摘要
目的 观察调神益智艾灸对遗忘型轻度认知障碍患者(aMCI)的临床疗效,并应用磁共振弥散张量成像技术(DTI)观察艾灸对脑白质(WM)的影响.方法 将 2018 年 4 月至2019 年 1 月深圳大学第二附属医院及附近社区招募的 aMCI患者 40 例随机分为艾灸组和安慰灸组,每组各 20 例,2 组患者于治疗前后采用 Rivermead行为记忆测验(RBMT)、简易精神状态检查量表(MMSE)及蒙特利尔认知评估量表(MoCA)评估整体认知功能和记忆功能,行颅脑 DTI检查观察艾灸对 WM 的影响.结果 与本组治疗前比较,治疗后艾灸组和安慰灸组 MoCA、MMSE及RBMT评分均明显升高(t=6.171、3.093、5.605、2.798、8.018、3.656,P 均<0.05).与安慰灸组比较,艾灸组 RBMT、MMSE 及 MoCA 评分差值明显升高(Z=-3.497、-2.536、-3.888,P均<0.05).与安慰灸组比较,艾灸组各向异性分数值(FA)明显增加的纤维束主要位于右侧前放射冠,胼胝体辐射线额部,右侧下额枕束,右侧钩束及右侧上纵束(P均<0.05);未发现FA值明显减少的纤维束.结论 调神益智艾灸能有效改善 aMCI患者的记忆功能,DTI可用于评估艾灸治疗后aMCI患者的WM网络结构变化.
Abstract
Objective To investigate the efficacy of mind-regulating intelligence-enhancing moxibustion in patients with amnestic mild cognitive impairment(aMCI)and its impact on brain white matter(WM)using diffusion tensor imaging(DTI)technology.Methods Forty aMCI patients recruited from the Second Affiliated Hospital of Shenzhen University and nearby communities from April 2018 to January 2019 were randomly divided into a real moxibustion group and a sham moxibustion group,with 20 patients in each group.Patients in both groups underwent the rivermead behavioral memory test(RBMT),mini-mental state examination(MMSE),and Montreal cognitive assessment(MoCA)before and after treatment to evaluate the overall cognitive function and memory domain function.Head DTI examination was performed to observe the impact of moxibustion treatment on white matter.Results Compared with the pre-treatment in each group,both the real moxibustion group and sham moxibustion group showed significant increases in MoCA,MMSE,and RBMT scores after intervention(t=6.171,3.093,5.605,2.798,8.018,3.656,P<0.05 for all).Compared with the sham moxibustion group,the RBMT,MMSE,and MoCA score differences in the real moxibustion group are significantly higher(Z=-3.497,-2.536,-3.888,P<0.05 for all).Additionally,compared with the sham moxibustion group,fractional anisotropy(FA)values of the real moxibustion group exhibited significant increases in fiber bundles mainly located in areas such as right anterior corona radiata,anterior forceps of corpus callosum,right inferior fronto-occipital fasciculus,right uncinate fasciculus,and right superior longitudinal fasciculus(P<0.05 for all);no fiber bundles with significantly decreased FA values were observed.Conclusions Mind-regulating intelligence-enhancing moxibustion might effectively improve the memory function in patients with aMCI.Moreover,DTI can be utilized to evaluate changes in WM network structure of aMCI patients after moxibustion therapy.
基金项目
国家自然科学基金(81973922)
深圳市宝安中医药发展基金(2022KJCX-ZJZL-14)
广东省基础与应用基础研究基金(2021A1515110764)
深圳市科技研发资金(JCYJ20220530142806014)
深圳市科技研发资金(JCYJ20210324110809025)
深圳市"医疗卫生三名工程"项目(2017)()
NETL
NSTL
万方数据