Objective: To observe the efficacy of Huayu Tongluo moxibustion combined with acupuncture at Jing-well points on the differentiated meridians and routine acupuncture for vascular dementia (VD) and its effect on serum levels of vascular endothelial growth factor (VEGF) and acetylcholinesterase (AChE).
Methods: A total of 60 patients with VD were randomized into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 2 cases dropped off). In the observation group, Huayu Tongluo moxibustion combined with acupuncture at Jing-well points on the differentiated meridians and routine acupuncture were adopted, Huayu Tongluo moxibustion was applied at Baihui (GV 20), Dazhui (GV 14) and Shenting (GV 24); acupuncture at Jing-well points on the differentiated meridians was applied at corresponding Jing-well points according to pattern of syndrome; routine acupuncture was applied at Baihui (GV 20), Sishencong (EX-HN 1), etc. Acupuncture and moxibustion were given once a day, 6 times a week for 4 weeks. In the control group, donepezil was prescribed for oral administration, 5 mg each time, once a day for 4 weeks. Before and after treatment, the scores of mini mental state examination (MMSE) and activities of daily living (ADL) were observed, and the serum levels of AChE and VEGF were detected in the two groups.
Results: Compared before treatment, the MMSE and ADL scores and serum level of VEGF were increased (P<0.05), the serum level of AChE was decreased (P<0.05) after treatment in the two groups. The MMSE and ADL scores after treatment in the observation group were higher than the control group (P<0.05).
Conclusion: Huayu Tongluo moxibustion combined with acupuncture at Jing-well points on the differentiated meridians and routine acupuncture could improve cognitive function and activities of daily living, which may be related to the regulation of serum levels of VEGF and AChE.
目的：观察化瘀通络灸联合辨经刺井针及常规针刺治疗血管性痴呆（VD）的疗效及对血清血管内皮生长因子（VEGF）、乙酰胆碱酯酶（AChE）水平的影响。方法：将60例VD患者随机分为观察组（30例，脱落1例）和对照组（30例，脱落2例）。观察组采用化瘀通络灸联合辨经刺井针及常规针刺治疗，化瘀通络灸选用百会、大椎、神庭穴，辨经刺井针根据证型选用相对应的井穴，常规针刺穴取百会、四神聪等，针灸均每日1次，每周6次，连续治疗4周；对照组口服多奈哌齐治疗，每次5 mg，每日1次，共4周。分别于治疗前后观察两组患者简易智能状态检查表（MMSE）、日常生活活动能力量表（ADL）评分变化，并检测血清AChE和VEGF水平。结果：与治疗前比较，两组患者治疗后MMSE、ADL评分及血清VEGF水平均升高（P<0.05），血清AChE水平降低（P<0.05）；观察组治疗后MMSE、ADL评分高于对照组（P<0.05）。结论：化瘀通络灸联合辨经刺井针及常规针刺可以改善VD患者认知功能及生活活动能力，其机制可能与调节血清AChE、VEGF水平有关。.
Keywords: Huayu Tongluo moxibustion; acetylcholinesterase (AChE); activities of daily living (ADL); acupuncture at Jing-well points on the differentiated meridians; mini mental state examination (MMSE); vascular dementia; vascular endothelial growth factor (VEGF).