Effects Of Acupuncture Combined With Cognitive Training On Memory Ability And Serum APP,A?_1-42and Hcy In Patients With Post-stroke Cognitive Impairment

Objective:To study the clinical efficacy of memory impairment and the influence for the serum level of Amyloid Precursor Protein(APP)and Beta-amyloid proteinl-42(A?1-42)and Homocysteine(Hcy)after acupuncture combined with cognitive rehabilitation training in patients with cognitive dysfunction after stroke.And to Analysis the correlation between the change of the serum biochemical indicators and memory scale scores,for clinical treatment providing objective evidences.Methods:Screening and enrolling 72 eligible patients with cognitive dysfunction after stroke,randomly allocated into the control group(n=36)or the experiment group(n=36).On the basis of conventional treatment,the control group was to the cognitive rehabilitation training,the experiment group was given to cognitive rehabilitation training and acupuncture at Baihui(DU20)and Shenting(DU24).Both lasting 30 minutes a day,five days a week for 12 weeks.Wechsler Memory Scale-Revised in China(WMS-RC),and the serum level of APP and A?1-42 and Hcy were tested in pre-and post-treatment respectively.Results:1.The difference of pre-and post-treatment in control was significant on "total scores","memory quotient","short-term memory" and "recall"(P<0.05).Moreover,the experiment group on "total scores","memory quotient" and subtests "digital span","visual recognition"were significant improvement(P<0.05).Contrast to the control group,the difference of pre-and post-treatment was significant on "short-term memory"," immediate memory " and subtest "digital span" in the experiment group(P<0.05).2.Interclass difference of pre-and post-treatment showed that the serum level of APP and A?1-42 dropped significantly in the control group(P<0.05),moreover the serum level of APP and A?1-42 and Hey level also dropped significantly in the experiment group(P<0.05).Compared with the control group,the serum level of APP and A?1-42 reduced more significantly in pre-and post-treatment of the experiment group(P<0.05).3.Correlation analysis results showed:The falling levels of APP and A?1-42 in pre-and post-treatment had no correlation with "total table points","memory quotient" and subtests"short-term memory" and "recall" in the control group(P>0.05).The falling levels of APP and A?1-42 and Hcy in pre-and post-treatment were not correlated with "total table points","memory quotient"," immediate memory "and subtest "visual regeneration" in experiment group(P>0.05).After treatment,the serum falling level of APP and A?1-42 was positively correlated with short-term memory(r=0.416 and r=0.300),the difference was statistically significant(P<0.05),but there is no correlation with immediate memory(P>0.05).Conclusion:1.Compared to cognitive rehabilitation training singlely,acupuncture combined with cognitive rehabilitation training improved memory function in patients with cognitive dysfunction after stroke better,especially in the short-term and immediate memory.2.The serum level of APP and A?1-42 falling lower,the more improvment in short-term memory.3.The improvement of memory function in patients with cognitive dysfunction after stroke may was not directly due to modulating APP and A?1-42 and Hcy metabolism in Serum.