Clinical Study Of Surrounding Needling Based On CT Location In Treating Vascular Dementia

BackgroundVascular Dementia (VD) is the most common form of the old age dementias. The dementia is always caused by brain function damage, which is the result of the ischemic and hemorrhagic cerebrovascular diseases. Its incidence rate in stroke survivors is about 1/3. With the prolonging of people's lives and growing incidence of cerebro-vascular diseases year by year, the incidence rate of the Vascular Dementia rises obviously. Vascular Dementia has become a common and difficult disease in the aged. And nowadays, there is no effective treatment and medicine to alleviate or cure the disease. The disease has not only brought seriously suffering to the patients, but also reduced the quality of lives. Meanwhile, it is aslo a heavy burden on families and the society. Therefor, the research on this subject really has an important social and realistic significance.ObjectiveVascular Dementia has characteristics of high incidence and recurrence rate, which is difficult to treat. This subject is aiming to observe the clinical curative effect of the Surrounding Needling Based on CT (computerized tomography) Location treatment, The efficacy was judged by the Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale (HDS), Ability of Daily Living scale (ADL), the Scale for the Differentiation of Syndromes of Vascular Dementia (SDSVD), Neurological Function Deficit Score (NFDS), Short Form 36 Health Survey Questionnaire (SF-36). Both of the two groups were tested the Serum Endothelin (ET)and Nitric Oxide (NO) before and after the treatment to investigate changes of them. In this way, providing scientific theory basis to the Surrounding Needling based on CT location treatment. Method81 patients who with the inclusion criteria and the exclusion standard were alloted by simple randomization into two groups:the Surrounding Needling based on CT location group (41 cases) and the Traditional Scalp Acupuncture group (40 cases). Extramural judgement was used to observe the results. All the 81 patients of Vascular Dementia were came from the Clinic of The First and Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. The areas of the Surrounding Needling based on CT location group (the treatment group) for acupuncture were selected according to the location by CT scan result and needles were inserted in the galea aponeurotics around the selected areas, while the Traditional Scalp Acupuncture group(the matched group) selected the top midline, frontal midline, temporal front and Linear temporal line as the area for acupuncture. Both of the two groups used the 1.5 inches of stainless needles inserted in the galea aponeurotics, then twisted the needles with 180～200 times per minute of frequency for two minutes. After having the sense of acupuncture, needles retain stay in the galea aponeurotics for 30 minutes, during this time, twisted 1 minute for once. One treatment each day, five days is a course, between courses of treatment for 2 days off. All the treatment lasted for 4 weeks. Before and after the treatment, the efficacy was judged by the Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale (HDS), Ability of Daily Living scale (ADL), the Scale for the Differentiation of Syndromes of Vascular Dementia (SDSVD), Neurological Function Deficit Score (NFDS), Short Form 36 Health Survey Questionnaire (SF-36). Both of the two groups were tested the serum Endothelin (ET) and Nitric Oxide (NO) before and after the treatment. All results were analyzed by the software SPSS 13.0. Results1 The result showed that the total effective rate of cognitive ability in Surrounding Needling Based on CT Location group (the treatment group) was 82.5%, while the traditional scalp acupuncture group (the matched group) was 56.41%, two groups on the clinical curative effect showed significant difference (P<0.05). Meanwhile, the significant efficiency in treatment group was 25%, which was better than the 7.69% in the matched one. Compared to the matched group, the cognitive abilities score in the treatment group was significantly improved, which had the statistical significant difference (P<0.05). The result showed that the Surrounding Needling based on CT location method had better effect to the VD patients than the Traditional Scalp Acupuncture group on cognitive ability improvement.2 The result showed that the total effective rate of dementia symptoms improvement in treatment group was 85%, while the rate in the matched one was 61.54%, two groups on the clinical curative effect showed significant difference (P<0.05).Meanwhile, the significant efficiency in the treatment group was 30%, which was obviously higher than the 10.3% in the matched one. Compared to the matched group, the total score of Hasegawa dementia scale (HDS) in the treatment group was significantly improved, which had the statistical significant difference (P<0.05). The result showed that the Surrounding Needling Based on CT Location method had better effect to the VD patients than the Traditional Scalp Acupuncture group on dementia symptoms improvement.3 The result showed that the total effective rate of the activities of daily living in treatment group was 85%, while the rate in the matched group was 69.2%, two groups on the clinical curative effect showed significant difference (P<0.05). Meanwhile, the significant efficiency in treatment group was 37.5%, which was obviously higher than the 15.4% in matched one. Compared to the matched group, the score of Ability of Daily Living scale (ADL) and Instrumental Activities of Daily Living ability scale (IADL) in the treatment group was significantly improved, which had the statistical significant difference (P<0.05). The result showed that the Surrounding Needling Based on CT Location method had better effect than the Traditional Scalp Acupuncture group on the activities of daily living improvement, especially in the executive ability.4 The result showed that the total effective rate of the scale for the Differentiation of Syndromes of Vascular Dementia (SDSVD) in treatment group was 72.5%, and the matched group was 66.67%, both of the two groups on the clinical curative effect showed no significant difference (P>0.05). Meanwhile, the score of the Scale for the Differentiation of Syndromes of Vascular Dementia (SDSVD) was significantly improved in both two groups, while the scores between them showed no significant difference (P>0.05).5 The result showed that the score of Neurological Function Deficit Score (NFDS) in the treatment group was significantly improved, which had the statistical significant difference (P<0.05). The result showed that the Surrounding Needling Based on CT Location method had better effect to the VD patients than the Traditional Scalp Acupuncture group on the neurological deficit improvement.6 The result showed that the score of Short Form 36 Health Survey Questionnaire (SF-36) in the treatment group was significantly improved, which had the statistical significant difference (P<0.05). The result showed that the Surrounding Needling Based on CT Location method had better effect to the VD patients than the traditional scalp acupuncture group on the quality of living improvement, Especially in in Social Function(SF), Role of Emotional (RE)and Mental Health(MH) fields.7 The result showed that both groups can significantly reduce patients'serum endothelin (ET) and increase nitric oxide (NO), which had the statistical significant difference (P<0.01), and the treatment group had obvious effects than the matched one (P<0.05). The result showed that Surrounding Needling based on CT location method had better effect to the VD patients than the traditional scalp acupuncture method on regulating cerebral blood flow.Conclusion1 Both of the two methods for treating Vascular Dementia had favourable clinical results.2 The Surrounding Needling Based on CT Location method had better clinical effect than scalp acupuncture method.3 The Surrounding Needling based on CT location method had better effect in the field affected by the Psychological factors, and superior to the traditional scalp acupuncture method in quality improvement.4 The Surrounding Needling based on CT location method had better effect in reducing patients'serum endothelin (ET) and increasing nitric oxide (NO), showed that Surrounding Needling based on CT location group had better effect to the VD patients than the traditional scalp acupuncture group on regulating cerebral blood flow.5 The Surrounding Needling based on CT location method is simple, convenient and effective, and is easily for application. It will have a broad application prospect in the future.