基于“脑肠轴”探讨腹针对轻中度阿尔茨海默病患者认知及睡眠质量的影响

Influence of Abdominal Acupuncture on Cognition and Sleep Quality of Patients with Mild to Moderate Alzheimer′s Disease Based on“Brain Gut Axis”

目的:从“脑肠轴”角度观察腹针对轻中度阿尔茨海默病患者认知及睡眠质量的影响。方法:选取2020年8月至2022年8月福建省康复医院及漳浦县中医院收治的轻中度阿尔茨海默病患者70例作为研究对象,按照随机数字表法随机分为对照组及观察组,每组35例。对照组口服盐酸多奈哌齐片和银杏叶提取物片治疗,观察组在对照组治疗的基础上加用腹针治疗,2组均连续治疗3个月。比较2组患者治疗后蒙特利尔认知评估量表(MoCA)评分、阿尔茨海默病评定量表-认知(ADAS-Cog)评分、记忆与执行筛查(MES)评分、日常生活能力(ADL)评分、匹兹堡睡眠质量指数(PSQI)评分、握力及2 min步行距离。结果:1)治疗后,2组患者的MoCA评分、ADAS-Cog评分、MES评分均升高,与治疗前比较差异均有统计学意义(均P<0.05),治疗后观察组上述评分均高于对照组,2组比较差异均有统计学意义(均P<0.05)。2)治疗后2组患者ADL评分均提高,PSQI评分均降低,与治疗前比较差异均有统计学意义(均P<0.05),治疗后观察组ADL评分高于对照组,PSQI评分低于对照组,2组比较差异均有统计学意义(均P<0.05)。3)治疗后2组患者的握力及2 min步行距离均较治疗前改善,观察组握力及2 min步行距离均高于对照组,2组比较差异均有统计学意义(均P<0.05)。结论:基于“脑肠轴”理论的腹针可明显改善轻中度阿尔茨海默病患者的认知水平,并较好地改善患者的日常生活能力及睡眠质量,值得临床推广应用。

Objective:To observe the effect of abdominal acupuncture on cognition and sleep quality of patients with mild to moderate Alzheimer′s disease from the perspective of“brain gut axis”.Methods:A total of 70 patients with mild and moderate Alzheimer′s disease admitted to Fujian Provincial Rehabilitation Hospital and Zhangpu County Hospital of Traditional Chinese Medicine from August 2020 to August 2022 were selected as the study subjects.They were randomly divided into control group and observation group according to the method of random number table,with 35 patients in each group.The control group took donepezil hydrochloride tablets and ginkgo biloba extract tablets.The observation group added abdominal acupuncture on the basis of the control group.Both groups were treated continuously for 3 months.After the treatment,the differences of Montreal Cognitive Assessment(MoCA),Alzheimer′s Disease Assessment Scale-cognitive Subscale(ADAS-Cog),Memory and Executive Screening(MES),Activity of Daily Living(ADL)and Pittsburgh Sleep Quality Index(PSQI)scores,grip strength and 2-min walking distance between the two groups were compared.Results:1)After treatment,the scores of MoCA,ADAS-Cog and MES in the two groups were higher than those before treatment(P s<0.05),and the scores of the above indicators in the observation group were higher than those in the control group(P s<0.05).2)After treatment,ADL score of patients in the two groups was higher than that before treatment,and PSQI score was lower than that before treatment,with statistically significant differences(P<0.05).After treatment,ADL score in the observation group was higher than that in the control group,and PSQI score was lower than that in the control group,with statistically significant differences(P s<0.05).3)After treatment,the grip strength and 2-minute walking distance of the patients in the two groups were improved compared with those before treatment(P<0.05).After treatment,the grip strength and 2-minute walking distance in the observation group were higher than those in the control group(P<0.05).Conclusion:Abdominal acupuncture based on the“brain gut axis”theory can significantly improve the cognitive level of patients with mild to moderate Alzheimer′s disease,and further improve ADL and sleep quality,which can be further popularized in clinical practice.