轻度认知功能障碍患者血清、尿液8-异前列腺素F2α的变化与认知功能的相关性及艾灸调养对其的影响

Correlation between the changes of 8-isoprostaglandin F2α in serum and urine and cognitive function in patients with mild cognitive impairment and the effect of moxibustion

目的探讨轻度认知功能障碍(MCI)患者血清、尿液8-异前列腺素(8-iso-PG)F2α的变化与认知功能的相关性及艾灸调养对其的影响。方法收集MCI患者152例,同年龄非MCI正常对照(NC)组62例进行血清及尿液8-iso-PGF2α水平检测;MCI患者中选取75例,按照随机数字表分为穴位艾灸组31例、非穴艾灸组24例和药物组20例,观察治疗前后血清、尿液8-iso-PGF2α水平及简易精神状态检查(MMSE)、蒙特利尔认知评估(MoCA)量表积分的变化及疗效评价。结果①MCI组血清、尿液8-iso-PGF2α水平明显高于NC组(P<0.01),MMSE及MoCA量表评分明显低于NC组(P<0.01)。血清8-iso-PGF2α、尿液8-iso-PGF2α与MMSE评分呈负相关(r=-0.445、r=-0.561,P均<0.001),血清8-iso-PGF2α、尿液8-iso-PGF2α与MoCA量表评分呈负相关(r=-0.248、r=-0.371,P均<0.001)。②3个治疗组治疗后尿液8-iso-PGF2α水平较治疗前显著下降,与NC组差异无统计学意义(P>0.05),治疗后血清8-iso-PGF2α水平较治疗前下降且与NC组差异有统计学意义(P<0.05)。③3个治疗组治疗后MMSE、MoCA评分较治疗前明显升高,与NC组差异无统计学意义(P>0.05)。④艾灸组、药物组、非穴组治疗后疗效有效率分别为71.0%、65.0%、70.8%,疗效比较差异无统计学意义(P>0.05)。结论MCI患者血清、尿8-iso-PGF2α升高,机体的抗氧化能力水平下降,可能是认知损害的重要因素;艾灸能提高MCI患者的认知水平与降低机体的氧化代谢产物密切相关,艾灸特定穴能改善MCI患者认知功能,疗效与药物组相当。

Objective To explore the correlation between the changes of 8-isoprostaglandin F2α(8-iso-PGF2α)in serum and urine and cognitive function in patients with mild cognitive impairment(MCI)and the effect of moxibustion treatment.Methods A total of 152 patients with MCI were collected.The levels of 8-iso-PGF2αin serum and urine were measured in 62 patients and normal control with the same age(n=62).75 patients with MCI were randomly divided into three groups according to random number table:acupoint moxibustion(n=31),non-point moxibustion(n=24)and drug groups(n=20).The level of 8-iso-PGF2αin serum and urine and changes as well as the curative effect evaluation of MMSE and MoCA scores were observed before and after treatment.Results(1)The levels of 8-iso-PGF2αin serum and urine of MCI group were significantly higher than those of the normal control group(P<0.01),scores of MMSE and MoCA were significantly lower than those of the normal control group(P<0.01),and the differences were statistically significant.Both 8-iso-PGF2αin serum and urine were negatively correlated with MMSE score(r=-0.445,r=-0.561,P<0.001)and MoCA score(r=-0.248,r=-0.371,P<0.001)respectively.(2)After treatment,the level of 8-iso-PGF2αin urine of three groups was lower than that before treatment,and there was no difference comparing with the normal control group(P>0.05).The level of 8-iso-PGF2αin serum was lower than that before treatment,but there was still a significant difference comparing with the normal control group(P<0.05).(3)After treatment,scores of MMSE and MoCA of three groups were higher than those before treatment,and there was no difference comparing with normal control group(P>0.05).(4)The curative effective rates of three groups were 71.0%,65.0%and 70.8%,respectively,in which there was no difference among three groups(P>0.05).Conclusions The increasing level of 8-iso-PGF2αin serum and urine and the decline of antioxidant capacity may be important factors of cognitive impairment.Moxibustion is able to improve the cognitive level of patients with MCI and reduce the body′s oxidative metabolites.Moxibustion at specific acupoints enable to improve the cognitive function of patients with MCI and curative effect of moxibustion and drug treatment is the same.