不同针刺留针时间对无痴呆型血管性认知障碍同型半胱氨酸和叶酸的影响

Effects of different times of needle retention at scalp-acupoints on the expression of homocysteine and folate in vascular cognitive impairment of none dementia patients

目的:观察针刺不同留针时间对无痴呆型血管性认知障碍(VCIND)患者同型半胱氨酸和叶酸的影响。方法:选取104例中医辨证属于髓海不足证的VCIND患者,随机分为治疗A组(头皮针留针30min)35例,治疗B组(头皮针留针1h)34例,治疗C组(头皮针留针10h)35例。均在针刺的基础上口服吡拉西坦片,每次1片,每日3次,连续治疗8周,并进行一般康复训练。评测3组在治疗前和治疗8周后MOCA评分,检测同型半胱氨酸(Hcy)和叶酸含量。结果:认知功能MOCA评分与治疗前比较各组治疗后均高于治疗前(P<0.05),治疗C组优于其他两组(P<0.05)。各组治疗后同型半胱氨酸含量均低于本组治疗前(P<0.05)。治疗C组同型半胱氨酸含量明显低于其他两组(P<0.05)。各组叶酸含量明显高于本组治疗前(P<0.05),治疗C组优于其他两组(P<0.05)。结论:针刺能提高VCIND患者MOCA评分,显著改善其认知功能。降低VCIND患者同型半胱氨酸含量,提高叶酸含量。头皮针长时间久留针效果尤为明显。针刺可能通过降低同型半胱氨酸水平,升高叶酸含量而起到治疗VCIND患者的作用。

Objective： To observe the effects of different times of needle retention at scalp-acupoints on the expression of homocysteine and folate in vascular cognitive impairment of none dementia（VCIND） patients. Methods： 104 cases of VCIND patients belonging to deficiency of marrow were randomly divided into three groups, 35 cases of 30 minutes retaining needle at scalp-acupoints was group A, 34 cases of one hour retaining needle at scalp-acupoints was group B, and 35 cases of 10 hours retaining needle at scalp-acupoints was group C. At the same time, the patients were given piracetam tablets based on the acupuncture treatment, one tablets each time, three times a day, treatment for 8 weeks continuously, and the general rehabilitation training was carrying on. Montreal cognitive assessment（MOCA） were used for assessment of symptoms and signs. At the same time, the content of homocysteine and folate were detected before and after the treatment. Results： After the treatment, MOCA score was increased in three groups（P〈0.05）, the group C was superior to the other two treatment groups（P〈0.05）. The content of homocysteine was lower in each group than before treatment（P〈0.05）. The content of homocysteine in group C was significantly lower than the other two groups（P〈0.05）. The content of homocysteine was higher in each group than before treatment（P〈0.05）. The content of folate in group C was significantly higher than the other two groups（P〈0.05）. Conclusion： Acupuncture could increase MOCA score, improve the cognitive function of VCIND patients, decrease the content of homocysteine and increase the content of folate, especially the long-time retaining needle at scalp-acupoints. Acupuncture had an positive effect on VCIND patients through reducing the content of homocysteine and increasing the content of folate.