The Effect Of Huayutongluo Moxibustion On Vascular Dementia With Spacial Cognition And Expression Of MAP?NeuN?CD34 In Hippocampus

Part 1 Experimental StudyObjectiveTo provide experimental basis of moxibustion for the treatment of spatial cognitive disorder in vascular dementia by transplanting endothelial cells and neural stem cells with mark of EGFP mediated by lentivirus into model rats' lateral ventricle,and detecting results with Morris water maze and laser scanning confocal microscope.Methods1.Cultivating and passaging neural stem cells and endothelial cells respectively,marking neural stem cells with lentivirus mediated EGFP,and constructing co-transplanted implant in virto for celluar transplantation.2.Establishing vascular dementia model in rats by ligating right and left common carotid artery successively after repeatedly ischemia-reperfusion.3.60 model rats were randomly divided into 5 groups as sham group,vascular dementia model group(VD group),NSCs+EPCs group(NE group),NSCs+EPCs+moxibustion gourp(NEM group)and NSCs+moxibustion group(NM group).Co-transplanted implant was transplanted into NE group,NEM group,and NM group was transplanted by NSCs only.NEM group and NM group had accepted 3 periods of moxibustion treatment on Baihui(GV 20),Dazhui(GV 14)and Shenting(GV 24).Each group was measured by Morris water maze to evaluate its spatial cognitive competence.4.72 model rats were divided into 4 groups randomly as VD group,NE group,NEM group and NM group.And each group was divided into 3 parts by the treatment intervention period as Tl,T2 and T3.Rat brains were taken on time after perfusion of 4%paraformaldehyde.Marker protein expression was detected by laser confocal microscope to analyse the moxibustion effect of neurogenesis and angiogenesis.Results1.Co-transplanted implant and rat model were established successfully.2.The latent period of Morris water maze after 3 periods of treatment was significantly reduced(P<0.05),and the lantency of NEM group was shorter than VD group and NE group(P<0.005).The number across platform of NEM group and NM group after treatment was significantly increased than before(P<0.05),and the number of NE group,NEM group and NM group was higher than VD group significantly(P<0.005).The lantency of NEM group in re-reverse platform experiment was shorter than NE group significantly(P<0.017).3.The MAP expression was detected positively in NE group,NEM group and NM group without VD group which expressed no positive expression in each detections of protein markers.The expression quantity of NEM group was higher than the other two groups(P<0.017).The expression quantity of 3 groups in T2 was higher than in T1 or T3(p<0.017).The relationship of expression of NeuN and CD34 in the 3 positive group was the same as MAP expression(P<0.017).Conclusion1.Moxibustion can improve VD model rats ' spatial cognition after cell transplantation,especially the ability of spatial orientation and reversal.2.Promoting differentation of NSCs into mature neurons and promoting differentiation of EPCs into new vascular endothelial cells may be the possible mechanism of moxibustion on improving model rats ' spatial cognition.Part 2 Case AnalysisObjectiveTo discuss the neuropsychological influence of Huayutongluo moxibustion to VD patients with spatial cognitive disorder on the basis of the experimental results by report a typical case.Methods1 patient was recruited from acupuncture clinic of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine with 3 periods of Huayutongluo moxibustion treatment,3 times a week,4weeks for 1 period.Several scales as MMSE,MoCA,CDT and NFDS,were measured before the treatment and after 1st and 3rd period of treatment to observe the effect of Huayutongluo moxibustion.And a half-year follow-up visit was taken for knowing patient s general condition.ResultsMMSE and MoCA scores were increased after 1st period while both reduced after 3 periods of treatment.NFDS score was diminished gradually through the whole treatment.CDT score was increased.The patient's mental outlook has improved significantly in the process of the follow-up.ConclusionHuayutongluo moxibustion can improve neuropsychological scores of VD patients with spatial cognitive disorder to a certain extent.