Baihui and Sishencong points.The intervention group were intervened for 2 hours each time,once a day for 1 month.After the intervention,Morris experiment was used to understand the behavioral changes of rats in each group.After Morris experiment,cardiac perfusion was carried out,and brain tissue was taken to prepare paraffin sections.HE staining was used to observation the morphological changes of hippocampal neurons in each group.The levels of SYN,PSD95 and GAP43 m RNA in the hippocampus was assessed by RT-q PCR.Results:1.The results of clinical observation showed that the scores of MMSE,HDS and ADL of VD subjects in the two groups after treatment were higher than those before treatment,and the difference was significant after statistical analysis(P < 0.05).The scores of the scale in the observation group after treatment were higher than those in the control group.After calculation by nimodipine formula,it was found that the total effective rate in the observation group was significantly higher than that in the control group(P <0.05).2.Morris experiment showed that the learning and memory function of rats in the model group was obviously impaired,and the learning and memory ability of rats in the intervention group was significantly improved compared with that in the model group(P < 0.05),especially in the exercise acupuncture group.HE staining showed that the morphology of hippocampal neurons in the model group was abnormal,the ruptured and swollen neurons fused into pieces,the number of neurons decreased and the staining was uneven;After intervention,the number of neurons with abnormal morphology in hippocampus decreased,while the number of normal morphologic neurons increased,especially in the exercise acupuncture group.RT-q PCR showed that the expression of SYN,PSD95 and GAP43 m RNA in hippocampus of model group decreased significantly(P < 0.05),and increased after intervention(P <0.05),especially in exercise acupuncture group(P < 0.05).Conclusions: 1.Conventional Western medicine combined with exercise acupuncture therapy has significant clinical efficacy in the treatment of VD.Compared with the simple conventional western medicine therapy,it can further improve the scores of MMSE,HDS and ADL of VD patients,further improve the cognitive function of VD patients,improve the independent living ability of VD patients,without obvious adverse reactions,and is worthy of clinical promotion.To provide new methods and ideas for clinical prevention and treatment of VD.2.Through basic research,it was found that exercise acupuncture might enhance the plasticity of synapses and improve the learning and memory ability of VD rats by up-regulating the expression of SYN,PSD95 and GAP43 m RNA.