上海针灸杂志2024，Vol.43Issue(5)：521-526,6.DOI:10.13460/j.issn.1005-0957.2024.05.0521
针刺配合通络益气汤治疗脑小血管病致认知功能障碍的疗效观察
Therapeutic observation of acupuncture combined with Tong Luo Yi Qi Tang for cognitive impairment due to cerebral small vessel disease
摘要
Abstract
Objective To observe the clinical efficacy of acupuncture plus Tong Luo Yi Qi Tang in treating cognitive impairment due to cerebral small vessel disease and its effects on the patient's cerebral microcirculation,gait balance,and expression of serum neuronal PAS domain protein 4(NPAS4)and CD62P.Method Ninety-eight patients with cognitive impairment due to cerebral small vessel disease were randomized into a treatment group and a control group,with 49 cases in each group.The treatment group received acupuncture plus Tong Luo Yi Qi Tang,and the control group only received Tong Luo Yi Qi Tang for treatment.Before and after the treatment,the two groups were observed for changes in the laboratory indexes[glutathione peroxidase(GSH-Px),advanced glycation end products(AGEs),NPAS4,CD62P,NO,cyclophilin A(CyPA),lipoprotein-associated phospholipase A2(Lp-PLA2),and von Willebrand factor(vFW)],cerebral microcirculation indicators[blood-brain barrier permeability,vascular differential pressure,critical pressure(CP),and cerebral vascular dynamic resistance(DR)],and scale scores[Berg balance scale(BBS),Tinetti balance and gait scale,and Montreal cognitive assessment(MoCA)].The clinical efficacy was also compared between the two groups.Result After the treatment,the levels of GSH-Px and NO,CP,and each scale score increased,and the levels of AGEs,NPAS4,CD62P,CyPA,Lp-PLA2,vFW,blood-brain barrier permeability,vascular differential pressure,and DR dropped in both groups,all showing statistical significance(P＜0.05).After the treatment,the levels of GSH-Px and NO,CP,and each scale score were higher in the treatment group than in the control group,and the levels of AGEs,NPAS4,CD62P,CyPA,Lp-PLA2,vFW,blood-brain barrier permeability,vascular differential pressure,and DR were lower in the treatment group;the between-group differences were statistically significant(P＜0.05).The treatment group achieved a total effective rate of 98.0%,higher than 87.8%in the control group,and the difference was statistically significant(P＜0.05).Conclusion Acupuncture plus Tong Luo Yi Qi Tang is effective in treating cognitive impairment due to cerebral small vessel disease.This method can reduce oxidative stress and inflammatory responses,down-regulate the levels of NPAS4 and CD62P,curb the damage to vascular endothelial function and cognitive function,and improve blood-brain barrier permeability,cerebral microcirculation,and gait balance.关键词
针刺疗法/认知功能障碍/针药并用/脑小血管病/氧化应激反应/血管内皮功能/血脑屏障通透性/脑微循环/通络益气汤Key words
Acupuncture therapy/Cognitive dysfunction/Acupuncture medication combined/Cerebral small vessel disease/Oxidative stress reaction/Vascular endothelial function/Blood-brain barrier permeability/Cerebral microcirculation/Tong Luo Yi Qi Tang分类
医药卫生引用本文复制引用
李鹏,窦海燕,张小雪..针刺配合通络益气汤治疗脑小血管病致认知功能障碍的疗效观察[J].上海针灸杂志,2024,43(5):521-526,6.基金项目
河南省重点研发与推广专项计划(2022YD10226) （2022YD10226）
河南省中医药科学研究计划(2018Z2002) （2018Z2002）
