Effect of Xingnao Kaiqiao acupuncture on clinical efficacy of patients with mild cognitive impairment after stroke and its mechanism / 中国中西医结合急救杂志

ABSTRACT

Objective To observe the effect of Xingnao Kaiqiao acupuncture on the clinical efficacy of patients with mild cognitive impairment (MCI) after stroke and to explore its mechanism. Methods A prospective randomized controlled clinical trial method was conducted, 128 patients with MCI after stroke admitted to Department of Acupuncture and Moxibustion of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from September 2015 to May 2017 were enrolled, and they were divided into a control group and an observation group according to the random number table method, 64 cases in each group. The control group took 40 mg of nimodipine, 3 times a day; on the basis of the treatment in control group, the observation group was additionally given acupuncture therapy for arousing the brain and opening the orifices or resuscitation as the interference, the main acupoints applied were renzhong, neiguan (bilateral) and sanyinjiao (bilateral), the scalp points used were mainly baihui joining qianding (GV-21WHO), xinhui (GV-22WHO) joining qianting and benshen (GB-13WHO, bilateral), once a day, 5 times a week; the therapeutic course was 10 weeks in both groups. The differences in scores of Montreal cognitive assessment scale (MoCA), mini-mental state examination (MMSE), and in the levels of serum amyloid A (SAA) andβ-amyloid (Aβ) between the two groups before and 6 and 10 weeks after treatment were compared. Results With the prolongation of therapeutic time, the MoCA and MMSE scores of the two groups were increased significantly after treatment compared with those before treatment, the levels of SAA and Aβ were obviously lower than those before treatment, and the degrees of changes of the above indexes in the observation group were more marked than those in the control group, after treatment for 10 weeks, there were statistical significant differences in MoCA and MMSE scores between the observation and control groups (MoCA score 25.32±2.54 vs. 22.67±3.17, MMSE score 28.38±2.74 vs. 24.36±3.27), while after 6 weeks of treatment, the statistical significant differences in SAA and Aβlevels appeared between the two groups [SAA (μg/L) 74.52±25.64 vs. 103.36±27.53, Aβ (ng/L) 95.32±25.64 vs. 127.27±29.73, both P ＜ 0.05], and the situation persisted to 10 weeks after treatment [SAA (μg/L) 57.36±18.24 vs. 84.37±25.56, Aβ (ng/L) 55.47±21.36 vs. 92.74±23.57, both P ＜ 0.05]. Conclusion Resuscitation acupuncture possibly can inhibit the expression protein levels of serum SAA and Aβto improve the cognitive function of patients with MCI after stroke.