头针对老年轻度认知功能障碍临床疗效及机制研究

Clinical effect and mechanism research of scalp acupuncture for mild cognitive impairment

目的:观察头针对老年轻度认知功能障碍(MCI)患者的临床疗效及机制研究。方法:采用前瞻性随机临床对照研究方法,将148例患者按随机数字表法分为对照组74例,治疗组74例。对照组予盐酸多奈哌齐片5mg,睡前口服;治疗组在对照组基础上给予头针(顶中线、额顶线、额中线、额旁1线、额旁2线)干预,留针180min,每日1次,1周5次,共治疗12周。通过比较蒙特利尔评估量表(Mo CA)、简易精神状态评估量表(MMSE)以及检测血清β淀粉样蛋白(Aβ)、S-100β、脑源性神经营养因子(BDNF)含量水平进行评价。结果:治疗8周、12周后,两组患者Mo CA、MMSE量表评分均较治疗前显著提高(P<0.05),且在治疗12周后,治疗组Mo CA、MMSE量表评分显著高于对照组(P<0.05)。治疗8周、12周后,两组患者血清Aβ、S-100β含量均较治疗前显著降低(P<0.05),BDNF含量较治疗前显著升高(P<0.05),且治疗组优于同期对照组(P<0.05)。结论:头针可能通过抑制血清Aβ、S-100β蛋白表达,上调血清BDNF蛋白表达,进而提高Mo CA、MMSE量表得分,从而改善患者认知功能障碍。

Objective： To observe the effects and mechanism of scalp acupuncture for mild cognitive impairment patients. Methods： Using randomized controlled clinical trial method, a total of 148 patients were randomly divided into control group（74 caces） and treatment group（74 caces）. The control group was received 5 mg donepezil; the treatment group accepted the scalp acupuncture（parietal line mid, parietal and frontal line, frontal line mid, lateral line 1 of forehead, lateral line 2 of forehead） on the basis of treatment in the control group. The changes of Montreal Cognitive Assessment（Mo CA）, Mini mental state examination scale（MMSE） were used as evaluating curative effect. Meanwhile, serumβ-amyloid（Aβ）, S-100β, brain-derived neurotrophic factor（BDNF） protein levels were detected by enzyme-linked immunosorbent assay. Results： After treatment of eight and twelve weeks, levels of Mo CA and MMSE were improved compared with those before treatment（P〈0.05）. After treatment of twelve weeks, scores of Mo CA and MMSE in the treatment group was significantly higher than the control group（P〈0.05）. After treatment of eight and twelve weeks, serum Aβ and S-100βlevels were reduced and BDNF levels were up-regulated compared with those before treatment（P〈0.05）, the treatment group was superior to the control group in the same period（P〈0.05）. Conclusion： Scalp acupuncture could inhibit the level of serum Aβ, S-100β protein and up-regulate BDNF protein level to improve the cognitive function of patients with mild cognitive impairment.