To Investigate The Mechanism Of Moxibustion Therapy For Vascular Dementia Based On Brain-renne-governor Axis

Objective: By observing the clinical effect of moxibustion Dumai group with acupoints as the main points and adding or reducing acupoints with the syndrome in the treatment of Va D and the changes of plasma Hcy level,PI value and average caloric value of the governor’s vein,to explore the correlation between PI,Hcy and average caloric value of the governor’s vein and vascular dementia,and to explore the clinical effect and possible mechanism of moxibustion in the early prevention and treatment of vascular dementia.To provide a new direction for clinical treatment of Va D.Methods:60 cases meeting the inclusion criteria were numbered according to the order of hospitalization and randomly divided into control group(western medicine group)and treatment group(moxibustion group)with 30 cases each using a random number table.The control group was treated with Donepezil hydrochloride(5mg,Qn before going to bed);the moxibustion group was treated with clear moxa stick hanging moxibustion at Shuangshenshu,Mingmen,Dazhui,Baihui,Shenting and other major points,adding or reducing points according to the syndrome,once a day,each point of moxibustion until the patient’s local skin was slightly flush,about 30 min each time,and each course of treatment lasted for 6 days.The interval of treatment was 1 day,and the treatment lasted for 4consecutive courses.Va D patients in each group were scored on SDSV,ADL scale,MMSE scale and Mo CA scale before and after treatment,and the changes of cerebral hemodynamic parameters(PI),vascular skin temperature and serum Hcy level were observed.All data were summarized and analyzed using SPSS25.0 statistical analysis software.Results:(1)The total clinical effective rate of the moxibustion group was 86.7%,and that of the western medicine group was 66.7%.The overall clinical effective rate of the moxibustion group was better than that of the western medicine group(P<0.05).(2)Comparison between groups: the scores of SDSVD,MMSE,Mo CA and ADL before intervention showed no statistical significance.After treatment,the scores of SDSVD and ADL in moxibustion group were lower than those in western medicine group,while the scores of MMSE and Mo CA were higher than those in western medicine group.The score difference before and after treatment in moxibustion group was higher than that in Western medicine group(P<0.05),showing statistical difference.The comparison of PI,Hcy and average calorific value of the governor’s pulse between the two groups before intervention showed no statistical significance;the PI,Hcy of the two groups after treatment and the difference before and after treatment showed no statistical difference(P>0.05);the average calorific value of the governor’s pulse after treatment in the moxibustion group and the difference of the governor’s pulse before and after treatment in the moxibustion group were higher than those in the western medicine group(P<0.05),showing statistical difference.(3)Intra-group comparison: After intervention,the scores of SDSVD,ADL,PI and Hcy were decreased,while the scores of MMSE,Mo CA and average caloric value of the coronary artery were increased in both groups(P<0.05),indicating statistical difference.(4)Correlation: Pearson correlation analysis showed that MMSE score before and after treatment was negatively correlated with PI value and Hcy level,and positively correlated with the average calorific value of the coronary artery.The average calorific value of the governor pulse was negatively correlated with the levels of PI and Hcy,and the correlation was statistically significant(P<0.05).(5)Multiple linear regression analysis: The PI value,Hcy level and the average caloric value of the governor’s pulse correlated with MMSE were used as independent variables,and the MMSE score was used as dependent variable to construct multiple linear regression equations.The results showed that the model could jointly explain the variation degree of the influence on MMSE score of patients was 86.1%,and the average caloric value of the governor’s pulse was a risk factor affecting MMSE(P<0.05).The lower the average heat value of the coronary artery,the more serious the cognitive impairment.Conclusions:1.PI and Hcy are negatively correlated with vascular dementia,which may affect the occurrence and development of Va D to a certain extent;There is a positive correlation between the average heat value of the vascular artery and vascular dementia.Yang Qi deficiency may be one of the risk factors of vascular dementia.2.Moxibustion may play the functions of warming Yang and regulating regulating the brain-renne-governor artery axis,tonifying kidney and nourishing marrow,removing blood stasis and enlightening wisdom;3.Moxibustion can improve cognitive function in patients with vascular dementia,which may be related to anti-vascular sclerosis,anti-oxidative stress,protection of vascular endothelial cells and improvement of brain microcirculation.