[Effect of early acupuncture on cognitive function in patients with vascular dementia after cerebral infarction]

To observe the clinical efficacy of early acupuncture for vascular dementia (VD) after cerebral infarction, and explore its possible mechanism.

A total of 120 patients with VD after cerebral infarction were randomized into an acupuncture combined with medication group (60 cases, 1 case dropped off) and a western medication group (60 cases, 1 case dropped off). In the western medication group, oxiracetam capsules were given orally, 2 capsules each time, 3 times a day. On the basis of the treatment as the western medication group, Bupi Peiyuan Yizhi acupuncture was applied at Baihui (GV 20), Sishencong (EX-HN 1), Zhongwan (CV 12), Wailing (ST 26), Xiawan (CV 10), Qihai (CV 6), Guanyuan (CV 4), etc. in the acupuncture combined with medication group, 30 min each time, once a day, 5 days a week. The treatment was given 8 weeks in both groups. Before and after treatment，the scores of mini-mental state examination (MMSE), Alzheimer's disease assessment scale cognitive part (ADAS-Cog), clock drawing test (CDT), Barthel index were observed, blood flow velocity of middle cerebral artery (MCA) was detected, and the clinical efficacy was evaluated in the two groups.

The total effective rate was 89.8% (53/59) in the acupuncture combined with medication group, which was superior to 76.3% (45/59) in the western medication group (P<0.01). Compared before treatment, the subitem scores and total scores of MMSE, ADAS-Cog score, CDT score and Barthel index score after treatment were improved in the two groups (P<0.01, P<0.05), and the scores in the acupuncture combined with medication group were superior to those in the western medication group (P<0.05, P<0.01). After treatment, the blood flow velocity of bilateral MCA was increased in the acupuncture combined with medication group (P<0.05), which was faster than the western medication group (P<0.05).

Early acupuncture could improve cognitive function and activities of daily living in patients with VD after cerebral infarction, its mechanism may be related to improving the blood flow velocity of MCA, promoting blood circulation, and improving cerebral perfusion.