壮医药线点灸治疗遗忘型轻度认知障碍伴睡眠障碍的疗效及对P300的影响OA

Objective To observe the clinical effect of medicated-thread moxibustion of Zhuang medicine on amnestic mild cognitive impairment(aMCI)with sleep disorder.Methods Sixty-four aMCI patients with sleep disorder were randomly divided into an observation group(32 cases,1 case withdrawn)and a control group(32 cases,1 case dropped out).Health education was performed in the control group.Besides the intervention as the control group,in the observation group,the medicated-thread moxibustion was delivered at Baihui(GV20)and Guanyuan(CV4),as well as bilateral Zusanli(ST36)and Sanyinjiao(SP6).The treatment was given once every 2 days in the 1st month and twice a week in the 2nd and 3rd months;and the duration of treatment was composed of 30 sessions.Montreal cognitive assessment(MoCA),Pittsburgh sleep quality index(PSQI),and World Health Organization quality of life-BREF(WHOQOL-BREF)were scored before and after treatment in the two groups;and the latency and amplitude of event-related potential P300 were detected.The clinical therapeutic effects for the cognitive function and sleep quality were evaluated in the two groups.Correlation analysis and linear regression analysis were conducted on the event-related potential P300 related to the total scores of MoCA and PSQI as well as the scores of each subscale.Results After treatment,in the observation group,the scores on attention,abstraction,delayed recall and the total score of MoCA,as well as the score of WHOQOL-BREF were higher in comparison with those before treatment(P＜0.05).After treatment,the observation group showed the higher scores on language,abstraction,delayed recall,and the total score of MoCA,as well as the score of WHOQOL-BREF when compared with those in the control group(P＜0.05).After treatment,the latency of the event-related potential P300 was shortened(P＜0.05)and the amplitude was increased(P＜0.05)compared to those before treatment in the observation group;and the latency was shorter(P＜0.05),and the amplitude was larger when compared with those in the control group(P＜0.05).After treatment,the score on subjective sleep quality,sleep latency,sleep efficiency,use of sleep medication and daytime dysfunction,and the total score of PSQI were lower than those before treatment in the observation group(P＜0.05);and the score on sleep duration was reduced in the control group(P＜0.05).After treatment,the scores on subjective sleep quality,use of sleep medication,and the total PSQI score in the observation group were lower when compared with those in the control group(P＜0.05).The total effective rates for the improvement in cognitive function and sleep quality in the observation group were higher than those in the control group,respectively(61.3%[19/31]vs 19.4%[6/31],80.6%[25/31]vs 19.4%[6/31],P＜0.05).The total score of MoCA was negatively correlated with P300 latency(r=-0.843,P＜0.001)and was positively correlated with P300 amplitude(r=0.722,P＜0.001).The total score of PSQI was positively correlated with P300 latency(r=0.552,P＜0.001)and was negatively correlated with P300 amplitude(r=-0.471,P＜0.001).Multiple linear regression analysis indicated that P300 latency was linearly related to abstraction,delayed recall,language,naming,attention and orientation;P300 amplitude showed a linear relationship with naming,abstraction,delayed recall and orientation;and both latency and amplitude of P300 were linearly related to subjective sleep quality and use of sleep medication.Conclusion The medicated-thread moxibustion of Zhuang medicine ameliorates cognitive function and improves sleep and quality of life in aMCI patients combined with sleep disorder.