Intervention Of Huayu Tongluo Moxibustion On White Matter In Patients With SIVD Based On DTI And Correlation With Neuropsychological Features

Objective:1.Observe the changes of MMSE and ADL scores of SIVD patients before and after Huayu Tongluo moxibustion intervention,and evaluate the clinical effect of Huayu Tongluo moxibustion on SIVD patients;2.Diffusion tensor imaging(DTI)technology and fiber bundle tracking spatial statistical analysis(TBSS)were used to observe the changes of ultrastructure of brain white matter in SIVD patients before and after intervention with Huayu Tongluo Moxibustion,and to explore the effects of Huayu Tongluo moxibustion on brain white matter in SIVD patients Influence of ultrastructure3.By comparing the changes of ultrastructure of brain white matter in patients with SIVD before and after the intervention of Huayutongluo moxibustion,combined with neuropsychological evaluation,the correlation between the changes of ultrastructure of white matter and cognitive dysfunction was explored.Method:Forty patients with SIVD were selected in strict accordance with the inclusion and exclusion criteria.Twenty patients in the Huayutongluo moxibustion group and 20 patients in the western medicine group were randomly selected.The Huayutongluo moxibustion group was treated with Huayutongluo moxibustion 3 times / week;the western medicine group was given donepezil hydrochloride 5 mg orally once a night;both groups were treated for 24 weeks.The neuropsychological scale MMSE and ADL scores of the two groups of patients were evaluated before treatment and 24 weeks after treatment.SPSS 22.0 statistical analysis was used to compare the differences between groups and between groups.Two were collected before treatment and 24 weeks after treatment.The brain magnetic resonance DTI data of the patients in the two groups were compared by TBSS and FSL software before,after 24 weeks and between the two groups.Result:1.Neuropsychological scoreComparison of scores before treatment of Huayu Tongluo moxibustion group with western medicine group SIVD patients: The data of the two groups were not statistically significant by t test(P>0.05),indicating that the two groups are comparable;Comparison of scale points after treatment between the two groups:(1)MMSE: The directional force,memory,language,visual space,computing power and total score of the Huayu Tongluo moxibustion group were all higher than before treatment(P<0.05),and the difference was statistically significant;Western medicine Patients in the group also had higher orientation,memory,language,computing power,and total scores than before treatment(P <0.05).The differences were statistically significant,and the visual space scale scores had no significant changes compared to before treatment.The differences were not statistically significant(P> 0.05);Comparison between the two groups: the computing power,memory and total points of the Huayutongluo moxibustion group were higher than those of the western medicine group(P <0.05),the differences were statistically significant,and the directional power,language,and visual space were not statistically significant.(P > 0.05);(2)ADL: comparison within the group: the scores of the two groups were higher than before treatment(P<0.05),and the differences were statistically significant;comparison between the two groups: the amount of ADL in the Huayutongluo moxibustion group The score is higher than the western medicine group(P<0.05),and the difference is statistically significant.The clinical efficacy of the two groups is compared: the total effective rate of the Huayutongluo moxibustion group is 92.8%,and the western medicine group is 80.0%.The difference in efficacy has Considered significant(P<0.05).2.DTI resultsAfter the Huayu Tongluo moxibustion group was compared with that before treatment,the areas showing increased FA values were mainly distributed in the left thalamicradiation,left cingulate tract,left lower forehead occipital tract,fusiform gyrus,and right frontal gyrus(P < 0.05,FWE corrected);areas showing reduced MD values are mainly distributed in the left anterior thalamus,left cortical spinal tract,hippocampal gyrus,and cerebellum(P <0.05,FWE corrected);areas showing reduced ADC values??are mainly distributed in the left cortical spinal cord Beam,left anterior thalamic radiation,right corticospinal tract,right anterior thalamic radiation(P <0.05,FWE correction).Compared with the western medicine group after treatment,there was no significant change in FA value;the areas showing reduced ADC value were located in the left cingulate tract,the left cortical spinal tract,the right lower longitudinal tract,and the cerebellum(P <0.05,FWE correction);Areas showing reduced MD values are located in front of the left thalamus and the cerebellum;The difference between before and after treatment of the Huayutongluo moxibustion group is compared with that before and after treatment in the western medicine group.The areas with higher FA difference than the western medicine group are mainly located in the left anterior thalamus radiation,left cingulate bundle,left lower longitudinal bundle,left upper longitudinal bundle,and left hook Bundle,upper right longitudinal bundle,right anterior thalamus radiation,right lower forehead occipital bundle,cerebellum(P <0.05,FWE correction);areas showing ADC differences lower than the western medicine group are located in the left anterior thalamus radiation,right anterior thalamus radiation,right cortex Spinal tract(P <0.05,FWE corrected);only the right thalamus radiation was shown in areas where the MD difference was lower than that of the western medicine group(P <0.05,FWE corrected).Conclusion:1.Huayutongluo moxibustion can improve the cognitive ability and daily life ability of patients with SIVD,and it is an effective method for clinical treatment of SIVD.The clinical effect is better than oral donepezil hydrochloride;2.Huayu Tongluo moxibustion has a benign intervention on the integrity andconnectivity of the ultrastructure of white matter in patients with SIVD,which may be one of the effective mechanisms of Huayu Tongluo moxibustion in the clinical treatment of SIVD;3.The ultrastructure of white matter in patients with SIVD is positively correlated with neuropsychological characteristics;4.DTI technology can be used as an objective indicator of clinical early diagnosis and curative effect evaluation standard for SIVD patients.