Studying On The Mechanism Of Acupuncture On Shenting And Baihui To Improve Cognitive Impairment Caused Small Cerebral Vascular Diseases Based On ASL-MRI

ObjectiveIn our country,with the improvement of medical level,the average life expectancy of the elderly is gradually prolonged.Accordingly,diseases such as dementia and cognitive impairment have attracted more and more attention,which seriously affect the quality of life of the elderly.Among the diseases leading to cognitive impairment,besides Alzheimer' s disease,vascular factors are the most common.In addition to the cognitive impairment caused by macrovascular factors after stroke,cerebrovascular disease can also lead to cognitive impairment mainly due to executive impairment.Cerebral small vessel disease is a group of diseases involving intracranial arterioles,arterioles,venules and capillaries.At present,the treatment of cerebrovascular disease is mainly aimed at etiological factors,such as lipid regulation and plaque stabilization,blood pressure and blood sugar control,and other risk factors.However,the drug focusing on cognitive dysfunction is only widely used in donepezil and memantine,and the clinical effect is not very significant.Cognitive dysfunction caused by cerebrovascular disease is called "dementia" in traditional Chinese medicine.To explore the mechanism of improving cognitive function of patients with cerebrovascular disease by acupuncture at Shenting and Baihui according to the treatment of Dumai.MethodsFrom December 2017 to December 2018,60 patients with cerebrovascular diseases in the inpatient and outpatient departments of Zhongshan hospital of Traditional Chinese Medicine were collected and divided into treatment group and control group according to the principle of random grouping.Each group had 30 cases.The control group was given basic treatment plus donepezil.The treatment group was given acupuncture at Shenting and Baihui on the basis of the control group,three times a week for 12 weeks.Before and after treatment,CBF values of patients with four diagnostic information of TCM,neuropsychological scale and cerebral blood flow collected by 3D-ASL were examined respectively.SPSS 20.0 was used for statistical analysis to evaluate the efficacy and mechanism of acupuncture at Shenting and Baihui on cognitive impairment caused by cerebrovascular disease.Results(1)Neuropsychological scale score:There was no significant difference in cognitive function between the treatment group and the control group before treatment(P>0.05).After 12 weeks of treatment,the scores of MoCA and Digital Width Test in both groups were improved compared with those before treatment(P<0.05),and the scores of MMSE and MoCA in Shenting Baihui group were more obvious than those in control group.(2)CBF value of cerebral blood flow:There was no significant difference in CBF values between the treatment group and the control group before treatment(P>0.05).After 12 weeks of treatment,CBF values of bilateral frontal lobe,semioval center,temporal lobe and basal ganglia in the control group and treatment group were improved compared with those before treatment(P<0.05).The CBF values of bilateral frontal lobe,bilateral semioval center,left temporal lobe and left basal ganglia in the acupuncture group were significantly higher than those in the control group(P<0.05).(3)The correlation between the scores of MMSE scale and MoCA scale and CBF value of cerebral blood flow before treatment in the two groups:The correlation analysis showed that before treatment,the scores of MMSE scale in treatment group and control group were positively correlated with CBF in left frontal lobe,left basal ganglia and right frontal lobe.Before treatment,the scores of MoCA scale in treatment group and control group were positively correlated with CBF values of cerebral blood flow in left frontal lobe,left temporal lobe,left basal ganglia,left semioval center,right frontal lobe,right temporal lobe,right basal ganglia and right semioval center.(4)Safety assessment:During the treatment period,there was 1 case of dizziness and discomfort in the acupuncture group and 1 case of palpitation in the control group.The symptoms disappeared after symptomatic treatment.There were no significant abnormalities in three routine examinations,liver and kidney function and electrocardiogram after treatment and follow-up in both groups.ConclusionAcupuncture god court will best group and the control group can effectively improve cognitive function in patients with cerebral small vascular disease,improve degree of the former is superior to the latter,at the same time the use of 3d ASL detection of two groups before and after treatment in patients with cerebral blood flow CBF value changes,the results found that acupuncture god court will best set of neuropsychological scale score and each part CBF value improvement degree of the cerebral blood flow were better tharesults of this study suggest that the change of cognitive function n control group(P<0.05).The caused by cerebrovascular disease may be related to the change of cerebral blood flow,and the mechanism of acupuncture on shentingbai to improve cognitive function in patients with cerebrovascular disease may be related to the increase of CBF value in cerebral blood flow.