Objective: To compare the clinical efficacy of abdominal acupoint thread embedding therapy based on "brain-intestinal connection" combined with donepezil hydrochloride tablets and oral donepezil hydrochloride tablets alone for mild-to-moderate Alzheimer's disease (AD) and observe its effects on amyloid precursor protein (APP) and β-amyloid protein1-42 (Aβ1-42).
Methods: Sixty patients with AD were randomly divided into an observation group (30 cases, 3 cases dropped off) and a control group (30 cases, 3 cases dropped off). The patients in the control group were treated with donepezil hydrochloride tablets (5 mg per day); based on the treatment in the control group, the patients in the observation group were treated with abdominal acupoint thread embedding therapy at Zhongwan (CV 12), Xiawan (CV 10), Huaroumen (ST 24), Wailing (ST 26), Daheng (SP 15), etc., once every 10 days. Both groups were treated for 2 months. The mini-mental state examination (MMSE), Alzheimer's disease assessment scale-cognitive subscale (ADAS-Cog), activity of daily living scale (ADL), neuropsychiatric inventory questionnaire (NPI) as well as the serum levels of APP and Aβ1-42 were observed before and after treatment in the two groups.
Results: After treatment, the MMSE scores in the two groups were higher than those before treatment (P<0.05), and the ADAS-Cog, ADL and NPI scores were lower than those before treatment (P<0.05). After treatment, the MMSE score in the observation group was higher than that in the control group (P<0.05), and the ADAS-Cog, ADL and NPI scores were lower than those in the control group (P<0.05). After treatment, the serum levels of APP and Aβ1-42 were lower than those before treatment (P<0.05), and the serum levels of APP and Aβ1-42 in the observation group was lower than those in the control group (P<0.05).
Conclusion: The abdominal acupoint thread embedding therapy based on the theory of "brain-intestinal connection" combined with donepezil hydrochloride tablets can improve cognitive function, self-care ability of daily life and mental behavior, and reduce the serum levels of APP and Aβ1-42 in patients with mild-to-moderate AD, which have superior clinical effect to donepezil hydrochloride tablets alone.
目的：比较基于“脑肠相通”理论的腹针埋线疗法联合盐酸多奈哌齐片与单纯口服盐酸多奈哌齐片治疗轻中度阿尔茨海默病（AD）患者的临床疗效及对血清β淀粉样蛋白（Aβ）前体蛋白（APP）、Aβ1-42的影响。方法：将60例AD患者随机分为观察组（30例，脱落3例）和对照组（30例，脱落3例）。对照组患者口服盐酸多奈哌齐片（每天5 mg）；观察组患者在对照组基础上予腹针埋线疗法，穴取中脘、下脘、滑肉门、外陵、大横等，每10天1次，两组均治疗2个月。观察两组患者治疗前后简易精神状态检查量表（MMSE）、AD认知评定量表（ADAS-Cog）、日常生活能力量表（ADL）、神经精神问卷（NPI）评分及血清APP、Aβ1-42水平。结果：治疗后，两组患者MMSE评分较治疗前升高（P<0.05），ADAS-Cog、ADL、NPI评分较治疗前降低（P<0.05）；观察组患者治疗后MMSE评分高于对照组（P<0.05），ADAS-Cog、ADL、NPI评分低于对照组（P<0.05）。治疗后，两组患者血清APP、Aβ1-42水平较治疗前降低（P<0.05），且观察组低于对照组（P<0.05）。结论：基于“脑肠相通”理论的腹针埋线疗法联合盐酸多奈哌齐片可改善轻中度AD患者的认知功能、日常生活自理能力及精神行为状态，降低血清APP、Aβ1-42水平，其临床疗效优于单纯口服盐酸多奈哌齐片。.
Keywords: Alzheimer's disease (AD); abdominal acupuncture therapy; amyloid precursor protein (APP); randomized controlled trial (RCT); theory of brain-intestinal connection; β- amyloid protein1-42 (Aβ1-42).