Clinical Observation Of Cluster Needling Of Prefrontal Area Combined With Donepezil In The Treatment Of Vascular Cognitive Impairment With Renal Essence Deficiency

Objective: To observe the clinical therapeutic efficacy of cluster needling of prefrontal area combined with Donepezil Hydrochloride Tablets in the treatment of vascular cognitive impairment with renal essence deficiency,as well as the changes in scores of Screening scale of cognitive function before and after the treatment.In order to provide a more effective therapeutic scheme for the clinical treatment of vascular cognitive impairment with renal essence deficiency.Method: Sixty patients suffering from vascular cognitive impairment with renal essence deficiency who met the inclusion criteria were selected from the outpatient department of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine.The patients were divided into Control group,Treatment group 1 and Treatment group 2 in proportion of1:1:1 by random number table method,with 20 cases in each group.Treatment group 1 received routine acupuncture and oral administration of Donepezil Hydrochloride Tablets.Acupuncture points selection for routine acupuncture treatment: “Baihui”(GV20),“Shenting”(GV24),“Yintang”(GV29),“Taixi”(KI3),“Xuanzhong”(GB39),“Sishencong”(EX-HN1).Acupuncture treatment once a day.Acupuncture treatment 6 days a week(Monday to Saturday).4 weeks for a course of the treatment.3 courses of the treatment,a total of 12 weeks.The initial dosage of oral administration of Donepezil Hydrochloride Tablets was 5mg per dose,once a day,take it orally before going to bed in the evening.The initial dosage was maintained for 4 weeks.Then the dose was increased to 10 mg at a time based on early clinical response and clinical assessment,once a day,take it orally before going to bed in the evening.This dose was maintained for 8 weeks.The drug was discontinued after a total of 12 weeks of treatment.In the Control group,the Donepezil Hydrochloride Tablets used in the Treatment group 1 were replaced with placebo.The use of placebo was completely consistent with the oral administration of Donepezil Hydrochloride Tablets in Treatment group 1.Theroutine acupuncture treatment was completely consistent with that of Treatment group 1.On the basis of the treatment plan of the Treatment group1,cluster needling of prefrontal area was added in the Treatment group 2.The course of treatment is the same as routine acupuncture.The routine acupuncture treatment and oral administration of Donepezil Hydrochloride Tablets were completely consistent with that of Treatment group 1.Observe the score changes of MMSE,Mo CA,ADL and SDSVD in the three groups before and after the treatment,as well as the clinical efficacy evaluation.The conclusion was drawn by statistical analysis.Result:1 After the treatment,the MMSE scores of the three groups were significantly higher than those before the treatment(P<0.05).There were significant differences in MMSE scores among the three groups after treatment(P<0.05).The MMSE scores of Treatment group 1 and Treatment group 2 were significantly higher than those of Control group(P<0.05).The MMSE scores of Treatment group 2 were significantly higher than those of Treatment group 1(P<0.05).2 After the treatment,the Mo CA scores of the three groups were significantly higher than those before the treatment(P<0.05).There were significant differences in Mo CA scores among the three groups after treatment(P<0.05).The Mo CA scores of Treatment group 1 and Treatment group 2 were significantly higher than those of Control group(P<0.05).The Mo CA scores of Treatment group 2 were significantly higher than those of Treatment group 1(P<0.05).3 After the treatment,the ADL scores of the three groups were significantly lower than those before the treatment(P<0.05).There were significant differences in ADL scores among the three groups after treatment(P<0.05).The ADL scores of Treatment group 1 and Treatment group 2 were significantly lower than those of Control group(P<0.05).The ADL scores of Treatment group 2 were significantly lower than those ofTreatment group 1(P<0.05).4 After the treatment,the SDSVD scores of the three groups were significantly lower than those before the treatment(P<0.05).There were no significant differences in SDSVD scores among the three groups after treatment(P>0.05).5 There was a significant difference in the total effective rate(%)among the three groups after treatment(P<0.05).The total effective rate(%)of Treatment group 1 and Treatment group 2 were significantly higher than that of Control group(P<0.05).The total effective rate(%)of Treatment group 2was significantly higher than that of Treatment group 1(P<0.05).Conclusion:1 Routine acupuncture treatment of vascular cognitive impairment can slightly improve patients’ cognitive function and their ability of daily living.Routine acupuncture treatment has a significant improvement effect on the Traditional Chinese Medicine syndrome of renal essence deficiency.2 On the basis of routine acupuncture treatment,the addition of oral administration of Donepezil Hydrochloride Tablets can lead to a better clinical efficacy for the treatment of vascular cognitive impairment than that of routine acupuncture treatment alone.3 On the basis of routine acupuncture treatment,the addition of cluster needling of prefrontal area as well as oral administration of Donepezil Hydrochloride Tablets can lead to a better clinical efficacy for the treatment of vascular cognitive impairment than that of only routine acupuncture treatment and oral administration of Donepezil Hydrochloride Tablets.The former can significantly improve patients’ cognitive function and their daily living ability,which has the value of clinical popularization and application.