Efficacy Of Acupuncture Treatment Of Non - Dementia Vascular Cognitive Impairment

Objective:Observed changes before and after treatment in patients of vascular cognitive impairment without dementia with cognitive function, visual-spatial abilities and neuropsychological characteristic variation of daily living, through clinical research with the "harmonizing Qi and blood, bushing educational" acupuncture treatment of VCIND. Systematically evaluate the clinical effect of acupuncture treatment of this disease, improve it to be promoted and clinical application, in order to improve the development of acupuncture treatment of VCIND.Methods:1.76 patients with non dementia vascular cognitive impairment recruited and randomly assigned acupuncture for two sessions/week (n=40) or citicoline 300 mg/day (n= 36),6-month trial, include a period of 12 weeks of treatment and 12 weeks after the end of treatment.2. Trerapeutic principle of acupuncture group is harmonizing Qi and blood, bushing educational. The acupuncture group received acupuncture at the Zusanli (ST36), Xuehai (SP10), Danzhong (RN17), Zhongwan (RN12), Qihai (RN6), Baihui (DU20), Fengfu (DU16), Xinshu (BL15), Yixi (BL45), Tongli (HT5) and Zhaohai (KI6) acupuncture points. Only sterile, stainless, single-use needles (Hwato, Suzhou, China) without guide tubes were used. The gauge is 0.25×40 mm or 0.25×25 mm and the depth of insertion is 4 to 50 mm, depending on the location of the needle. Needles are correctly inserted and manually stimulated until the ’De Qi’ sensation is elicited. ST36, SP10, RN17, RN12, RN6, and DU16 was inserted 10 to 15 mm deep with a 0.25 mm × 40 mm acupuncture needle. DU20, BL15, BL45, HT5 and KI6will were inserted 5 to 10 mm deep with a 0.25 mm × 25 mm acupuncture needle. The needles were retained for 20 minutes in every session, treatment twice a week for 12 weeks.3.The citicoline control group received oral citicoline 100 mg/time, three times/day.4. Before and after treatment, the investigator observes and evaluates of curative efficacy index and ratings, The primary endpoint is cognition (Alzheimer’s Disease Assessment Scale, Cognitive Subscale (ADAS-cog)). Secondary endpoints include assessments of activities of daily living and behavioral symptoms (Clock Drawing Test (CDT), Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living scale (IADL)):Results:1.Before treatment, there was no significant difference (P>0.05) between the four groups of patients in terms of gender, age, duration, education level, Hanchinski ischemic score, Mini-mental state examination, Montreal cognitive assessment, Alzheimer’s disease assessment scale-cognition, Clock drawing test, Activity of daily living.2. Acupuncture treatment of cognitive impairment in VCIND patients, visuospatial ability damage, damage of daily living and efficacy of drug treatment equal(P>0.05).3. The treatment group can dramatically increase patients the score of ADAS-cog, and the result had the statistical difference (P<0.01). The treatment group can dramatically increase patients the score of CDT (P<0.01),ADL (P<0.01), both of the two groups revealed no significant difference (P>0.05).4. The result revealed that both groups can dramatically increase patients the score of ADAS-cog (P<0.01), CDT (P<0.01), ADL (P<0.01).5. After stopping treatment for 3 months, The treatment group was without syndrome relapse and still better than before(P<0.01).The drug group has syndrome relapse(p> 0.05),but still better than before(P<0.01).6. After stopping treatment for 3 months, both of the two groups maintained at levels after treatment, but still better than before(P<0.01).Conclusions:The curative effect of treating VCIND patients with cognitive impairment, visual spatial ability damage, ability damage daily life, the same acupuncture therapy and drug therapy. Acupuncture treatment has obvious advantages than drug treatment about improving the corresponding cognitive dysfunction rating scale. Acupuncture therapy and drug therapy is the same about improving corresponding scale score of the visual spatial ability damage, ability damage daily life.After stopping treatment for 3 months, the effect of the acupuncture treatment no worse about improving corresponding scale score of cognitive impairment and ability damage daily life. The effect of drug has worsened about both of them. The effect of acupuncture therapy and drug therapy are stable about improving corresponding scale score of visual spatial ability damage.