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8[4] Yu Zhishun, the scalp basic and clinical [M]. Beijing: Chinese Medical Science and Technology Press, 1992
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Clinical Study on the Intervention Effect of Scalp Clustery Accupuncture on Cognitive Function of Subcortical Arteriosclerotic Encephalopathy
SUN Yuan-zheng\ SUN Ying-zhe2.
l.The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150001,China; 2.Heilongjiang University of Traditional Chinese Medicine, Harbin 150040,China
[Abstract] ObjectiveTo explore the effectiveness of the intervention of scalp clustery acupuncture in treating cognitive function of subcortical arteriosclerotic encephalopathy. Method Sixty patients with SAE who met inclusion and exclusion criteria were randomized into atreatment group and a control group, 30 in each group. The treatment group was intervened by scalp clustery acupuncture, and the control group was by Donepezil Hydrochloride Tables. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and determination of P300 latency period and amplitude were adopted for evaluation. Result The total effective rate was 83.3% in the treatment group versus 53.3% in the control group, and the difference was statistically significant (P<0.01). After treatment, inner-group comparison of MMSE and MoCA scores and P300 latency period and amplitude showed significant improvements (all P<0.01); after treatment, the differences between the treatment group and control group were statistically significant in comparing MMSE and MoCA scores, and P300 latency period and amplitude (P<0.05). ConclusionFontal and Parietal congthornis an effective and feasible approach, which can significantly improve MMSE and MoCA scores, shorten P300 latency periodand increase P300 amplitude. And it is conductive to the improvement of cognitive function.
[Key words] Acupuncture therapy, Scalp acupuncture, Cognitive function, Cluster needling, Dementia, Vascular
Subcortical arterioscleroticencephalopathy(SAE) ,as a type of vascular dementia, belongs to leukoaraiosis. The disease is mainly due tohypertension, which leads tosmall intracranial atherosclerosis, vascular wall thickening,fatty hyaline degeneration andischemic white matter demyelination. The most characteristicclinicalmanifestation ischronic progressivecognitive impairment. In addition,Pyramidal tract damage is often accompanied[1]. Modernmedicine indiagnosis of the diseasehas madegreat progress, but in approach mainly adoptssymptomatic treatment, lack of effective approach to improve cognitive function and prevent disease progression. Many studies have reported that Yushi scalp clustery acupuncturehas a unique advantage in treatment of the disease. The author adoptedscalp clustery acupuncture to treat the disease 30 cases and 30 caseswith the drugcompared in the clinical.Reported as follows: 1 Clinical data 1.1 General Information
Sixty patients with SAE who met inclusion and exclusion criteria were randomized into atreatment group and a control group,30 in each group. All cases were from the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine.Compared two groups ofpatients with general information, the difference was not statistically significant(JP>0.05). Table 1 Comparison of two groups of patients in general information
Category n - Gender (n) Average age MMSEscore
Male Female (x ±s,Years) (x ±s, point)
Treatment group 30 18 12 61.87±4.40 16.50±3.80
Control group 30 16 14 61.77±4.58 15.73±3.26
1.2 Diagnostic criteria
Reference to thediagnostic criteria proposed byGuo Hongzhi [2]:©The elderly witha history
ofhypertension(Or unstable blood pressure). ©Cognitive impairment (dementia)is a
necessarycondition. ©Most are latentonset and slow progress. Typicalclinical
manifestationsarehypertension,stroke and chronicprogressive dementiathreemain symptoms. ©Must have acumulativeneurological signs, such as movement or sensory disturbances or only tendon hyperreflexia. There may or may not be parkinsonism, pseudobulbar palsy,individual patients with
incontinence or seizures in the middle and later periods. ©Accord with imaging standards.
1.3 Inclusion criteria
©Accord with diagnostic standard.© Male or female which between the age of 50 to 70 years old. ©Accord with MMSE score which is classified by level of education, illiteracy MMSE for 917 points, primary MMSE for 9-17 points, and secondary school or above for 10-20 points. ©Meet
Hachinski Ischemic Score>7 points. ©Signed the informed consent form.
1.4 Exclusion criteria
©Thosewith mental disorder (e.g., depression), agnosia or aphasia. ©Lowthyroid function,
serum vitamin B12 and folic acid deficiency. ©Acupuncture points have scar, infection, or lack of
skull. ©Those who are in active peptic ulcer, active epilepsy and asthma ©Take drug to improve
cognitive function in two weeks. ©Those who have known are allergic to cholinergic drugs.
©Those with movement disturbances, parkinsonism or pseudobulbar palsy. ©Those with serious organ disease of heart, liver or kidney ,which affect efficacy evaluation
1.5 Weed out criteria
©Going against the doctor's advice for treatment. ©Existing illness deteriorates in the process of treatment.
1.6 Fall off criteria
©Those who think efficacy is poor refuse to continue treatment. ©Can't continue the
treatment because of serious adverse events or complications occurred in the process. ©Quit without any reasons 2 Treatment method
All sixty patients with underlying diseases (such as hypertension, diabetes, abnormal lipid metabolism, etc.) were given the conventional treatment. 2.1 The treatment group
Frontal and parietal areas of Yu's scalp acupuncture were adopted for treatment. Patients took sitting or supine position. Healer used long retaining needle discontinuous line stitch, namely using 0.35 mm x 40 mm acupuncture needle. After routine disinfection, frontal area was pinpricked five needles [from Shenting(DU 24) to Xinghui(DU 22)and to the left and right's 1 and 2 inch parallel lines ], parietal area was five needles [from Qingding (DU 21)to Baihui (DU 20) and to the left and right's 1 and 2 inch parallel lines ].According to the above points, healer pinpricked from front to back. The needle bodies were 15 ° with the skin, and then along Subgaleal with 0.8 ~ 1.0 inch.
Twisting after acupuncture, the twirling frequency was 200 times/min, 1 minutes one time, and retaining needle for 6 hours , during the retaining process, twisting the needles for three times. Treatment for 1 times per day, 6 times per week and 6 weeks for a duration. 2.2 The control group
The oral drug Donepezil Hydrochloride Tables[Approved by Eisai (China) Pharmaceutical Co., Ltd.], 5 mg each time, after 4 weeks increased to 10mg, 1 time per night,6 weeks for a duration.
3 Treatment effect
3. 1 Observation index
Mini-mental state examination(MMSE),Montreal Cognitive Assessment (MoCA), and determination of P300 latency period and amplitude were adopted for evaluation.
3.2 Therapeutic effect criterion
According to MMSE score, efficacy index=[(Score after treatment —Score before treatment)^Score
after treatment]* 100%D
Excellent: Efficacy index>20%
Effective: 12%<Efficacy index< 19%
Invalid: Efficacy index< 12%
3.3 Statisticalmethod
The statistics were analyzed by SPSS17.0 software. Categorical data used chi-square test. Measurement data was expressed by (mean ± standard deviation).Comparison between groups used independent sample t test. Inner-group comparison used paired sample t test. P< 0.05 showed statistically significant difference.
3.4 Treatment outcome
3.4.1 Comparison of two groups of patients in clinical efficacy
Seen from Table 2.The total effective rate was 83.3% in the treatment group versus 53.3% in the control group, and the difference was statistically significant(P<0.01).Description of the treatment group is better than the control group in clinical efficacy.
Table 2 Comparison of two groups of patients in clinical efficacy (n)_
Category n Excellent Effective Invalid Total effective rate /%
Treatment group 30 6 19 5 83.31)
Control group 30 2 14 14 53.3
Note: Compared with control group
3.4.2 Comparison of two groups of patients in MMSE and MoCA scores
Seen from Table 3. Compared two groups ofpatients with MMSE and MoCA scores before treatment, the difference were not statistically significant(both P>0.05). After treatment, inner-group comparison of MMSE and MoCA scores showed significant improvements (all P<0.01). After treatment, the differences between the treatment group and control group were statistically significant in comparing MMSE and MoCA scores, description of the treatment group is better than the control group in the improvement of MMSE and MoCA scores.
Table 3Comparison of two groups of patients in MMSE and MoCA scores ( x ±.v,point)_
Category n Time MMSE MoCA
Treatment group 30 Before treatment After treatment 16.50±3.80 19.63±4.911)2) 15.37±3.18 18.23±4.311)2)
Control group 30 Before treatment 15.73±3.26 14.90±2.72
After treatment 17.37±3.721) 16.30±2.961)
Note: Compared with the same group before treatment 1)P<0.01.Compared with control group 2)P<0.05
3.4.3 Comparison of two groups of patients in P300 latency period and amplitude
Seen from Table 4. Compared two groups ofpatients with P300 latency period and amplitude scores before treatment, the difference were not statistically significant(both P>0.05). After treatment, inner-group comparison of P300 latency period and amplitude showed significant
improvements (alLP<0.01). After treatment, the differences between the treatment group and control group were statistically significant in comparing P300 latency period and amplitude, description of the treatment group is better than the control group in the shortening of P300 latency period and the increase of P300 amplitude.
Table4Comparison of two groups of patients in P300 latency period and amplitude ( x ±5)
Category n Time Latency period (ms) Amplitude (pV)
Treatment group 30 Before treatment 456.67±20.40 1.44±0.26
After treatment 437.67±28.971)2) 1.75±0.511)2)
Control group 30 Before treatment 460.67±18.18 1.38±0.20
After treatment 451.00i19.361-1 1.50±0.231)
Note: Compared with the same group before treatment '/<0.01 .Compared with control group
2)PD0.05
3.5 Adverse reactions and cases of loss
One case appeared nausea and mild epigastric pain in the control group during the treatment, the symptom disappeared after taking gastric mucosa protectant. One case suffered from insomnia in the control group, the symptoms disappeared after taking morning medication instead. The treatment group had no adverse effect in the whole course of the treatment .
No one fall off due to poor compliance during the treatment. 4 Discussion
The clinical presentations of subcortical arteriosclerotic encephalopathy (SAE) could be mainl y manifested by dementia, it belongs to " dementia "or "forgetfulness" in Traditional Chinese Medicine.Disease located in the brain. The basic pathogenesis is lack of the brain.The brain isclear yangorgan, the center of yang, full of blood and qi, so the the focus of treatment should be the brain, using the scalp needling. Acupuncture has been frequently used in treating this disease[3-4] .
According to the acupoint property of nearby-action. Plus the view ' acupuncture field' of Dr. yu. The reseach chose the frontal and parietal areas[5]. The frontal area, as one of intelligence representative district, which is on the anterior part of thefrontal lobe is related to the mental activity. While the parietal area which is on the precentral gyrus, postcentral gyrus,paracentral lobule,inferiorparietal lobule, and part of superior parietal lobule is to space location. Besides,Baihui (DU20) and Sishencong (EX-HN1) are located in parietal area, and they are all conductive to the improvement of cognitive function[6-8].
The results showthat scalp clustery acupuncture and theoral drug 'Donepezil Hydrochloride Tables' are both effective treatments for the cognitive impairment from SAE, and the former is better than the latter in clinical efficacy. However, the further study about the onset time, the optimal efficacy, and the duration will be needed in the future. Reference
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The clinical study of post-stroke depression of heart and spleen deficiency treated with music electro-acupuncture
Sun Yuanzheng1, Yu Jiani2
The Second Affiliated Hospital of Heilongjiang University of Chinese MedicineHarbin, ChinaHeilongjiang University of Chinese Medicine ,Harbin ,China
Abstract. Objective: To observe the therapeutic effects of post stroke depression of heart-spleen deficiency with the method of music electro-acupuncture in order to find a safe and effective treatment. Methods: 90 patients randomly divided into acupuncture group treated with twist reinforcing method, electro-acupuncture group (EA group) treated with electro-acupuncture method, music electro-acupuncture group (music EA group) treated with electro-acupuncture method and listen to antidepressant music. Using HAMDMESSSWHOQOL-BREF to estimate the effect of three methods before and after treatment. Results: 1.Compared with acupuncture group and EA group, music EA group is better in improving depressive symptoms (P<0.01). 2. Compared with acupuncture group and EA group, music EA group is better in improving nerve function (P<0.01). 3.Compared with acupuncture group and EA group, music EA group is better in G1G4physical fieldpsychological field (P<0.01). 4. Total efficiency of HAMD and MESSS of music EA group is better than the other two groups (P<0.05). Conclusions: 1.The music EA therapy is superior to the other two groups in the fields of improving the depressive symptoms, restoring from the deficit neural function and improving the quality of the patients' lives.2.The music EA therapy can comprehensively ameliorate the Depressive symptoms of the stroke depressive patients by improving the patient's physical and psychological condition.
Key words: Post stroke depression (PSD), Music electro-acupuncture, Heart-spleen deficiency,Quality of life
Introduction:
Depression after stroke (PSD) offen appears cardinal syndroms such as low spirite, flagging interestsleep disorder, which not only influence mood of patients, but also obstruct to rehabilitation of neurological function impairment. Because of side reactions, no quick results in early treatment and palindromia after drug withdrawing, the application of Western medicine is currently restricted. In this study, we observe the effect of 90 patients of PSD through three intervene therapies such as the acupuncture, electro-acupuncture, music electro-acupuncture to explore a safe and effective new approach .
Materials and methods:
1. General information
90 observed cases all came from the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from Jan, 2012 to Jun, 2012. These observed cases were randomly divided into acupuncture group, EA group and music EA group by PEMS3.1 software (n=30), including 51 male
