摘要
目的:比较电针联合盐酸多奈哌齐与单纯盐酸多奈哌齐对改善阿尔茨海默病患者学习记忆能力的疗效,并探讨其作用机制。方法:将60例阿尔茨海默病患者随机分为观察组、对照组,每组30例。观察组采用督脉电针结合盐酸多奈哌齐治疗,电针穴取百会、风府,予疏密波,频率10 Hz/50 Hz,强度0.5~5.0 mA,留针40 min,每日1次;口服盐酸多奈哌齐片,每次5mg,每日1次,口服4周后可依具体情况增至10mg/d,均治疗8周。对照组仅采用盐酸多奈哌齐治疗,用法用量及疗程同观察组。治疗前后分别评价两组蒙特利尔认知评估量表(MoCA)、阿尔茨海默病评估量表认知部分(ADAS-Cog)评分,采用EEG/ERP系统脑事件相关电位仪检测P300中N2、P3潜伏期及波幅,采用酶联免疫吸附法(ELISA)检测血清中Aβ前体蛋白(APP)、β淀粉样蛋白1-42(Aβ1–42)水平。结果:治疗后两组Mo CA评分均高于治疗前(P<0.05),且观察组高于对照组(P<0.05);治疗后两组ADAS-Cog评分均降低(P<0.05),且观察组低于对照组(P<0.05)。与治疗前比较,治疗后两组患者N2和P3潜伏期均缩短、波幅均增高(P<0.05);治疗后观察组患者N2和P3潜伏期短于对照组,波幅高于对照组(P<0.05)。两组治疗后血清APP、Aβ1–42水平均较治疗前下降(P<0.05),且观察组低于对照组(P<0.05)。结论:电针百会、风府穴联合盐酸多奈哌齐治疗可有效降低阿尔茨海默病患者血清APP、Aβ1–42水平,改善Mo CA、ADAS-Cog评分及P300中N2和P3水平,在改善阿尔茨海默病患者学习记忆方面优于单纯盐酸多奈哌齐治疗。
Objective To compare the therapeutic effect of electroacupuncture(EA)combined with donepezil hydrochloride and donepezil hydrochloride alone on improving learning-memory ability in patients with Alzheimer’s disease(AD),and to explore its action mechanism.Methods Sixty patients of AD were randomly divided into an observation group and a control group,30 cases in each group.The patients in the observation group were treated with EA at governor vessel(GV)combined with donepezil hydrochloride.EA was applied at Baihui(GV 20)and Fengfu(GV 16)with dilatational wave(10 Hz/50 Hz of frequency,0.5 to 5.0 mA of intensity),and the needles were kept for 40 min,EA was given once a day;the donepezil hydrochloride tablet was taken orally,5 mg,once a day,and after 4 weeks the dosage might be increased to 10 mg per day according to the specific situation.All the treatment was given for 8 weeks.The patients in the control group were only treated with donepezil hydrochloride with the identical procedure as the observation group.The Montreal cognitive assessment(MoCA)and Alzheimer’s disease assessment scale cognitive part(ADAS-Cog)were evaluated before and after treatment;P300(latency and amplitude of N2 and P3)was detected by EEG/ERP system brain event related potential instrument,and amyloid precursor protein(APP)andβ-amyloid protein 1-42(Aβ1-42)were detected by ELISA.Results Compared before treatment,the MoCA scores were increased after treatment in the two groups(P<0.05),and the MoCA score in the observation group was higher than that in the control group(P<0.05).Compared before treatment,the ADAS-Cog scores were decreased after treatment in the two groups(P<0.05),and the ADAS-Cog score in the observation group was lower than that in the control group(P<0.05).Compared before treatment,the latency of N2 and P3 was shortened and the amplitude was increased after treatment in the two groups(P<0.05);after treatment,the latency of N2 and P3 in the observation group was shorter than that in the control group and the amplitude was higher than that in the control group(P<0.05).Compared before treatment,the serum levels of APP and Aβ1-42 were lower after treatment in the two groups(P<0.05),and the serum levels of APP and Aβ1-42 in the observation group were lower than those in the control group(P<0.05).Conclusion EA at Baihui(GV 20)and Fengfu(GV 6)combined with donepezil hydrochloride can effectively reduce the serum levels of APP and Aβ1-42 and improve the scores of MoCA and ADAS-Cog and the levels of N2 and P3 of P300 in AD patients,which has superior effect to donepezil hydrochloride alone in improving the learning-memory of AD patients.
作者
夏昆鹏
逄静
李书霖
张淼
李虹霖
王玉珏
XIA Kun-peng;PANG Jing;LI Shu-lin;ZHANG Miao;LI Hong-lin;WANG Yu-jue(Graduate School of Heilongjiang University of CM,Harbin 150040,China;Third Ward of Rehabilitation Department,Second Clinical Medical College of Heilongjiang University of CM,Harbin 150001)
出处
《中国针灸》
CAS
CSCD
北大核心
2020年第4期375-378,共4页
Chinese Acupuncture & Moxibustion
基金
黑龙江省自然科学基金联合引导项目:LH2019H047
黑龙江省卫生健康委科研课题项目:2019-192。
关键词
阿尔茨海默病
电针
督脉
穴
百会
穴
风府
学习记忆能力
随机对照研究
Alzheimer’s disease(AD)
electroacupuncture(EA)
governor vessel(GV)
Point GV 20(Baihui)
Point GV 16(Fengfu)
learning and memory ability
randomized controlled trial(RCT)
作者简介
通信作者:李书霖,主任医师。E-mail:zydeylishulin@163.com。
