Objectives: To observe the effects on cognitive function, sleep quality and hemodynamics in the patients with subjective cognitive decline (SCD) after treated with acupuncture at neck-Jiaji (EX-B 2) and tuina on the base of healthy lifestyle education and meta-memory training.
Methods: Sixty SCD patients were randomly divided into an observation group (30 cases, 1 case dropped out) and a control group (30 cases, 3 cases dropped out). In the control group, the healthy lifestyle education and meta-memory training was performed, twice daily, 15 min each time; the 5-day intervention was delivered a week, lasting consecutively 4 weeks. On the base of the intervention as the control group, in the observation group, acupuncture at neck-Jiaji (EX-B 2) and tuina was conducted. First, one-finger pushing and plucking method of tuina was exerted on the neck region along the running courses of the bladder meridian of foot-taiyang and the governor vessel, for 10 min to 15 min; afterwards, acupuncture was delivered at bilateral neck-Jiaji (EX-B 2), from C1 to C7; and the needles were retained for 30 min. This intervention was given once daily, 5 times a week, for consecutive 4 weeks. Before and after treatment, the score of the mini-mental state examination (MMSE), the score of full scale memory quotient (FSMQ) were assessed by Wechsler memory scale-fourth edition (WMS-Ⅳ) and the score of the Pittsburgh sleep quality index (PSQI) was compared between the two groups. Using transcranial Doppler ultrasound, the hemodynamic indexes (the mean velocity [Vm] and pulsatility index [PI] of the left vertebral artery [LVA], the right vertebral artery [RVA] and the basilar artery [BA]) were determined in the two groups.
Results: After treatment, the scores of MMSE and FSMQ increased compared with those before treatment in the two groups (P<0.05, P<0.001), PSQI score was lower (P<0.05) and Vm of BA was higher (P<0.001) in the observation group when compared with those before treatment. The scores of MMSE and FSMQ, as well as Vm of BA were higher (P<0.05, P<0.001), and PSQI score was decreased (P<0.05) in the observation group when compared with the control group.
Conclusions: The combined therapy of acupuncture at neck-Jiaji (EX-B 2) and tuina is more advantageous to improving cognitive function, relieving chronic emotional stress and ameliorating sleeping quality in the patients with subjective cognitive decline, which may be achieved by improving the blood supply of the basilar artery.
目的: 在生活方式健康宣教、元记忆训练基础上，观察针刺颈夹脊穴联合推拿对主观认知下降（SCD）患者认知功能、睡眠质量、血流动力学指标的影响。方法: 将60例SCD患者随机分为观察组（30例，脱落1例）和对照组（30例，脱落3例）。对照组予生活方式健康宣教和元记忆训练，每天训练2次，每次15 min，每周5 d，连续4周；在对照组基础上，观察组采用针刺颈夹脊穴联合推拿治疗，先使用一指禅偏锋推法结合拨法分别沿足太阳膀胱经和督脉按摩颈部10~15 min，然后针刺双侧C1-C7颈夹脊穴，留针30 min，每日1次，每周5次，连续4周。于治疗前后，观察两组简易智能精神状态量表（MMSE）评分、韦克斯勒记忆量表第四版（WMS-Ⅳ）评估的总记忆商（FSMQ）评分、匹兹堡睡眠质量指数（PSQI）评分，采用经颅多普勒超声检测两组患者血流动力学指标［左侧椎动脉（LVA）、右侧椎动脉（RVA）、基底动脉（BA）的平均血流速度（Vm）和血管搏动指数（PI）］。结果: 治疗后，两组患者MMSE、FSMQ评分较治疗前升高（P<0.05，P<0.001），观察组PSQI评分较治疗前降低（P<0.05），观察组BA的Vm值较治疗前升高（P<0.001）；观察组MMSE、FSMQ评分以及BA的Vm值均高于对照组（P<0.05，P<0.001），PSQI评分低于对照组（P<0.05）。结论: 针刺颈夹脊穴联合推拿在改善SCD患者认知功能、缓解慢性情绪应激和改善睡眠状态方面更具优势，其作用机制可能是改善BA的供血。.
Keywords: acupuncture; cognitive function; neck-Jiaji (EX-B 2); randomized controlled trial (RCT); subjective cognitive decline; tuina.