[Effect of early acupuncture on cognitive function in patients with vascular dementia after cerebral infarction].

To observe the clinical efficacy of early acupuncture for vascular dementia (VD) after cerebral infarction, and explore its possible mechanism.A total of 120 patients with VD after cerebral infarction were randomized into an acupuncture combined with medication group (60 cases, 1 case dropped off) and a western medication group (60 cases, 1 case dropped off). In the western medication group, oxiracetam capsules were given orally, 2 capsules each time, 3 times a day. On the basis of the treatment as the western medication group, Bupi Peiyuan Yizhi acupuncture was applied at Baihui (GV 20), Sishencong (EX-HN 1), Zhongwan (CV 12), Wailing (ST 26), Xiawan (CV 10), Qihai (CV 6), Guanyuan (CV 4), etc. in the acupuncture combined with medication group, 30 min each time, once a day, 5 days a week. The treatment was given 8 weeks in both groups. Before and after treatment，the scores of mini-mental state examination (MMSE), Alzheimer's disease assessment scale cognitive part (ADAS-Cog), clock drawing test (CDT), Barthel index were observed, blood flow velocity of middle cerebral artery (MCA) was detected, and the clinical efficacy was evaluated in the two groups.The total effective rate was 89.8% (53/59) in the acupuncture combined with medication group, which was superior to 76.3% (45/59) in the western medication group (P<0.01). Compared before treatment, the subitem scores and total scores of MMSE, ADAS-Cog score, CDT score and Barthel index score after treatment were improved in the two groups (P<0.01, P<0.05), and the scores in the acupuncture combined with medication group were superior to those in the western medication group (P<0.05, P<0.01). After treatment, the blood flow velocity of bilateral MCA was increased in the acupuncture combined with medication group (P<0.05), which was faster than the western medication group (P<0.05).Early acupuncture could improve cognitive function and activities of daily living in patients with VD after cerebral infarction, its mechanism may be related to improving the blood flow velocity of MCA, promoting blood circulation, and improving cerebral perfusion.目的：观察早期针刺治疗脑梗死后血管性痴呆（VD）的临床疗效，探讨其可能机制。方法：将120例脑梗死后VD患者随机分为针药组（60例，脱落1例）和西药组（60例，脱落1例）。西药组予奥拉西坦胶囊口服，每次2粒，每日3次；针药组在西药组基础上予“补脾培元益智”针刺，穴取百会、四神聪、中脘、外陵、下脘、气海、关元等，每次30 min，每日1次，每周5 d，两组均治疗8周。观察两组患者治疗前后简易精神状态评价量表（MMSE）评分、阿尔茨海默病评定量表-认知量表（ADAS-Cog）评分、画钟试验（CDT）评分及Barthel指数评分变化，检测大脑中动脉（MCA）血流变化，并评价临床疗效。结果：针药组总有效率为89.8%（53/59），优于西药组的76.3%（45/59，P<0.01）。两组治疗后MMSE各子项评分及总分、ADAS-Cog评分、CDT评分、Barthel指数评分均较治疗前改善（P<0.01，P<0.05），且针药组优于西药组（P<0.05，P<0.01）。针药组治疗后双侧MCA血流速度较治疗前增快（P<0.05），且快于西药组（P<0.05）。结论：早期针刺治疗能改善脑梗死后VD患者的认知功能及日常生活能力，其机制可能与改善MCA血流速度、促进血液循环、提高脑灌注有关。.