| Objective:Based on the clinical efficacy and safety of electroacupuncture in the treatment of alcohol dependent cognitive impairment due to hyperactivity of heart and liver fire,to preliminarily explore the biomarkers and possible biological mechanisms of electroacupuncture in the treatment of alcohol dependent cognitive impairment.Method:Study 1:This study collected 200 male alcohol dependent patients hospitalized in the Alcohol Addiction and Internet Addiction Department of Hunan Provincial Brain Hospital(Hunan Second People’s Hospital)from March 2021 to April 2022,and used the Montreal Cognitive Assessment Scale(MoCA)to initially assess cognitive function.MoCA≤26 points were classified as cognitive function impairment.Subsequently,patients with cognitive function impairment were classified according to the "Guidelines for the Diagnosis and Treatment of Mental Disorders with Integrated Traditional Chinese and Western Medicine",Screening out the TCM syndrome types with the highest proportion of cognitive impairment due to alcohol dependence,and selecting the main research syndrome types to discuss the relationship between them and cognitive function.Study 2:Based on dialectical treatment,electroacupuncture is used to treat cognitive impairment in patients with the most common type of alcohol dependence in traditional Chinese medicinehyperactivity of heart and liver fire.From April 2022 to October 2022,100 patients with cognitive impairment due to alcohol dependence who were hospitalized in the Alcohol Addiction and Internet Addiction Department of Hunan Provincial Brain Hospital(Hunan Second People’s Hospital)were randomly divided into an electroacupuncture treatment group(n=40),a pseudo stimulation treatment group(n=20),and a conventional treatment group(n=40)according to a ratio of 2:1:2.The electroacupuncture treatment group was treated with routine treatment plus electroacupuncture(acupuncture at acupoints and stimulation with an electroacupuncture instrument for 30 minutes,10 times a day,once a day),the pseudo stimulation group was treated with routine treatment plus pseudo stimulation(there was no acupoint area at an inch next to the acupuncture point,and the duration,frequency,and course of electroacupuncture stimulation were the same as those of the electroacupuncture group),and the conventional treatment group received routine alcohol withdrawal treatment.Efficacy evaluation was conducted at baseline and after treatment.The primary efficacy index was cognitive function,evaluated using the Repetitive Neuropsychological Assessment System(RBANS),and the secondary efficacy index was emotional symptoms,evaluated using the Self Rating Anxiety Scale(SAS),Self RatingDepression Scale(SDS),and sleep symptoms were evaluated using the Pittsburgh Sleep Inventory(PSQI).Adverse events were recorded to assess the safety of treatment.Collect blood samples from patients in each group before and after treatment,detect the changes in the concentration of superoxide dismutase(SOD)and brain derived neurotrophic factor(BDNF)before and after treatment,and preliminarily explore the correlation between the treatment effect,with a view to further clarifying the possible biological mechanism of electroacupuncture treatment.result:Study 1:According to the syndrome differentiation and classification in the "Guidelines for the Diagnosis and Treatment of Mental Disorders with Integrated Traditional Chinese and Western Medicine",in patients with alcohol dependence,the central liver fire syndrome(23.5%),the heart and spleen deficiency syndrome(20%),the damp-heat internal accumulation syndrome(10%),the liver stagnation and spleen deficiency syndrome(13.5%),the liver and kidney deficiency syndrome,the wind-yang disturbance syndrome(16%),and the phlegm heat internal excess syndrome(17%),with the central liver fire excess syndrome accounting for the highest proportion.Study 2:Clinical efficacy(1)Main Outcome Measures:After treatment,the scores of the five dimensions of the RBANS scale in the three groups,including immediate memory,visual span,speech function,attention and delayed memory,and comprehensive total score,were better than those before treatment(P<0.05).After treatment,the electroacupuncture treatment group was significantly higher than the pseudo stimulation group and the conventional treatment group in six aspects:immediate memory,visual span,speech function,attention and delayed memory,and total score(P<0.05);(2)Secondary outcome measures:After treatment,the SAS and SDS reduced scores in the electroacupuncture treatment group were higher than those in the pseudo stimulation group and the conventional treatment group(P<0.05).After treatment,the total scores of SAS and SDS in the electroacupuncture treatment group were lower than those in the pseudo stimulation group and the conventional treatment group(P<0.05).In terms of sleep symptoms,the PSQI score of the electroacupuncture treatment group after treatment was significantly lower than that of the pseudo stimulation treatment group and the conventional treatment group(P<0.05).Biological indicatorsThere was no significant difference in the concentration of SOD and BDNF in the blood of the three groups of patients before treatment(P>0.05).After treatment,the content and changes of SOD and BDNF in the blood of patients in the electroacupuncture treatment group were significantly higher than those in the pseudo stimulation group and the conventional treatment group(P>0.05).Correlation analysisIn the correlation analysis of changes in various test indicators before and after treatment,except SAS,which was not correlated with RBANS speech comprehension and total RBANS score,all other research indicators showed a positive correlation in pairs.SOD,BDNF,and PSQI were significantly correlated with the five dimensions and total score of the RBANS scale(P<0.01),SDS was significantly correlated with delayed memory(P<0.05),and the other four dimensions were significantly correlated with total score(P<0.01),SAS was significantly correlated with immediate and delayed memory(P<0.01).Conclusion:1.Traditional Chinese medicine syndrome differentiation and classification of cognitive impairment due to alcohol dependence is mainly characterized by hyperactivity of heart and liver,and the main clinical symptoms are irritability,sweating and thirst,irritability,insomnia,restlessness,constipation,etc.2.After electroacupuncture treatment,it can improve the cognitive function of patients with alcohol dependence due to hyperactivity of heart,liver,and fire,involving dimensions such as memory,visual span,speech function,attention,and delayed memory.At the same time,it can improve anxiety and depression symptoms of patients with alcohol dependence due to hyperactivity of heart,liver,and fire,and improve sleep quality.3.Electroacupuncture treatment has a low incidence of adverse reactions,mainly with local discomfort symptoms,and is relatively safe;4.Electroacupuncture may protect cognitive function by increasing the levels of SOD and BDNF,regulate anxiety and depression,and improve sleep.Objective:Based on the clinical efficacy and safety of electroacupuncture in the treatment of alcohol dependent cognitive impairment due to hyperactivity of heart and liver fire,to preliminarily explore the biomarkers and possible biological mechanisms of electroacupuncture in the treatment of alcohol dependent cognitive impairment. |
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