Clinical effects of acupuncture therapy for vascular dementia

OBJECTIVE： To evaluate clinical acupuncture treatment studies for vascular dementia, as well as to collect high-quality evidence related to clinical acupuncture treatment for clinical diagnosis. DATA SOURCES： PubMed database （1966-2010）, Embase database （1986-2010）, Cochrane Library （Issue 1,2010）, Chinese Biomedical Literature Database （1979-2010）, China HowNet database （1979-2010）, VlP Journals Database （1989-2010）, and Wanfang database （1998-2010） were analyzed by computer.

Effects of electro-acupuncture on Noxa and caspase-3 expression in hippocampal CA1 region of a vascular dementia rat model

BACKGROUND：Noxa, a pro-apoptotic member of the Bcl-2 protein family, has been shown to induce the mitochondrial pathway of apoptosis and to mediate hypoxic cell death in a rat model of cerebral ischemia. This suggests that Noxa could participate in apoptosis during vascular dementia （VD）. OBJECTIVE： To detect Noxa and caspase-3 expression after electro-acupuncture in VD rats to further validate the mechanism of electro-acupuncture-induced effects in the treatment of VD. DESIGN, TIME AND SETTING： A randomized, controlled study was performed at the Center for the Neurobiology of Fujian Medical University between January 2006 and March 2007. MATERIALS： A total of forty adult, male, Sprague Dawley rats were included in this study. The following equipment was used： confocal laser scanning microscope （Sp5, Leica, Germany）, water maze （Bejing Suntendy Science and Technology Co., Ltd., China）, and SDZ-II electronic acupuncture treatment instruments （Suzhou Medical Appliance Factory, China）. METHODS： Thirty-eight rats with sufficient learning and memory abilities were selected by Morris water maze criteria. Twelve rats received sham-surgery; the remaining 26 rats were used to establish a VD model by bilateral occlusion of the common carotid arteries. The rats that survived the occlusion procedure were randomly assigned into an electro-acupuncture group （n = 11） and a VD model group （n = 12）. MAIN OUTCOME MEASURES： Neuropathological changes were observed with hematoxylin-eosin staining of the hippocampus and expression of Noxa and caspase-3 in the hippocampal CA1 region was analyzed by confocal laser scanning microscope following immunofluorescence staining. RESULTS： Expressions of Noxa and caspase-3 in the electro-acupuncture group and sham-operated group were less than in the VD model group （P 〈 0.01）. Electro-acupuncture reduced the amount of apoptotic neurons in hippocampal CA1 area of rats with VD. The average latency in the Morris water maze test was significantly shorter, and escape strategies improved from edge and random searches to more linear swim pathways in the electro-acupuncture group compared with the VD model group （P 〈 0.01）. CONCLUSION： Electro-acupuncture can improve learning and memory ability and inhibit the occurrence of apoptosis by blocking expression of Noxa and caspase-3 in the hippocampal CA1 region of VD rats.

CLINICAL STUDY ON TREATMENT OF VASCULAR DEMENTIA WITH ELECTROACUPUNCTURE OF "SISHENCHONG

Aim: To observe the therapeutic effect of electroacupuncture (EA) in the treatment of vascular dementia. Methods: A total of 46 cases of vascular dementia (VD) patients were divided into 3 classes according to the scores of the revised Hasegawa dementia scale (HDS), and then randomized into EA group (n=23) and medication (Nimodipine) group (n=23). The acupoints used were "Zhisanzhen" [Shenting (GV 24) and bilateral Benshen (GB 13)] and Sishenchong (EX HN 1) etc.. Scores of HDS, ability of daily life (ADL), neurofunctional defect and main symptoms were used as the indexes for assessing the therapeutic effect. Results: Following treatment, scores of HDS and ADL of two groups increased significantly, while those of neurofunctional defect and main symptoms decreased evidently (P<0.01), and the therapeutic effect of EA was obviously superior to that of medication (P<0.01). Conclusion: EA of "Zhisanzhen" and Sishenchong (EX HN 1) is a good approach for treatment of VD.

Neuroprotection against vascular dementia after acupuncture combined with donepezil hydrochloride：P300 event related potential

Acupuncture can be used to treat various nervous system diseases.Here,168 vascular dementia patients were orally administered donepezil hydrochloride alone（5 mg/day,once a day for 56 days）,or combined with acupuncture at Shenting（DU24）,Tianzhu（BL10）,Sishencong（Extra）,Yintang（Extra）,Renzhong（DU26）,Neiguan（PC6）,Shenmen（HT7）,Fengchi（GB20）,Wangu（GB12） and Baihui（DU20）（once a day for 56 days）.Compared with donepezil hydrochloride alone,P300 event related potential latency was shorter with an increased amplitude in patients treated with donepezil hydrochloride and acupuncture.Mini-Mental State Examination score was also higher.Moreover,these differences in P300 latency were identified within different infarcted regions in patients treated with donepezil hydrochloride and acupuncture.These findings indicate that acupuncture combined with donepezil hydrochloride noticeably improves cognitive function in patients with vascular dementia,and exerts neuroprotective effects against vascular dementia.

Clinical Observation on Acupuncture Treatment of Cerebrovascular Dementia——A Report of 32 Cases

Cerebrovascular dementia is a common disease in the middle-aged and old people. Its incidence makes up about 10-20% of all kinds of dementia. It is mainly caused by general degeneration of the brain function resulted from cerebral arteriosclerosis and cerebral infarction. The author has treated 32 cases of cerebrovascular dementia with acupuncture in the recent years with satisfactory therapeutic results. A report follows.

STUDY ON TREATMENT OF VASCULAR DEMENTIA WITH ACUPUNCTURE AND MOXIBUSTION PRINCIPALLY

32 cases of vascular dementia were randomly assigned to acupuncture-medicine group (16 cases) and Chinese drug group(16 cases). After treatment for two months, there was a significant difference between the two groups in the therapeutic effects(P < 0.01 ). The therapeutic effect in the acupuncturer-medicine group was superior to that in the Chinese drug group. The levels of superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px) were increased and the level of lipids peroxide (LPO) was decreased in the two groups. Acupuncture and moxibustion combined with Chinese drugs for tonifying the kidney had the better action.

CLINICAL OBSERVATION ON ACUPUNCTURE TREATMENT OF VASCULAR DEMENTIA

This paper reports results of acupuncture and moxibustion for treatment of 18 cases of vascular dementia. After 2 months’ treatment, 5 cases were markedly effective, 11 effective and 2 ineffective, with the total effective rate of 89 %. Results showed that acupuncture and moxibustion could regulate the contents of serum trace elements in favour of delaying ageing.

CLINICAL OBSERVATION ON COMBINED TREATMENT OF VASCULAR DEMENTIA WITH ACUPUNCTURE, MOXIBUSTION AND CHINESE MEDICINAL HERBS

In the present study, the clinical effect of acupuncture, moxibustion plus Chinese medicinal herbs for treatment of 30 cases of vascular dementia (VD) was observed and their mechanisms were analyzed by determining the activity of SOD, LPO and GSH-Px. Results showed that after 2 months’combined treatment, of the 30 cases, 12 had marked improvement, 15 had improvement and 3 had not any improvement, with an effective rate of 90%; the activity of SOD and GSH-Px increased considerably while the content of LPO lowered strikingly. There were significant differences between pre-and post-treatment in the activity of SOD and GSH-Px and the content of LPO (P<0. 01). It reveals that this method is capable of improving VD patients’ clinical symptoms and signs such as headache, dizziness, hemi-paralysis or hemianesthesia, forced crying and laughing, etc.and also raising the ability of the body in removing oxygen free radical, and suppressing peroxidization of free radical to reduce its products, thereby alleviating the toxic effect of oxygen free radical on the brain tissues.

EFFECTS OF COMBINATION OF ACUPUNCTURE AND MOXIBUSTION WITH CHINESE DRUGS ON LIPIDS PEROXIDE AND ANTIOXIDASE IN PATIENTS OF VASCULAR DEMENTIA

In the present paper, blood lipids peroxide(LPO) level and activities of glutathione peroxidase(GSH-Px) and superoxide dismutase(SOD) were investigated before and after combined treatment of acupuncture and moxibustion and Chinese drugs in patients of vascular dementia(VD), and their results were compared with those in healthy persons with the similar ages to the patients. The results showed that the blood LPO level increased significantly, and the activities of SOD and GSH-Px reduced significantly in patients of VD as compared with those in the control group. Degrees of patient’s condition were related with amplitudes of the increase of LPO and the reduction of activities of GSHPx and SOD. Combined treatment of acupuncture and moxibustion and Chinese drugs could raise markedly activitles of blood GSH-Px and SOD, and lowered LPO level in the patients of VD, which are related to clinical therapeutic effects. It is considered that combination of acupuncture and moxibustion with Chinese drugs can increase the action of the antiperoxidative system in the patients of VD, exerting anti-peroxidative ability and clearing LPO and reducing the oxidative injury of the organism by oxygen free radical, which is one of mechanisms of combined treatment of acupuncture and moxibustion with Chinese drugs.

EFFECT OF ACUPUNCTURE-MOXIBUSTION PLUS CHINESE MEDICINAL HERBS ON PLASMA TXB_2, 6-Keto-PGF1α IN PATIENTS WITH VASCULAR DEMENTIA

In the present paper, changes of TXB2, 6-Keto-PGF1α contents before and after treatment by using acupuncture, moxibustion and Chinese medicinal herbs and in comparison with the normal values of healthy people were observed in 30 vascular dementia (VD) patients. Results showed that in VD patients, the content of serum TXB2 increased significantly and that of 6-Keto-PG1α decreased markedly in comparison with control group (P<0. 01), suggesting a significant imbalance between plasma TXB2 and 6-Keto-PG1α; after combined treatment with acupuncture, moxibustion and Chinese herbs, the content of plasma 6-Keto-PG1α raised remarkably and that of TXBα lowered,which had a positive correlation with clinical therapeutic effect. The fact indicates that this combined treatment is capable of regulating the balance between plasma TXB2 and 6-Keto-PG1α, increasing cerebral blood flow, raising the metabolic rate of the brain tissues and improving functions of the brain.

Clinical Study on Treatment of Senile Vascular Dementia by Acupuncture

63 patients with senile vascular dementia were randomly divided into the treatment group (treated by acupuncture) and the control group (treated with piracetam). The authors observed the changes in the score of Hasegawa's dementia scale (HDS), p300, rheoencephalogram, topographic EEG, superoxide dismutase (SOD) activity in erythrocytes, and lipid peroxide (LPO) level in plasma before and after treatment. The statistical data showed that the total effective rate in the treatment group (80.6%) was significantly higher than that in the control group (25%), and the differences in the observed indexes before and after treatment were significant (P 0.05), indicating that the acupuncture treatment was superior in immediate therapeutic effect on senile vascular dementia to drug treatment.

EFFECT OF AURICULAR ACUPUNCTURE ON THE LEARNING AND MEMORY AND bcl-2 EXPRESSION IN VASCULAR DEMENTIA RATS

Objective: To study the effect of auricular acupuncture on dysmnesia and the relationship between the memory improvement and bcl 2 protein expression in vascular dementia (VD) rats. Methods: Forty Wistar rats were randomized into control group, VD group, acupuncture+VD group and pseudo operation group, with 10 cases in each group. Rat VD model was established by using 4 vessel occlusion method. Otopoint "Nao" point and "Shen"(MA SC) were punctured, once daily continuously for 15 days. The rats’ memory capability was tested with Y maze method and bcl 2 expression of the brain tissues displayed by immunohistochemical method and measured using MIAS 2000 Image Analyzer. Results: Results showed that the scores of control group, VD group and acupuncture+VD group before operation were 5.68±1.29, 6.07±1.67 and 5.86±1.74 respectively, while following auricular acupuncture treatment, the scores of the 3 groups were 5.81±1.51, 18.06±2.68 and 8.31±1.85 separately, suggesting that the VD rat’s learning and memory abilities in acupuncture+VD group were raised apparently in comparison with those of VD group (P<0.01). In control, VD and acupuncture+VD group, bcl 2 immuno reaction positive neurons in CA 1 area of the hippocampus were 14.31±4.87, 28.67±5.63 and 65.74±8.19 respectively, displaying that the improvement of learning and memory abilities caused by auricular acupuncture treatment may be related to the up regulation of bcl 2 expression (an inhibitory gene of apoptosis). In comparison with control group, the loss of neurons in the pyramidal cell layer of the hippocampal CA 1 area of VD group was more severe, while that of acupuncture group was markedly lighter. Conclusion: Auricular acupuncture of otopoint "Nao" point and "Shen"(MA SC) can raise the learning and memory abilities of VD rats, which may be realized by its inhibitory effect on apoptosis and the protection action on ischemic hippocampal neurons.

Evaluation of the Clinical Efficacy of Acupuncture and Moxibustion Combined with Repetitive Transcranial Magnetic Stimulation on Cognitive Function and Sleep Disorders in Patients with Mild Vascular Dementia

Objective:To explore the clinical effects of acupuncture and repeated transcranial magnetic stimulation in patients with mild vascular dementia.Method:From May 2020 to May 2021,40 patients with mild vascular dementia in Harbin Fourth Hospital(our hospital)were divided into the experimental group(20 cases,using conventional drugs+acupuncture+repeated transcranial magnetic stimulation)and the control group(20 cases,for example,the application of conventional medication).The improvement of cognitive function score,sleep quality score,quality of life score,and cerebral hemodynamics before and after treatment were compared between the two groups.Result:Before treatment,the difference in cognitive function score,sleep quality score,quality of life score,and cerebral hemodynamic index between the two groups of patients did not form,that is,p>0.05;after treatment,the experimental group5s cognitive function score was(19.45±2.47)points,Sleep quality score(12.18±2.09),quality of life score(33.29±4.08),left cerebral blood flow velocity(65.76±3.32)cm/s,right cerebral blood flow velocity(64.32±3.25)cm/s,more For the control group,P<0.05・Conclusion:In the clinical treatment of patients with mild vascular dementia,based on conventional drugs,combined with acupuncture and repetitive transcranial magnetic stimulation,the patients?cognitive function can be improved,and the quality of sleep and quality of life can be improved.Comprehensive clinical promotion.

Research progress on the mechanism of acupuncture treatment for vascular dementia

Acupuncture can intervene with and treat vascular dementia(VD)through multiple targets and pathways.The mechanisms of its action involve inhibiting central inflammatory responses,regulating neuronal synaptic plasticity,modulating oxidative stress,reducing neuronal apoptosis,and adjusting cellular autophagy.This paper summarizes researches on the mechanisms of acupuncture treatment for vD over the past decade,aiming to provide theoretical support for the clinical application of acupuncture in treating VD and offer a reference for future in-depth research in this field.

Effects of electroacupuncture of different frequencies on free radicals in hippocampus of mice with vascular dementia

Objective:To observe the effects of electroacupuncture (EA) of three different frequencies (2 Hz,80 Hz and 2 Hz/80 Hz) on the free radicals in hippocampus of vascular dementia (VD) model mice.Methods:A total of 100 Kunming mice were randomly divided into a sham operation group,a model group,a 2 Hz EA group,an 80 Hz EA group and a 2 Hz/80 Hz EA group,with 20 mice in each group.The ischemia-reperfusion VD model was established by repeated blockade of bilateral common carotid arteries.Mice in EA groups began EA treatment on the 4th day after the operation.Baihui (GV 20),Dazhui (GV 14),Geshu (BL 17) and Zusanli (ST 36) were punctured and then connected to EA instrument,with different waves of 2 Hz,80 Hz or 2 Hz/80 Hz (10 min/time) applied accordingly,once a day.During the jumping stand experiment,the learning performance,memory performance and hippocampal calcitonin gene-related peptide (CGRP),nitric oxide synthase (NOS),malondialdehyde (MDA),changes in superoxide dismutase (SOD) and true choline esterase (TChE) were observed.In hippocampus,the CGRP level was determined by radioimmunoassay;the MDA level was determined by thiobarbituric acid colorimetric method;the activities of NOS and TChE were determined by spectrophotometry;the activity of SOD was determined by xanthine oxidase method.Results:Compared with the sham operation group,the performances of learning and memory decreased significantly in the model group (P＜0.01);in hippocampus,the CGRP level decreased,the MDA level increased,the activities of NOS and TChE increased,and the activity of SOD decreased in the model group.Compared with the model group,the learning and memory performances of the EA groups were significantly improved (P＜0.05 or P＜0.01);in hippocampus,the CGRP level increased,the MDA level decreased,the NOS and TChE activities decreased,and the SOD activity increased (P＜0.05 or P＜0.01).Among EA groups,the 2 Hz/80 Hz EA group was superior to the 2 Hz EA group and the 80 Hz EA group (P＜0.05 or P＜0.01).Conclusion:EA can improve the cognitive impairment of mice with ischemia-reperfusion VD.The mechanism may be related to the improvement of cerebral blood circulation,regulation of the central neurotransmitters,fighting lipid peroxidation and promoting nerve cell repair.The therapeutic effects of EA with different frequencies were different,and the intervention effect by EA at 2 Hz/80Hz is the most significant.

IMPACTS OF PENETRATION THERAPY WITH HEAD ELECTRICAL ACUPUNCTURE ON PROLIFERATION OF NEURAL STEM CELLS IN SUBSTANTIA NIGRA OF RAT MODEL OF PARKINSON'S DISEASE

Objective To probe into the function mechanism of penetration therapy with head electrical acupuncture on Parkinson＇s disease. Methods Microinjection of 6-hydroxydopamin （6-OHDA） on the left cor- pus striatum was adopted to prepare rotation model of Parkinson^s disease in rat. Penetration therapy with head electrical acupuncture was administered in treatment. Normal group, sham-operation group, model group and penetration therapy group were set up. （1）lmmunohistochemical （IHC） method was used to test the morphology and count of positive cell of tyrosine hydroxylase （TH）. （2）RT-PCR technology was used to detect the expression of nestin mRNA of neural stem cell （NSC）. Results （1）Compared with model group, in pene- tration therapy group, the expressions of TH-positive neurons in immune response were increased in areal density （AD）, numerical density （ND） and integrating optic density （P〈0.05）. （2）Compared with model group, in penetration therapy group, the expression of nestin mRNA was increased （P〈0. 05）. Conclusion Penetration therapy with head electrical acupuncture promotes the proliferation of endogenous neural stem cells in substantia nigra of rat model of Parkinson＇s disease.

Effects of electroacupuncture with different frequencies on hippocampal neuronal apoptosis and JNK signaling pathway in rats with vascular dementia

Objective:To observe the effects of electroacupuncture(EA)with three frequencies(100 Hz,2 Hz,and 2 Hz/100 Hz)on the apoptosis of neurons and c-Jun N-terminal kinase(JNK)signaling pathway in the hippocampus of rats with vascular dementia(VD),and explore the mechanism of EA intervention for VD.Methods:Fifty male Sprague-Dawley rats were randomly divided into a model group,a sham operation group,a 100 Hz EA group,a 2 Hz EA group,and a 2 Hz/100 Hz EA group,with ten rats in each group.The VD model rats were established by repeated ischemia-reperfusion of bilateral common carotid arteries.The rats in the EA groups received EA intervention at Baihui(GV20),Dazhui(GV14),Geshu(BL17)and Zusanli(ST36),once a day for 14 d.Afterward,Morris water maze was used to examine the learning and memory performances of the rats in each group,hematoxylin-eosin staining to observe the histomorphological changes in the hippocampal CA1 region,terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling to test the apoptosis of neurons in the hippocampal CA1 region,and Western blot to detect the protein expression levels of JNK,phosphorylated JNK(p-JNK),Caspase-8,and Caspase-3 in the hippocampus tissue.Results:Compared with the sham operation group,the escape latency of the model group in water maze test was prolonged;the number of crossing the original platform was decreased(P<0.01);the hippocampal neurons were severely damaged and the number of surviving neurons was decreased(P<0.01),whereas the number of apoptotic neurons was increased(P<0.01);the protein expression levels of JNK,p-JNK,Caspase-8,and Caspase-3 in the hippocampus were significantly increased(P<0.01).Compared with the model group,the escape latency of each EA group was significantly shortened;the number of crossing the original platform was significantly increased(P<0.01);the damage of hippocampal neurons was alleviated,the number of surviving neurons was increased(P<0.01),and the number of apoptotic neurons was decreased(P<0.01);the protein expression levels of JNK,p-JNK,Caspase-8,and Caspase-3 in the hippocampus were decreased(P<0.01).The results in the 2 Hz EA group and the 2 Hz/100 Hz EA group were superior to those in the 100 Hz EA group.Conclusion:EA with the three frequencies(100 Hz,2 Hz,and 2 Hz/100 Hz)can improve the learning and memory performances in VD rats subjected to ischemia-reperfusion,its mechanism may be related to the inhibition of neuronal apoptosis and the regulation of the related protein expression of JNK signaling pathway,and the intervention effects of EA with 2 Hz and 2 Hz/100 Hz are more significant.

Effect of Electroacupuncture on Learning and Memory in Rats with Vascular Dementia

Objective：To observe the effect of electroacupuncture on learning and memory in rats with vascular dementia.Methods：Seventy-two SD rats were randomly divided into 4 groups,a normal group,a sham operation group,a model group and an electroacupuncture （EA） pretreatment group.Modified intraluminal embolism method with nylon thread was applied to make rat model of vascular dementia,and the ability of learning and memory was observed in Morris water maze.Results：The average time of escape and latency in the rats of model group in the water maze test was prolonged,with significant difference compared with that in the sham group （P〈0.01）.The average time of escape and latency and navigation test results of rats pretreated by EA had statistically significant difference compared with those of the model group （P〈0.01）.Conclusion：EA pretreatment can significantly improve the ability of learning and memory of the rats with vascular dementia.

Effects of Acupuncture on Chinese Medicine Syndromes of Vascular Dementia

Objective： To study the effects of acupuncture on Chinese medicine syndromes of vascular dementia （VaD）. Methods： Sixty-three VaD patients were divided into three groups. Those willing to be randomized were randomly assigned to receive either acupuncture （random acupuncture group, 24 cases） or rehabilitation training （guided rehabilitation group, 24 cases） for 6 weeks. Those unwilling to be randomized also received acupuncture for 6 weeks （non-random acupuncture group, 19 cases）. Patient syndromes and their severity were evaluated before treatment （baseline）, at the end of treatment, and at 4-week follow-up after the completion of treatment using a CM scoring system （scale of differentiation of syndromes of vascular dementia, SDSVD）. The SDSVD scores of the random and non-random acupuncture groups, and of all patients who received acupuncture （combined acupuncture group, 43 cases）, were compared with those in the guided rehabilitation group. Results： In the random, non-random, and combined acupuncture groups, SDSVD scores were significantly reduced at the end of treatment and at follow- up than at baseline. In the guided rehabilitation group, SDSVD scores were similar to baseline scores at the end of treatment and at follow-up. However, there were no significant differences in SDSVD scores among the three groups or between the combined acupuncture group and the guided rehabilitation group at any time points. In the non-random and combined acupuncture groups, SDSVD scores were significantly reduced at the end of treatment than at baseline in patients with hyperactivity of Liver （Gan）-yang or phlegm obstruction of the orifices. Conclusions： Acupuncture reduced the severity of VaD. The improvement was the greatest in patients undergoing their treatment of choice. Treatments in this study were more effective for excess syndromes, such as Liver-yang hyperactivity or phlegm obstruction of the orifices than deficiency syndromes, such as Kidney （Shen）-essence deficiency.

Clinical Study on Treatment of Vascular Dementia with Scalp Acupuncture

Objective： To explore a treatment method for vascular dementia. Methods： Sixty patients were randomly allocated into two groups. The observation group was treated with long-term needle-retaining method of scalp acupuncture and the control group was treated by medications. Evaluation was made respectively before and after the treatment by means of Hasegawa dementia scale （HDS）, neurological function deficit （NFD） score and main symptom （MS） score. Results： There were statistically significant differences in HDS, NFD score and MS score in both groups （P〈0.01） before and after the treatment. There were statistically significant differences in HDS, NFD score and MS score between the two groups （P〈0.05） before and after the treatment. The total effective rate was 86.8% in the observation group and 80.0% in the control group. There was a statistically significant difference in the effects between the two groups （P〈0.05）. Conclusion： This long-term needle-retaining method of scalp acupuncture is precisely effective for vascular dementia.