血栓通天真灸刺治疗阿尔茨海默病临床研究

目的:观察血栓通天真灸刺治疗阿尔茨海默病(AD)的临床疗效并探讨机制。方法:将150例AD患者随机分成针药组50例、针灸组50例与西药组50例。针药组取百会、四神聪、脑功能投影区等穴位,予血栓通天真灸刺,同时服用多奈哌齐;针灸组针灸和针药组相同但不服用多奈哌齐;西药组服用多奈哌齐。比较3组治疗6个月前后IL-6、TNF-α、淀粉样β蛋白、8-IPF2α、TCD相关参数、脑电图总异常率,比较临床疗效。结果:针药组总有效率70.0%,优于针灸组58.0%和西药组48.0%(均P<0.05);针灸组总有效率优于西药组(P<0.05)。3组治疗后IL-6、TNF-α、淀粉样β均降低(均P<0.05);针药组与针灸组、西药组IL-6、TNF-α、淀粉样β蛋白治疗后比较,针药组降低更明显(均P<0.05);针灸组与西药组IL-6、TNF-α、淀粉样β蛋白治疗后比较,差异有统计学意义(P<0.05)。3组治疗后8-IPF2α均降低(均P<0.05);针药组与针灸组、西药组8-IPF2α治疗后比较,针药组降低更明显(均P<0.05);针灸组与西药组8-IPF2α治疗后比较差异有统计学意义(P<0.05)。3组治疗后Vp、Vd均升高(均P<0.05);针药组与针灸组、西药组Vp、Vd治疗后比较,针药组升高更明显(均P<0.05);针灸组与西药组Vp、Vd治疗后比较,差异有统计学意义(P<0.05)。3组治疗后PI及RI均降低(均P<0.05);针药组与针灸组、西药组PI、RI治疗后比较,针药组降低更明显(均P<0.05);针灸组与西药组PI、RI治疗后比较,差异有统计学意义(P<0.05);针药组与针灸组、西药组治疗后EEG总异常率比较,差异均有统计学意义(均P<0.05);针灸组与西药组治疗后EEG总异常率比较,差异有统计学意义(P<0.05)。结论:血栓通针天真灸刺治疗AD疗效确切,与多奈哌齐有协同作用。可能是通过降低IL-6、TNF-α、淀粉样β蛋白、8-IPF2α,升高Vp、Vd,降低PI、RI,降低EEG异常率而实现。

Clinical Research of Acupoint Intradermic Injection of Xueshuantong in the Treatment of AD

Objective:To observe the clinical effect of acupoint intradermic injection of Xueshuantong in the treatment of alzheimer disease(AD)and to explore its action mechanism.Methods:150 AD cases were randomly divided into the combination group of acupuncture and medication,the acupuncture group and the western medication group,with 50 cases in each group.The western medication group was treated with Donepezil;on which basis,the combination group was also treated with acupoint intradermic injection of Xueshuantong to points of Baihui(GV20),Sishencong(EX-HN1),and points of brain function shadow area;the acupuncture group was treated with the same treatment as the combination group except for Donepezil.IL-6,TNF-α,amyloidβprotein,8-IPF2α,TCD related parameters and electroencephalogram abnormal rates were evaluated and compared among the three groups before and after the six months of treatment,the clinical curative effect was also compared among the three groups.Results:The total effective rate was 70.0%in the combination group,which was significantly higher than 58.0%in the acupuncture group and 48.0%in the western medication group(P<0.05).The levels of IL-6,TNF-αand amyloidβprotein decreased in the three groups after the treatment(P<0.05);the decreases in the combination group were more significant than those in the other two groups(P<0.05);there were also differences in IL-6,TNF-αand amyloidβprotein between the acupuncture group and the western medication group(P<0.05).The content of 8-IPF2αalso decreased in the three groups after the treatment(P<0.05);the decrease was more obvious in the combination group(P<0.05);there was a difference in 8-IPF2αbetween the acupuncture group and the western medication group(P<0.05).Vp and Vd increased in the three groups after the treatment(P<0.05);the increases in the combination group were more significant(P<0.05);there were differences in the increases of Vp and Vd between the acupuncture group and the western medication group(P<0.05).PI and RI decreased in the three groups after the treatment(P<0.05);the decreases in the combination group were more obvious(P<0.05);there were differences in PI and RI between the acupuncture group and the western medication group(P<0.05).There were differences in total abnormal rate of EEG after the treatment among the groups(P<0.05).Conclusion:The acupoint intradermic injection of Xueshuantong is effective for AD,and has a synergistic effect with Donepezil.Its action mechanism may be obtained by reducing the expressions of IL-6,TNF-α,amyloidβand 8-IPF2α,increasing Vp and Vd and decreasing PI and RI,thereby improving the cerebral blood supply.It can also reduce the abnormal rate of EEG.