化瘀通络灸对血管性痴呆患者认知功能及外周血BDNF、VEGF水平的影响

Effect of Huayu Tongluo Moxibustion on Cognitive Function and Peripheral Blood Levels of BDNF and VEGF in Patients with VD

目的:通过化瘀通络灸对血管性痴呆(VD)患者的临床干预,观察其对认知功能的影响并探讨认知功能的改变与脑源性神经营养因子(BDNF)及血管内皮生长因子(VEGF)之间的相关性。方法:严格按照纳入与排除标准筛选30例VD患者,分为化瘀通络灸组15例与西药组15例。化瘀通络灸组予艾灸治疗,3次/周;西药组予盐酸多奈哌齐口服,5 mg/晚;两组均口服尼莫地平为基础治疗,30 mg,3次/d两组均治疗12周。观察两组治疗前及12周后MMSE、ADL量表积分及血清BDNF、VEGF水平的变化。结果:化瘀通络灸组治疗后MMSE、ADL量表评分、血清BDNF、VEGF水平均较治疗前显著升高(P<0.05);且治疗后各量表积分及血清BDNF、VEGF水平与西药组比较均显著增高(P<0.01)。化瘀通络灸组总有效率93.3%(14/15),西药组总有效率53.3%(8/15),差异具有统计学意义(P<0.05)。结论:化瘀通络灸是一种有效的治疗方法,可能通过增加VEGF、BDNF的表达,保护受损的血管及神经元,促进新神经元的形成,从而改善VD患者的认知功能与日常生活能力,为临床诊断和治疗VD提供参考。

Objective:To observe the effect of Huayu Tongluo moxibustion on cognitive function in patients with vascular dementia(VD)and to explore its effect on brain-derived neurotrophic factor(BDNF)and vascular endothelial growth factor(VEGF).Methods:30 VD patients were randomly divided into the Huayu Tongluo moxibusiton group(n=15)and the western medication group(n=15).The Huayu Tongluo moxibustion group was treated with moxibustion(three times a week).The western medication group was treated with Donepezil Hydrochloric acid(5mg/night).Both groups were also treated with Nimodipine(30 mg,3 times a day).The treatment duration was 12 weeks.The scores changes of MMSE and ADL scale,and serum levels of BDNF and VEGF were observed before and after the treatment in the two groups.Results:The scores of MMSE and ADL scale,the serum levels of BDNF and VEGF were significantly higher after the treatment than those before the treatment in the Huayu Tongluo moxibustion group(P<0.05);of which the improvements were more significant in the moxibustion group than those in the western medication group(P<0.01).The total effective rate was 93.3%(14/15)in the Huayu Tongluo moxibustion group,which was significantly higher than 53.3%(8/15)in the western medication group(P<0.05).Conclusion:Huayu Tongluo moxibustion is an effective treatment,which may improve the cognitive function and daily living ability of patients with VD by increasing the expressions of VEGF and BDNF,protecting the damaged blood vessels and neurons,and promoting the formation of new neurons.It provides a reference for the diagnosis and treatment of VD in clinic.