Effects of pressing moxibustion at Baihui (GV 20) and Guanyuan (CV 4) on cognitive impairment and serum levels of Aβ1-42, tau, P-tau in patients with mild to moderate Alzheimer's disease

OBJECTIVES

To compare the effects of pressing moxibustion at Baihui (GV 20) and Guanyuan (CV 4) combined with donepezil hydrochloride tablets and donepezil hydrochloride tablets alone on cognitive impairment in patients with mild to moderate Alzheimer's disease(AD), and to explore the mechanism of pressing moxibustion in the treatment of mild to moderate AD from the serum levels of β-amyloid 1-42 (Aβ1-42), microtubule-associated protein tau and phosphorylated tau (P-tau).

METHODS

A total of 76 patients with mild to moderate AD were randomly divided into an observation group (38 cases, 4 cases dropped out) and a control group (38 cases, 2 cases dropped out). Patients in the control group were given oral donepezil hydrochloride tablets (5 mg each time, once a day). On the basis of the control group, patients in the observation group were treated with pressing moxibustion at Baihui (GV 20) and Guanyuan (CV 4), 5 cones per acupoint, once every other day, three times a week. Both groups were treated for 8 weeks. The scores of mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were compared between the two groups before treatment, after treatment and after 4 and 12 weeks of treatment completion. The serum levels of Aβ1-42, tau and P-tau were detected before and after treatment in the two groups, and the safety was evaluated.

RESULTS

At each time point after treatment, the MMSE and MoCA scores of the two groups were higher than those before treatment (P<0.05), and the scores in the observation group were higher than those in the control group (P<0.05). After treatment, the serum levels of Aβ1-42, tau and P-tau in the two groups were lower than those before treatment (P<0.05), and above indexes in the observation group were lower than those in the control group (P<0.05). There was no significant difference in the safety level between the two groups (P>0.05).

CONCLUSIONS

The short-term and long-term effect of pressing moxibustion at Baihui (GV 20) and Guanyuan (CV 4) combined with donepezil hydrochloride tablets in improving cognitive impairment in mild to moderate AD is better than that of donepezil hydrochloride tablets alone, and can reduce serum levels of Aβ1-42, tau and P-tau, which may be one of the mechanisms of pressing moxibustion to improve cognitive impairment.

Needle retaining after electroacupuncture combined with cognitive training for post-stroke cognitive impairment: a multi-center randomized controlled trial

OBJECTIVES

To compare the efficacy of needle retaining after electroacupuncture combined with cognitive training and electroacupuncture combined with cognitive training in the treatment of post-stroke cognitive impairment (PSCI).

METHODS

A total of 206 patients with PSCI were randomized into a needle retaining group (103 cases, 9 cases dropped out) and an electroacupuncture group (103 cases, 6 cases dropped out). In addition to the conventional basic medical treatment and the rehabilitation treatment, in the needle retaining group, electroacupuncture at Shenting (GV 24) and Baihui (GV 20) was applied, with continuous wave of 50 Hz in the first 15 min and with disperse-dense wave of 2 Hz/50 Hz in the last 15 min, the needles were continuously retained for 1 h after electroacupuncture, during which cognitive training was adopted; in the electroacupuncture group, cognitive training was performed after the same electric stimulation exerted for 30 min, without additional needles retaining. The treatment was given once a day, 5 times a week for totally 8 weeks in the two groups. Before and after 8-week treatment, the TCM syndrome score was observed; before and after 4,8-week treatment, the scores of mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and ability of daily living were observed in the two groups. The clinical efficacy of the two groups was evaluated after 8-week treatment.

RESULTS

After 8-week treatment, the TCM syndrome scores were increased compared with those before treatment in both groups (P<0.05); the TCM syndrome score in the needle retaining group was higher than that in the electroacupuncture group (P<0.05).After 4,8-week treatment, the scores of MMSE, MoCA and ability of daily living were increased compared with those before treatment in both groups (P<0.05); MMSE, MoCA scores after 4,8-week treatment and ability of daily living score after 8-week treatment in the needle retaining group were higher than those in the electroacupuncture group (P<0.05). The total effective rate was 90.4% (85/94) in the needle retaining group, which was superior to 82.5% (80/97) in the electroacupuncture group (P<0.05).

CONCLUSIONS

Both needle retaining after electroacupuncture combined with cognitive training and electroacupuncture combined with cognitive training can effectively treat PSCI, improve the clinical symptom, cognitive function and ability of daily living in PSCI patients. Needle retaining after electroacupuncture combined with cognitive training has a better therapeutic effect.

[Effects of moxibustion on serum levels of β-EP, SP and expression of IL-1β and COX-2 protein in brainstem in rats with migraine]

OBJECTIVE

To observe the effects of moxibustion at "Baihui" (GV 20) and "Dazhui" (GV 14) at different time points on the serum level of β-endorphin (β-EP), substance P (SP) and expression of interleukin-1β (IL-1β) and cyclooxygenase-2 (COX-2) protein in brainstem in rats with migraine, and to explore the effect and mechanism of moxibustion in preventing and treating migraine.

METHODS

Forty male SD rats were randomly divided into a blank group, a model group, a prevention+treatment (PT) group and a treatment group, 10 rats in each group. Except the blank group, the rats in the remaining groups were injected with nitroglycerin subcutaneously to prepare migraine model. The rats in the PT group were treated with moxibustion 7 days before modeling (once a day) and 30 min after modeling, while the rats in the treatment group were treated with moxibustion 30 min after modeling. The "Baihui" (GV 20) and "Dazhui" (GV 14) were taken for 30 minutes each time. The behavioral scores in each group were observed before and after modeling. After intervention, ELISA method was used to detect the serum level of β-EP and SP; the immunohistochemistry method was used to detect the number of positive cells of IL-1β in brainstem; the Western blot method was used to detect the expression of COX-2 protein in brainstem.

RESULTS

Compared with the blank group, the behavioral scores in the model group were increased 0-30 min, 60-90 min and 90-120 min after modeling (P<0.01); compared with the model group, in the treatment group and the PT group, the behavioral scores were decreased 60-90 min and 90-120 min after modeling (P<0.01). Compared with the blank group, in the model group, the serum level of β-EP was decreased (P<0.01), while the serum level of SP, the number of positive cells of IL-1β in brainstem and the expression of COX-2 protein were increased (P<0.01). Compared with the model group, in the PT group and and the treatment group, the serum level of β-EP was increased (P<0.01), while the serum level of SP, the number of positive cells of IL-1β and the expression of COX-2 protein in brainstem were decreased (P<0.01, P<0.05). Compared with the treatment group, in the PT group, the serum level of β-EP was increased and COX-2 protein expression was decreased (P<0.05).

CONCLUSION

Moxibustion could effectively relieve migraine. The mechanism may be related to reduce the serum level of SP, IL-1β and COX-2 protein expression in brainstem, and increase the serum level of β-EP, and the optimal effect is observed in the PT group.

[Effect of electroacupuncture at governor vessel on learning-memory ability and serum level of APP, Aβ1-42 in patients with Alzheimer's disease]

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) and β-amyloid protein 1-42 (Aβ_1-42) 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 Aβ_1-42 were lower after treatment in the two groups (P<0.05), and the serum levels of APP and Aβ_1-42 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 Aβ_1-42 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.

[Clinical observation of long-time needle retaining at Baihui (GV 20) on post-stroke cognitive disorder of qi deficiency and blood stasis]

OBJECTIVE

To observe the clinical efficacy of long-time needle retaining at Baihui (GV 20) on post-stroke cognitive disorder of qi deficiency and blood stasis.

METHODS

A total of 70 patients (3 cases dropping) with post-stroke cognitive disorder of qi deficiency and blood stasis were randomized into an observation group (34 cases) and a control group (33 cases). Neurological routine treatment and western medicine rehabilitation therapy were given in the control group as the basic treatment, on the basis of the treatment as the control group, long-time needle retaining at Baihui (GV 20) was applied in the observation group. The treatment was given once every other day, 3 times a week for a total of 4 weeks. The National Institute of Health stroke scale (NIHSS), mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and qi deficiency blood stasis syndrome scale score were observed before and after treatment, and the clinical efficacy was compared between the two groups.

RESULTS

After 4 weeks of treatment, the NIHSS scores of the two groups were lower than those before treatment (both P<0.01), and the MMSE and MoCA scores were higher than those before treatment (P<0.05, P<0.01), and the scores in the observation group were better than those in the control group (all P<0.01). After treatment, the scores of qi deficiency and blood stasis syndrome were lower than those before treatment (all P<0.01). The scores of the shortness of breath, facial color, tongue pulse and dizziness in the observation group were better than those in the control group (all P<0.05), there was no significant difference in the degree of spontaneous sweating between the two groups (P>0.05). The total effective rate was 94.1% (32/34) in the observation group, which was higher than 75.8% (25/33) in the control group (P<0.05).

CONCLUSION

Long-time needle retaining at Baihui (GV 20) is safe and effective in treating with post-stroke cognitive disorder of qi deficiency and blood stasis.

[Effect of moxibustion on prevention and treatment of nausea and vomiting caused by cisplatin in lung cancer]

OBJECTIVE

To observe the clinical effects between moxibustion combined with 5-hydroxy tryptamine (5-HT) receptor antagonist and simple 5-HT receptor antagonist in the prevention and treatment of nausea and vomiting caused by cisplatin chemotherapy in patients with lung cancer.

METHODS

Fifty-eight patients with lung cancer who were treated with cisplatin chemotherapy were randomly assigned into an observation group and a control group, 29 cases in each one. The patients in the two groups were applied by 5-HT receptor antagonist to prevent nausea and vomiting on the 1st through 3rd days of chemotherapy. Moxibustion at Baihui (GV 20) and Zhongwan (CV 12) was used in the observation group 1-3 days before chemotherapy for 1 course, 3 days as 1 course, 5 cones each acupoint and once a day. Rhodes's index of nausea and vomiting and retching (INVR) was recorded in 0-24 h, 24-48 h, 48-72 h and 72-96 h of chemotherapy. The rates of nausea and vomiting, as well as fatigue degree were observed in the above 4 time periods. The safety was assessed.

RESULTS

After treatment, the scores of nausea and vomiting in 0-24 h, 24-48 h, 48-72 h and 72-96 h of chemotherapy in the observation group were lower than those in the control group (all P<0.01). The nausea rates in the above 4 time periods in the observation group were 37.9% (11/29), 62.1% (18/29), 60.7% (17/28) and 17.4% (4/23), which were lower than 93.1% (27/29), 89.7% (26/29), 89.3% (25/28), 52.0% (13/25) in the control group respectively (all P<0.05). The vomiting rates in the above 4 time periods in the observation group were 10.3% (3/29), 31.0% (9/29), 32.1% (9/28) and 13.0% (3/23), which were better than 37.9% (11/29), 79.3% (23/29), 82.1% (23/28) and 44.0% (11/25) in the control group (all P<0.05). The fatigue scores in the observation group in 0-24 h, 24-48 h, 48-72 h and 72-96 h of chemotherapy were lower than those in the control group (all P<0.01). There was no adverse reactions in the two groups during chemotherapy, such as skin toxicity, diarrhea, fever, allergy, etc.

CONCLUSION

Moxibustion combined with 5-HT receptor antagonist can obviously reduce the rates and degrees of nausea and vomiting caused by cisplatin chemotherapy in patients with lung cancer, which are better than simple 5-HT receptor antagonist, without apparent adverse reactions.