Clinical Observation On Treatment Of Mild And Moderate Vascular Dementia With Yiqi Tiaoshen Acupuncture Method

1 BackgroundVascular dementia(VD)refers to the brain syndrome caused by various cerebrovascular diseases,resulting in clinical syndromes with varying degrees of intellectual impairment.The incidence population is mainly elderly people.With the improvement of economic and changes in people’s diet and activity habits,the incidence of cerebrovascular disease continues to rise,lead to a high incidence of VD.The early stage of VD is generally manifested as a decline in the level of intelligence such as memory,orientation,comprehension,and computational power,which varies depending on the lesions.Severe vascular dementia patients may show a significant decline in their daily life ability,and even may show personality changes,irritability,split personality and other psychiatric symptoms.The long course of the disease not only has a serious impact on the patient’s personal life,but also imposes a great burden on the family and becomes an increasingly serious social problem.VD is the only preventable dementia so far,and earlier intervention can delay or even reverse the disease.At present,there are no specific drugs and therapies for the disease.Western medicine can improve the cognitive function of VD patients to a certain extent,but many drug indications are relatively single,there are a large number of contraindications and easy to produce drug resistance.It also can easily cause cardiovascular and cerebrovascular events,neurological symptoms,gastrointestinal symptoms and other adverse reactions.Other western medicine therapy is not yet mature,in the experimental stage or the operation is complex.Chinese medicine has shown certain clinical advantages in the treatment of VD.It is of great significance to explore a safe and effective treatment method for preventing and reversing intelligent damage.Studies have shown that acupuncture can inhibit nerve cell apoptosis,regulate cholinergic nervous system,promote brain damage repair function,improve hippocampal mitochondrial function,resist free radical damage,improve blood flow,etc.,can improve the neurological function of VD caused by neurological impairment effectively.According to Chinese medicine,the pathological nature of dementia is deficiency in origin and excess in superficiality,mostly due to old age with weak constitution,damaged by excess of seven emotions,long-term disease and other causes,lead to deficiency of both qi and blood,deficiency of marrow,or phlegm,stasis,turbidity confuse the orifices,qi,fire,phlegm,stasis.,turbidity and other evils in the body,disturb the orifices,blocking the brain vein,so that the mental activities are disturbed,the machine is lost,this is an important pathological links of dementia,and the deficiency of vital energy is the root cause of AD,the motivation factor.Deficiency of vital energy lead to the lack of blood and body fluids,qi deficiency promotes weakness lead to generate of phlegm,stasis and turbidity,they confuse the orifices and develop into dementia.On one hand,Yiqi Tiaoshen Acupuncture can not only invigorate kidney-qi but also reinforce the spleen stomach qi.And it can combine the two gases,promotes the subtlety of the substance to the brain,allows the brain to be supported and rehabilitated.On the other hand,it can regulate the mental activity and make it peace and clear in order to the purpose of recovery of function.2 objectiveIn this study,the patient’s Mini Mental State Examination(MMSE)and Activity of Daily Living(ADL)were used as the main efficacy evaluation indicators,and the Montreal Cognitive Assessment(MoCA)was used as the secondary efficacy evaluation indicator to adjust the validity of acupuncture for the treatment of mild and moderate vascular dementia with a view to obtaining safe and effective treatments or preventing further deterioration of vascular dementia.3 research methodsExperimental methods:Among the patients diagnosed in the encephalopathy ward and outpatient department of Beijing University of Chinese Medicine Oriental Hospital,30 patients with mild and moderate vascular dementia who met the criteria for diagnosis and inclusion were selected for open-label clinical trials.This study did not establish a control group.First of all,VD does not belong to diseases with high morbidity,and the research time is limited.There are certain difficulties in the inclusion of patients;Secondly,early onset of VD is not highly valued,if the drug is used for comparison,the patients must be asked to pay for themselves.The feasibility is not so good,so the funding problem remains to be solved.And the adverse drug reactions are unclear,the efficacy is not significant,Some patients and their families have difficulties in participating in the drug control group,and there is no recognized,large-scale randomized controlled trial confirming some kind of The efficacy of drug treatment for mild and moderate vascular dementia is contradictory in the choice of control drugs;again,the VD clinical studies are mostly controlled by drug therapies that control underlying diseases.Because of individual differences in patients,drugs that control underlying diseases are differently,it cannot be confirmed that the results are not related to drugs.If strict blank controls are used,it is not ethical and the compliance of the blank control group is slightly poor.Because of the limited study time,no follow-up survey was conducted on the subjects.This study used its own before and after comparison,observe the clinical efficacy of the treatment of mild and moderate vascular dementia by reinforcing qi and regulating mental activity.Treatment methods:Choose acupuncture points on the principle of reinforcing qi and regulating mental activity.Point Selection:Baihui,Shenting,Benshen(double),Neiguan(double),Zhongwan,Qihai,Guanyuan,Tianshu(double),Zusanli(double),Sanyinjiao(double),Taichong(double).After entering the needle,make the patient Deqi.a group of Baihui and Shenting,a group of Qihai and Zhongwan are connected to the Yingdi acupuncture treatment instrument.And the density wave is used to measure the patient’s feeling moderate and the degree of slight tremor of the needle handle is the degree.The needle was kept for 20 minutes,and the treatment was performed once every other day for a total of 3 months.Before and after treatment,neuropsychological scores(MMSE,MoCA,ADL)were used to calculate the effectiveness of each score change,and the clinical efficacy of mild and moderate vascular dementia was evaluated according to the results.All data were analyzed using SPSS21.0 statistical software for statistical analysis.4 resultsThis study included 30 patients who met the inclusion criteria.All patients were in good compliance.Acupuncture treatment and observation indicators were performed on time.No rejection,shedding cases and no adverse reactions were observed.4.1 Efficacy evaluation of cognitive function(1)Comparison of therapeutic effect of MMSE score:After treatment,the MMSE score increased from 24.40±2.27 to 27.20±2.04.The difference was statistically significant(P<0.01),the effective rate was 70%;There was a significant difference in directional force and abstract thinking ability scores(P<0.01).There was no significant difference in attention and calculation before and after treatment(P>0.05).(2)Comparison of therapeutic effect of MoCA score:After treatment,the MoCA score increased from 20.00±2.90 to 22.20±3.59.The difference was statistically significant(P<0.01),the effective rate was 63.3%;the difference in recall ability score was statistically significant(P<0.05);there was a significant difference in executive function scores before and after treatment(P<0.01).Suggesting that Yiqi Tiaoshen Acupuncture can significantly improve cognitive function in patients with mild and moderate vascular dementia;it has markedly improved effects on directional force,executive function and abstract thinking ability,and has a better effect on recall ability.However,the improvement of attention and calculation is not obvious4.2 Efficacy evaluation of the efficacy of daily lifeComparison of therapeutic effect of ADL score:After treatment,the ADL score decreased from 17.03±1.81 to 15.37±1.96.The difference was statistically significant(P<0.01).The effective rate was 56.7%.Suggesting that Yiqi Tiaoshen Acupuncture can significantly improve the daily life ability of patients with mild and moderate vascular dementia5 ConclusionBased on 30 patients with mild and moderate vascular dementia before and after the clinical efficacy of acupuncture treatment of contrast found that this acupuncture treatment can effectively improve the cognitive function and daily life ability of the subjects,among which the directional force,executive function and abstract thinking ability has a significant improvement effect,and it has a better improvement effect on the recall ability,but the effect on the improvement of attention and calculation is not obvious.Acupuncture treatment is safe,effective with little pain,side effects and no obvious adverse reactions,easily accepted by patients.It is worth further clinical and experimental research to promote the application.