Scholarly article on topic 'Progress in Research on Acupuncture Treatment of Senile Dementia'

Progress in Research on Acupuncture Treatment of Senile Dementia Academic research paper on "Clinical medicine"

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Academic research paper on topic "Progress in Research on Acupuncture Treatment of Senile Dementia"

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Progress in Research on Acupuncture Treatment of Senile Dementia

CHENG Hai-ying 1 & CHENG Dong-qi UMM 2

1Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China 2China Academy of Chinese Medical Sciences, Beijing 100007, China

Senile dementia is a chronic retrograde encephalopathy seriously jeopardizing the health of elderly people. It is clinically manifested by progressive remote and recent dysmnesia, declined ability in analysis and judgment, emotional changes, abnormal behaviors, and even disturbances of consciousness. In recent years, acupuncture has been used to treat dementia with satisfactory therapeutic effects. The following is a survey for the progress in research on acupuncture treatment of senile dementia in the past 10 years.

1. Acupuncture with Filiform Needles

In order to observe the therapeutic effects of acupuncture for senile dementia, DONG Hong-tao et al.1 divided 31 cases of senile dementia into 3 groups: an acupuncture group, a drug group (treated with Haboyin) and a control group (psychotherapy). The patients were treated for 3 months. The MMSE and ADL scoring systems were used to evaluate the improvements in memory, intelligence, daily life abilities and the other clinical symptoms. After the treatment, MMSE score obviously increased and the ADL score decreased in the acupuncture group and the drug group, but no obvious improvements were found in the control group, indicating that acupuncture and Haboyin may show certain effects for senile dementia with the former superior to the latter in improving some symptoms. Mei Jing et al.2 horizontally inserted a one-cun No.30 filiform needle, backward into Baihui (GV 20) for 0.5 cun with the uniform reinforcing-reducing method until the needling sensation was felt. After that, a No.30 filiform needle was horizontally inserted outward

into Sishencong (EX-HNI) for 0.5 cun with the uniform reinforcing-reducing method until the needling sensation was felt. The third needle was obliquely inserted upward into Dazhui (GV 14) for 0.5-0.8 cun. The needles in Baihui (GV 20) and Dazhui (GV 14) were then simultaneously twirled with the uniform reinforcing-reducing method to make as fully as possible the needling sensations radiate from Baihui (GV 20) to the spine and from Dazhui (GV 14) to the vertex, followed by the reducing method for Dazhui (GV 14) to make the needling sensation radiate in all directions. After the patient was made comfortable in the nape, the needle was taken out from Dazhui (GV 14). The uniform reinforcing-reducing method was also performed at Sishencong (EX-HNI) to make the needling sensation felt throughout the head. The needles in Baihui (GV 20) and Sishencong (EX-HNI) were retained for about 5 hours, with ginger moxibustion given at Guanyuan (CV 6) 4 moxa-cones each time, 4 sessions of treatment constituted one therapeutic course. Of the 76 cases treated, 7 cases were basically cured, 33 cases markedly relieved, 26 cases improved and 10 cases failed. WU Di3 observed the effects of acupuncture in 36 cases of senile dementia. The main points used were Guanyuan (CV 6), Baihui (GV 20), Fengchi (GB 20) and Shenmen (HT 7), and the adjunct points were Sanyinjiao (SP 6), Zusanli (ST 36) and Fenglong (ST 40). 3 consecutive courses were given (3 weeks as one therapeutic course). Of the 36 cases treated, 5 cases were markedly relieved, 30 cases improved, and one case failed. SHEN Wei-dong et al.4 performed acupuncture at Shenting (GV 24), Hegu (LI 4), Shenmen (HT 7), Jianshi (PC 5),

Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3), with the twirling method for Shenting (GV 24) the lifting-thrusting-twirling method for the rest points. The needle was retained for 30 minutes each time. The clinical symptoms were obviously improved in each of the 40 cases treated. YANG Xiang-tan5 per-formedacu-puncture with Neiguan-through-Waiguan (about 1 cun deep) using the lifting- thrusting method to produce strong stimulation for 30 seconds. For Taixi (KI 3) the needle was vertically inserted 0.5-1 cun deep and for Xuanzhong (GB 39) the needle was vertically inserted 1-1.5 cun deep with the twirling -reinforcing method. The above points on two sides were alternately used with the needle retained for 30 minutes. Bilateral Fengchi (GB 20) were obliquely punctured with the uniform reinforcing-reducing method with the needles retained for 20 minutes. Baihui (GV 20) was punctured along the skin, and Dazhui (GV 14) was punctured obliquely upward for 1.5-2 cun with the reinforcing method for 30 seconds; after the needles had been taken out, moxibustion was given for 3-5 minutes. The therapy was performed with the No.28 filiform needles, once a day, for 10 times as one therapeutic course with a 2-day interval between courses. After 10 treatments, the therapy was given once every other day according to the illness condition. As a result, 9 cases were cured, 11 cases markedly relieved, 4 cases improved, and 2 cases failed. SUN Chang-wang6 performed acupuncture in 70 cases at the main point Sishencong (EX-HN1) and at the adjunct points Guanyuan (CV 6), Dazhui (GV 14), Zusanli (ST 36), Tianshu (ST 25), Xuehai (SP 10) and Sanyinjiao (SP 6) with the needle retained for 30 minutes. The total effective rate was 95.5%. WANG Zhen-long' treated 31 cases, with a 1.5 cun No.30 filiform needle, first inserted into the space below Dazhui (GV 14) in anterosuperior direction to induce an electric shock sensation or heavy sensation. Then, the patient was asked to take a sitting position, a needle was inserted into Renzhong (GV 26) with its tip reaching the nasal septum, and the bird-pecking manipulation was given for one minute to produce a strong stimulation to the point that the patient had tears in eyes. Baihui (GV 20)

was punctured with the uniform reinforcing-reducing method. Tianzhu (BL 10) was punctured with the lifting-thrusting-twirling manipulation to make the needling sensation reach the vertex. Finally, the patient was asked to take a horizontal position, and acupuncture was performed at Neiguan (PC 6), Shenmen (HT 7), Sanyinjiao (SP 6), Dazhong (KI 4) and Xuanzhong (GB 39) with the lifting-thrusting-reducing manipulation given for one minute to produce strong stimulation. The needles were retained for 45 minutes and manipulated once every 15 minutes. 10 sessions of treatment constituted one therapeutic course. As a result, 12 cases were basically cured, 9 cases markedly relieved, 8 cases improved and 2 cases failed with a total effective rate of 94%.

2. Special Acupuncture Therapies

BU Yuan et al.8 acupunctured the patients at Sishencong (EX-HN1), Baihui (GV 20), Shenmen (HT 7), Fenglong (ST 40) and Neiguan (PC 6) with the reducing method and at Ganshu (BL 18), Shenshu (BL 23) and Zusanli (ST 36) with the reinforcing method; and asked them to inhale the mist made from oxygen and the Chinese drugs for inducing resuscitation, nourishing the liver and kidneys, promoting blood circulation and removing blood stasis, yielding marked curative effects. GENG Jian9 observed the therapeutic effects of the drug-oxygen-acupuncture therapy for senile dementia. The patients were randomly divided into two groups, 50 cases in each group. In the treatment group, a supersonic atomizer was used to give drugs and oxygen with the oxygen flow 3 L/minutes and the atomizing time was 30 minutes; and acupuncture was performed at Sishencong (EX-HN1), Baihui (GV 20), Shenmen (HT 7), Fenglong (ST 40) and Neiguan (PC 6) with the reducing method. For the control group, Ganshu (BL 18), Shenshu (BL 23) and Zusanli (ST 36) were punctured with the reinforcing method. Acupuncture was performed once a day with the needles retained for 30 minutes, 12 sessions constituting one course of treatment. After 3 courses of treatment, 12 cases were cured, 36 cases improved and 2 cases failed in the treatment group; and 8 cases were cured, 30 cases

improved and 12 cases failed in the control group. The total effective rates were respectively 96% and 76%. He came to the conclusion that the drug-oxygen-acupuncture therapy is effective for senile dementia, which may promote regeneration and compensation of the neurons in the brain. Hou Anle et al.10 observed the curative effects of the drug-oxygen-acupuncture therapy for senile dementia. For the treatment group, the drug used was made from active ingredients extracted from She Xiang (M^ Moschus), Zao Jiao (^ft Fructus Gleditsiae), Bing Pian Borneolum), Chuan Xiong (j 1Rhizoma Ligustici Chuanxiong), Huang Jing (^M Rhizoma Polygonati), Shou Wu ( ^ ^ Radix Polygoni Multiflori) and Tu Si Zi (^^T Semen Cuscutae). 15ml of the drug and 15ml of distilled water 15ml were poured into a supersonic atomizer, which was connected to medical pure oxygen with an oxygen flow 3 L/min for 30 minutes. The patient was asked to inhale the drug-oxygen mist through the mouth and acupunctured at the same time. The first group of points were Sishencong (EX-HN1), Baihui (GV 20), Shenmen (HT 7), Fenglong (ST 40) and Neiguan (PC 6) (with reducing method), and the second group of points were Ganshu (BL 18), Shenshu (BL 23) and Zusanli (ST 36) (with reinforcing method). The two groups of points were alternately punctured once a day with the needles retained for 30 minutes. In the control group, an intravenous drip of normal saline 250ml and cytidine diphosphate choline 0.75 g was given once a day. The two groups of patients were treated for 12 sessions as one therapeutic course. After 3 courses of treatment, 14 cases were cured, 12 cases improved and 4 cases failed in the treatment group with a total effective rate of 86.7%; but the effective rate was 63.6% in the control group. HOU Anle et al.11 randomly divided 120 patients with senile dementia into a drug-oxygen-acupuncture group, an oxygen-acupuncture group, an acupuncture group and a Western drug group (cytidine diphosphate choline). The results showed that the drug-oxygen-acupuncture therapy can obviously reduce the TCH, TG, LPO and the FAQ score, enhance HDL, SOD and the HDS score, and remarkably improve the clinical symptoms, with a

total effective rate of 90.6%.

DONG Yu-xiang et al.12 acupunctured 46 cases at Baihui (GV 20), Shenmen (HT 7), Shuaigu (GB 8), Yuzhen (BL 9), Shenting (GV 24), Taiyang (EX-HN5), Sishencong (EX-HN1) and Yintang (EX-HN3) with the needles connected to a G6805 electric stimulator at low intensity, once a day, 30 sessions constituting one course of treatment. The first groups of points were left Fengchi (GB 20), Jiuwei (CV 15), Shenshu (BL 23) and Zusanli (ST 36) and the second group of points were right Fengchi (GB 20), Dazhui (GV 14), Ganshu (BL 18) and Sanyinjiao (SP 6). The two groups of points were alternatively used for point injection once a day. Naohuosu (fla^^) was used in the treatment group, and normal saline in the control group, 30 sessions constituting one therapeutic course. In the treatment group, 26 cases were markedly relieved, 19 cases improved and 1 case failed. In the control group, 8 cases were markedly relieved, 13 cases improved and 1 case failed. DONG Jun-feng 13 took Shenshu (BL 23) at the main point punctured with the reinforcing method, and Zusanli (ST 36) and Sanyinjiao (SP 6) as the adjunct points punctured with the reducing method. 2ml of acetyl-glutamine and 4ml of compound danggui injection (containing Dang Gui

Radix Angelicae Sinensis), Chuan Xiong Rhizoma Ligustici Chuanxiong) and Hong Hua (^X^ Flos Carthami)) were mixed in a syringe and injected with a No.6 needle into the above-mentioned points, 1.5ml each point, once every other day. 10 sessions of treatment constituted one therapeutic course with 3-day interval between courses. After 1-3 courses of treatment, 56 cases were cured, 28 cases improved and 2 cases failed.

HUANG Qin-feng16 used acupuncture, moxibustion and electroacupuncture at Baihui (GV 20), Shenting (GV 24), Renzhong (GV 26), Neiguan (PC 6), Fengchi (GB 20), Shenmen (HT 7), Sishencong (EX-HN1) and Zusanli (ST 36); point injection into Fengchi (GB 20), Zusanli (ST 36) and Shenshu (BL 23) with cytidine diphosphate choline, acetyl-glutamine, Ginseng Injection or compound Danggui

Injection (1ml for each point); scalp acupuncture at central line of the vertex, central line of the temple, front line of the temple, rear line of the temple, first line beside the temple, second line beside the temple and third line beside the temple; and auricular acupuncture at Heart, Brain, Subcortex, Kidney, Liver, Endocrine and Shenmen (HT 7) to comprehensively treat the patients with the mental symptoms alleviated and the nervous symptoms improved. LÛ Jia-xiang et al.17 punctured Sishencong (EX-HN1) with the needle retained for 30 minutes, and the anterior oblique line of the temple, posterior oblique line of the vertex and first lateral line of the vertex with the needles retained for 2 minutes (twice for each session) to treat 60 patients with an effective rate of 81.67%. SHEN Wei-dong et al.18 vertically punctured bilateral Hegu (LI 4), Shenmen (HT 7), Jianshi (PC 5), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) to a depth of 0.5-1 cun, and Shenting (GV 24) with the needle inserted upward along the channel. After the needling sensation was felt, the needles were retained for 30 minutes. Electric stimulation was added to ipsilateral Zusanli (ST 36) and Sanyinjiao (SP 6) with the G6805-II instrument at frequency 2 Hz to produce continuous stimulation for 30 minutes. Fu Zi (^T Radix Aconiti Praeparata), Ma Huang Herba Ephedrae) and

Rou Gui ( Cortex Cinnamomi) were ground into powder, which was mixed with water and honey to make round medicinal cakes (1cm in thickness). Then, medicinal cake moxibustion was performed with 3 moxa-cones at Baihui (GV 20) for about 1 hour. The treatment was given once every other day, 30 sessions constituting one therapeutic course. In this series of 40 cases, 10 cases were markedly relieved, 24 cases improved and 6 cases failed. YANG Zi-jiang et al.19 acupunctured 29 cases of senile dementia by Baihui-through-Sishencong, Shenting-through-Dan-gyang-through-Shangxing, Shoumian-through-Bijiao, Dingshen-through-Shuigou, Zusanli-through-Feng-long, Fengfu-through-Yamen, Dazhui-through-Shenzhu, Mingmen-through-Shenshu, Neiguan-through-Daling, Lingdao-through-Shenmen, and

Fuliu-through-Taixi. The treatment was given once a day, with 10 sessions constituting one therapeutic course, usually for 1-3 courses, with a 2-day interval between courses. As a result, 6 cases were cured by 10 sessions, 9 cases were cured by 20 sessions, 12 cases were cured by 30 sessions; and 2 cases improved. YANG Zheng-zhi 20 moved a cup slowly along the Du channel back and forth 3 times, then gave cupping at (Du 14); and moved other two cups back and forth from bilateral Shenshu (BL 23) to Dazhu (BL 11) 3 times with the cups left at bilateral Shenshu for capping. The above procedure was repeated until the skin became flush, with final cupping for 30 minutes. As a result, 6 cases were markedly relieved, 10 cases improved and 2 cases failed. YU Nai-shu 21 pressed Renzhong (GV 26) and Baihui (GV 20) and massaged Fengchi (GB 20), Fengfu (GV 16) and Jianjing (GV 21) to induce resuscitation, tranquilize the mind, calm the liver and expel the wind; pressed Neiguan (PC 6), Quchi (LI 11), Zusanli (ST 36), Sanyinjiao (SP 6) and Yongquan (KI 1) to relax the muscles and promote blood circulation; massaged Qihai (CV 6), Guanyuan (CV 4), Zhongwan (CV 12), Xiawan (CV 10) and Tianshu (ST 25) to regulate the spleen and stomach; and pinched the muscles along the spine to regulate the internal organs. One patient was treated by 4 courses of treatment with satisfactory result. It is reported that daily practicing of calligraphy for one month can improve the patients' calculating ability, memory, clinical symptoms, and regulate the level of free radicals in blood.

14, 15

3. The Combined Use of Acupuncture and Medications

JIANG Wen et al. 22 observed the therapeutic effects of acupuncture for restoring consciousness and clearing collaterals on senile dementia. The patients were randomly divided into an experiment group of 32 cases and a control group of 18 cases. In the experiment group, 1.5-cun filiform needles were rapidly inserted into Fengchi (GB 20) (both), Fengfu (GV 16), Baihui (GV 20) and the neck 3-7 Jiaji points (EX-B2) with the reinforcing method, and

retained for 30 minutes to produce medium stimulation. Both the two groups were given routine intravenous injections of qingkailing, cytidine diphosphate choline or naofusu once a day for 10 days as one therapeutic course with a 1-day interval between courses. The results showed that 17 cases and 5 cases were cured, 13 cases and 10 cases improved, 2 cases and 3 cases failed respectively in the experiment group and the control group with significant difference in Riddit statistical analysis, indicating that the therapeutic effects in the experiment group were better than that of the control group. DUO Xiu-ying observed the therapeutic effects of Fu Zhi Tang (M^Wffi intelligence-restoring decoction) and scalp acupuncture for senile dementia. Fu Zhi Tang (consisting of Shu Di (^tt Radix Rehmanniae Praeparata) 15g, Gou Qi Zi (f^ET Fructus Lycii) 15g, Yuan Zhi Radix Polygalae) 15g, Shan Yu Rou Fructus Corni) 15g, Yi

Zhi Ren (M^-f^ Fructus Alpiniae Oxyphyllae) 15g and Huang Jing (^M Rhizoma Polygonati) 40g) was modified according to the symptoms to be orally taken one dose a day. Scalp acupuncture was performed on the third lateral line of the forehead, the central line of the forehead, the anterior oblique line of the vertex and temple, and the central line of the occiput. The adjunct points were taken according to the symptoms. Scalp acupuncture was given once every other day, with the needles inserted in an angle of 15-30°, retained for 60 minutes, and manipulated 3-4 times. In this series of 54 cases, 16 cases were markedly relieved, 33 cases improved and 5 cases failed, with a total effective rate of 91%. LIANG Zhong et al.24 randomly divided the patients into a Chinese drug group of 29 cases, an acupuncture group of 29 cases and an acupuncture- drug group of 57 cases. The main points used were Hegu (LI 4), Neiguan (PC 6), Dazhui (GV 14), Fengfu (GV 16) and Shenmen (HT 7), and the adjunct points were Zusanli (ST 36), Jiexi (ST 41), Taichong (LR 3), Fenglong (ST 40), Baihui (GV 20), Xinshu (BL 15) and Ganshu (BL 18). 1-2 main points and 2-3 adjunct points were taken for acupuncture once a day with the needles retained for 15 minutes. The results showed that the total effective rate was 84.21% in the

acupuncture-drug group, which was much better than 58.62% in the acupuncture group or 65.5% in the Chinese drug group (P<0.01), indicating that the combined use of acupuncture and drugs is the best therapy for treating senile dementia. WANG Hui-xian et al. performed moxibustion at Sishencong (EX-HN1) and Fenglong (ST 40) with 3-5 moxa-cones made from 3-year old mugwort floss and a little artificial musk. Pishu (BL 20), Shenshu (BL 23), Mingmen (GV 4) and Zusanli (ST 36) were punctured for those with yang deficiency of the spleen and kidney, and Ganshu (BL 18), Shenshu (BL 23), Sanyinjiao (SP 6) and Taixi (KI 3) for those with deficiency of the liver and the kidneys, using the reinforcing method or warming needle. Taichong (LR 3), Xiaxi (GB 43) and Yanglingquan (GB 34) were used for those with fire stagnated in the liver and gallbladder, using the reducing method. Acupuncture was given once every other day for 3 courses of treatment with 10 sessions as one therapeutic course. In a series of 52 cases, 29 cases were markedly relieved, 18 cases improved and 5 cases failed. LI Xiao-heng et al. performed acupuncture at Renzhong (GV 26), Dazhui (GV 14), Baihui (GV 20), Fengchi (GB 20), Neiguan-through- Waiguan, Taixi (KI 3) and Juegu (GB 39), with the needles retained for 20-30 minutes. The treatment was given once a day for 10 sessions as one therapeutic course with a 3-day interval between courses. Zhibai Dihuang Wan (^nttift^A) was orally administered to those with yin deficiency of the liver and kidney, Jinkui Shenqi Wan (^K'ff^A) to those with deficiency of the spleen and kidney, Taohong Siwu Tang to those with qi stagnation and blood deficiency, and Xi Xin Tang (^fr^) to those with stagnation of phlegm. The total effective rate of the combined therapy was 85%. WEI Si-quan observed the therapeutic effects of the acupuncture-drug therapy for senile dementia. The patients with deficiency of qi and blood and malnutrition of the brain were treated with the decoction consisting of Dang Shen Radix Codonopsis Pilosulae) 10g, Bai Zhu (S ^ Rhizoma Atractylodis Macrocephalae) 10g, E Jiao (I^K Colla Corii Asini) 10g (to be melted), Dang Gui Radix Angelicae Sinensis) 10g, Yi Zhi Ren

(ffl^i— Fructus Alpiniae Oxyphyllae) 15g, Huang Qi Radix Astragali seu Hedysari) 15g, Huai Shan Yao (Rhizoma Dioscoreae) 12g, Shi Chang Pu (^S^ Rhizoma Acori Graminei) 20g, Hei Zao (M^ Fructus Diospyri Loti) 4 pieces and Gan Cao Radix Glycyrrhizae) 6g. And acupuncture was performed at Baihui (GV 20), Shenmen (HT 7) (bilateral), Zusanli (ST 36) (bilateral), Qihai (CV 6) and Sishencong (EX-HN1), using the reinforcing method with the needles retained for 20 minutes. The treatment was given once a day for 10 sessions as one course of treatment. The patients with yin deficiency of the liver and kidneys and hyperactivity of the liver-yang were treated with the decoction composed of Tian Ma Rhizoma Gastrodiae) 12g, Bai Shao

Radix Paeoniae Alba) 12g, Yuan Zhi Radix Polygalae) 12g, Gou Teng (^M Ramulus Uncariae cum Uncis) 15g, Shi Chang Pu Rhizoma Acori Graminei) 15g, Chi Shao Radix Paeoniae Rubra) 15g, Sheng Di ( ^ № Radix Rehmanniae) 15g, Niu Xi Radix Achyranthis Bidentatae) 15g, Suan Zao Ren (^^^ Semen Ziziphi Spinosae) 15g, Huang Qin ( ^^ Radix Scutellariae) 10g, Du Zhong ( |± ^ Cortex Eucommiae) 10g, Gou Qi Zi (f^ET Fructus Lycii) 10g, Shi Jue Ming Concha Haliotidis) 30g

(to be decocted earlier) and Gan Cao Radix

Glycyrrhizae) 6g. And acupuncture was performed at Baihui (GV 20), Shenmen (HT 7) (bilateral), Sishencong (EX-HN1), Guanyuan (CV 4) (reinforcing method), Taixi (KI 3) (bilateral, reducing method), Taichong (LR 3) (bilateral, reducing method) and Sanyinjiao (SP 6) (reinforcing method) with the needles retained for 20 minutes. The treatment was given once a day for 10 sessions as one course of treatment. The patients with mental confusion due to phlegm stagnation were treated with decoction made from Huang Qi Radix Astragali seu Hedysari) 40g, Dang Gui Wei ( Radix Angelicae

Sinensis) 10g, Chuanxiong Rhizoma Ligustici Chuanxiong) 10g, Chi Shao Radix Paeoniae

Rubra) 10g, Tao Ren Semen Persicae) 10g,

Dan Nan Xing (IS^M Arisaema cum Bile) 10g, Zhu Ru Caulis Bambusae in Taeniam) 10g, Di Long Lumbricus) 10g, Jiang Can (MS Bombyx

Batryticatus) 10g, Fa Ban Xia (^^H Rhizoma Pinelliae Preparata) 15g, Shi Chang Pu ( ^^^ Rhizoma Acori Graminei) 15g, Fu Ling Poria) 20g, Hong Hua (^X^ Flos Carthami) 6g and Quan Chong ( ^^ Scorpio) 4g. And acupuncture was performed once a day at Baihui (GV 20), Shenmen (HT 7) (bilateral) and Fenglong (ST 40) (bilateral), using the uniform reinforcing-reducing method with the needles retained for 20 minutes. For those with hemiparalysis or facial hemiparalysis, Dicang (ST 4), Jiache (ST 6), Qian Zheng, Jianyu (LI 15), Quchi (LI 11), Hegu (LI 4), Huantiao (GB 30), Yanglingquan (GB 34), Xuanzhong (GB 39) and Taichong (LR 3) were added and punctured on the affected side. As a result, of the 25 cases treated, 4 cases were cured, 17 cases improved and 4 cases failed. Che Jian et al. used scalp acupuncture, eye acupuncture, body acupuncture, auricular acupuncture and Chinese medicines to treat 25 cases. Detection with the Hasegawa intelligence-measuring list showed that the intelligence score increased by 10 in 11 cases, by 6-10 in 8 cases, and by 2-5 in 4 cases. LIU Chang treated the patients according to their syndrome types. Those with deficiency of the heart-qi was treated with Bu Xin Dan (^h^^ Pills for reinforcing the heart) and Guipi Tang ( 0 ^ Decoction for invigorating the Spleen), and given body acupuncture at Xinshu (BL 15), Zusanli (SP 36), Shanzhong (CV 17), Juque (CV 14) and Neiguan (PC 6), and auricular acupuncture at Heart, Liver, Shenmen, Occiput and Subcortex. Those with hyperactivity of the liver-yang was treated Tianma Gouteng Tang (^ M^Wfâ Decoction of Gastrodia and Uncaria) or Yuejiancao preparation (B Ä^^M), and given body acupuncture at Taichong (LR 3), Xingjian (LR 2), Ganshu (L 18), Qimen (LR 14), Taiyang (EX-HN5) and Sishencong (EX-HN1), and auricular acupuncture at Liver, Gallbladder, Shenmen, Occiput, Subcortex, Jiang Ya Gou (I^H^) and the ear tip. Those with stagnation of the liver-qi were treated with Chaihu Shugan Tang (^ÄJI^^^ Decoction of bupleurum for relieving liver-qi), and given body acupuncture at Laogong (PC 8), Zusanli (ST 36), Taichong (LR 3), Ganshu (BL 18) and Danshu (BL 19), and auricular acupuncture at Liver, Gallbladder,

Brain, Temple, Shenmen, Occiput and Heart. Those with deficiency of the spleen-qi was treated with Guipi Tang Decoction for invigorating the

spleen) and Wendan Tang (SIS^ Decoction for clearing away heat from gallbladder), and given body acupuncture at Zusanli (ST 36), Fenglong (ST 40), Sanyinjiao (SP 6), Taibai (SP 3), Pishu (BL 20) and Zhangmen (LR 13), and auricular acupuncture at Shenmen, Occiput, Spleen, Stomach, Lung, Mouth, Large Intestine and Small Intestine. Those with deficiency of the kidney-qi was treated with Liuwei Dihuang Wan (A^Bolus of six drugs including rehmannia) or Zuo Gui Wan bolus

for reinforcing the kidney-yin), and given body acupuncture at Shenshu (BL 23), Guanyuan (CV 4), Qihai (CV 6), Yongquan (KI 1), Taixi (KI 3) and Zusanli (ST 36), and auricular acupuncture at Shenmen, Occiput, Kidney, Subcortex, Adrenal Gland, Temple, Spleen and Liver. MA Mei-qing30 observed the therapeutic effects of Anshen Xingnao Tang (^tiUfla^ Decoction for tranquilizing the mind and restoring consciousness) plus acupuncture for senile dementia. Patients of both the treatment and control groups took the decoction consisting of Zhen Zhu Mu Concha Margaritifera Usta)

15g, He Huan Pi Cortex Albiziae) 15g, Suan

Zao Ren Semen Ziziphi Spinosae) 15g, Yu

Jin Radix Curcumae) 12g, Yi Zhi Ren (ffl^fc Fructus Alpiniae Oxyphyllae) 12g, Yin Yang Huo (S ^M Herba Epimedii) 12g and Gan Cao Radix Glycyrrhizae) 6g, one dose a day for 30 days. The patients in the treatment group were at the same time acupunctured at Shenting (GV 24), Baihui (GV 20), Fengchi (GB 20), Shenmen (HT 7), Dazhui (GV 14), Dazhong (KI 4), Taixi (KI 3) and Xuanzhong (GB 39), 30 minutes each time, once a day, for 4 weeks with a 1-day interval every 7 days. In the treatment group of 56 cases, 29 cases were markedly relieved, 19 cases improved, and 8 cases failed. Of the 30 cases in the control group, 12 cases were markedly relieved, 13 cases improved, and 5 cases failed. LIU Yong-qian et al. observed the therapeutic effects of moxibustion at Baihui (GV 20) plus Baxian Yizhi Zhou Gruel containing 8 Chinese drugs

for strengthening intelligence) in senile dementia

patients. Moxibustion was performed for 15-30 minutes each time, once a day, for 2 months as one course of treatment with a 1-day interval every 10 days. The gruel contained the following 8 Chinese drugs: He Shou Wu (M ^ ^ Radix Polygoni Multiflori), Baihe (W^ Bulbus Lilii), Yi Yi Ren (M Semen Coicis), Jue Ming Zi (^^T Semen Cassiae), Huang Qi (M ^ Radix Astragali seu hedysari), Ren Shen (A# Radix Ginseng), Nu Zhen Zi (A^T Fructus Ligustri Lucidi) and Dan Shen Radix Salviae Miltiorrhizae) together with He Tao Ren (^ jZ Semen Juglandis), pine nuts, watermelon seeds, black sesame, soya beans, black soya beans, maize and chestnuts, which were ground into powder to be orally taken one pack (15g) each time, 3 times a day. The patients in the control group orally took Doukexi one tablet a time,

twice a day, for 2 months as one therapeutic course. In the treatment group of 98 cases, 28 cases were markedly relieved, 56 cases improved, and 14 cases failed, with a total effective rate of 85.7%. Of the 98 cases in the control group, 8 cases were markedly relieved, 54 cases improved, and 36 cases failed, with a total effective rate of 63.3%. The curative effect in the treatment group was better than that in the control group (P<0.05).

4. Effects of Acupuncture on the Relevant Indexes

DONG Hong-tao et al.32 observed the influence of acupuncture on the MMSE score for senile dementia patients. The patients were randomly divided into 3 groups. In the acupuncture group of 11 patients, the first group of points Baihui (GV 20), Dazhui (GV 14), Shenshu (BL 23), Shenmen (HT 7), Neiguan (PC 6) and Sanyinjiao (SP 6) were punctured in prone position, and the second group of points Sishencong (EX-HN1), Fengchi (GB 20), Taixi (KI 3), Zusanli (ST 36), Fenglong (ST 40) and Taichong (LR 3) were punctured in supine position. The two groups of points were alternatively used to be punctured on both sides. Electric stimulation with continuous wave, pulse frequency at 180 per minute and intensity tolerable to patients was added at Baihui (GV 20), Dazhui (GV 14), Sishencong (EX-HN1) and Fengchi (GB 20). 15 minutes later, the continuous wave was

changed to sparse-dense wave in order to avoid producing electric adaptation. After the needling sensation had been achieved, the lifting-thrusting-twirling manipulation was properly used at the other points to strengthen the needling response, and the needles were retained for 40 minutes. The acupuncture was performed once a day, 5 times a week, 4 weeks as one treatment course for 3 courses. In the Western medicine group of 10 cases, Haboyin tablets were orally administered 100^g a

time, twice a day, one month as one therapeutic course for 3 months. And the 10 patients in the consultation group were only given psychotherapy and instruction on daily life for 3 months with no acupuncture and medicine given. As a result, both acupuncture and medicine enhanced the MMSE score and obviously improved the calculating ability. The difference of the accumulated scores in reading, writing and drawing ability before and after treatment in both the acupuncture group and the medicine group quite differed from that in the consultation group (P<0.01). The combined use of acupuncture and medicine may possibly further enhance the curative effect for senile dementia. LUN Xin et al.33 observed the curative effects of the CT-positioned surrounding acupuncture for senile dementia. The patients were randomly divided into 2 groups, 25 cases in each group. In the treatment group, the filiform needles were horizontally inserted around the CT-positioned focus for one cun with the needle tips pointing to the center. After the needling sensation had been achieved with the twirling manipulation, the filiform needles were connected to a G6805-I electric stimulator with the sparse-dense wave at an intensity tolerable to the patients, and retained for 30 min. The adjunct points used were Shenmen (HT 7) and Zusanli (ST 36). In the control group, the filiform needles were horizontally inserted into the main points of Sishencong (EX-HN1) and Fengchi (GB 20) and the adjunct points of Shenmen (HT 7) and Zusanli (ST 36), and retained for 30 minutes. The treatment was given once a day for 15 sessions as one therapeutic course with a 5-day interval between courses. After 2 courses of treatment, 5 and 2 cases

were cured, 17 and 13 cases improved, 3 and 10 cases failed, treatment and control respectively in the 2 groups. The curative effect in the treatment group was much better than that of the control group (P<0.01). SHANG Ying et al.34 observed the influence of acupuncture on TCD in 24 cases of senile dementia. The points used were Baihui (GV 20), Dazhui (CV 14), Shanzhong (CV 17), Guanyuan (CV 4), Shenmen (HT 7), Taixi (KI 3), Feiyang (BL 58), Taibai (SP 3), Fenglong (ST 40), Fengchi (GB 20), Benshen (GB 13), Taichong (LI 3) and Quchi (LI 11). As a result, the average speeds of blood flow were 30.00±7.58 and 37.00±9.43, the systolic peak values were (96.12±33.78) and 87.43±27.32, the pulse index values were 0.89±0.15 and 0.85±0.22, respectively before and after treatment. All the above values were improved after treatment as compared to those before treatment, indicating that acupuncture may show good therapeutic effects for senile dementia. TANG Yong et al.35' 36 observed the effects of acupuncture on gnosia, free radicals and acetylcholine esterase in patients with senile dementia. 8 cases of mild or moderate senile dementia were acupunctured at Sishencong (EX-HN1), Shenmen (HT 7) and Taixi (KI 3) for one month. Before and after treatment, gnosia was evaluated with the MMSE scoring system; the activities of plasma free radicals (SOD, GSH and MDA) were detected; and the activity of acetylcholine esterase in plasma was determined with fluorescent method. It was found that acupuncture can improve gnosia for senile dementia patients, but with no obvious influence on the activities of plasma three free radicals and acetylcholin esterase. JIANG Guo-hua et al.37 explored the mechanisms of acupuncture for senile dementia, and evaluated its curative effects with the MMSE, CDR and ADL scales. As a result, 1) the MMSE scores for gnosia after treatment showed no obvious difference between the acupuncture group and the drug group (P>0.05), but they were much higher than that before treatment in both the two groups (P<0.05); 2) the CDR scores for dementia after treatment showed no obvious difference between the acupuncture group

and the drug group (P>0.05), but they were much lower than that before treatment in both the two groups (P<0.05); and 3) the ADL scores for the daily life ability after treatment showed no obvious difference between the acupuncture group and the drug group (P>0.05), but they were much higher than that before treatment in both the two groups. The conclusion is that acupuncture can improve gnosia, dementia and the daily life in mild cases of senile dementia.

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(Translated by DUAN Shu-min gWK)