目的：运用脑功能成像技术，研究不同穴位针刺前后，血管性痴呆(VD)患者大脑皮层葡萄糖代谢的变化。方法：25例VD病人，随机分为5组。A组治以针对偏瘫的常规穴位(手足三阳经为主)，B组加用百会，C组加用水沟，D组加用神门，E组加用百会、水沟和神门。治疗前后，所有病人均接受正电子发射型计算机断层显像(PET)检测。划定VD患者双侧额叶(眶回)、双侧顶叶、双侧颞叶(海马及海马旁回)、双侧枕叶、双侧丘脑、双侧豆状核、双侧尾核、双侧扣带回、双侧小脑为感兴趣区。结果：针刺偏瘫的常规穴位，豆状核和颞叶葡萄糖代谢升高；针刺百会穴额叶、颞叶和豆状核葡萄糖代谢升高，针刺水沟穴则额叶、丘脑和豆状核升高，针刺神门穴顶叶和豆状核升高，同时针刺三穴，额叶、颞叶、丘脑和豆状核等不同脑区葡萄糖代谢升高。结论：百会、水沟、神门对不同脑功能区的葡萄糖代谢产生不同的影响，在脑区有着不同的作用侧重。

BACKGROUND: Although a specific and satisfactory therapeutic method for vascular dementia(VD) has not been developed, it is important to prevent VD by effectively avoiding risk factors, prevnting cerebrovascular accident(CVA) or preventing the recurrence, development and complications in patients with CVA. Exploring the effective mechanism for VD treatment with electroacupuncture method is one of the hot is suse in the study of VD therapy. OBJECTIVE: To observe the effects of electroacupuncture on learning and memory abilities and the apoptosis of cerebral cells in rats with VD DESIGN: A randomized and controlled experimental study. SETTING: Acupuncture and Massage Vocational College and College of Basic Medical Sciences, Guangzhou University of Traditional Chinese Medicine. MATERIALS: Sixty female and male(half-half) healthy adult SD rats, weighing 200-250g, were provided by the Research Center of Laboratory Animals, Guangzhou University of Traditional Chinese Medicine. METHODS: VD model of four-vessel occlusion was made in healthy SD rats from the Experimental Animal Center, Guangzhou University of Traditional Chinese Medicine, Morris water maze tests were used for place navigation test and spatial probe test. The apoptosis of nerve cells in the cerebral cortex and hippocampus were also tested with TUNEL method. RESULTS: The escape time(Latency) of rats in model group(58.08

目的:比较百会、水沟、神门治疗血管性痴呆(VD) 的相对特异性。方法:50例血管性痴呆患者，随机分为5组，A组治以常规穴位针刺，在A组基础上B组加用百会、C组加用水沟，D组加用神门，E组加用百会、水沟和神门3穴。治疗前后均观察临床症状的变化,并运用修订长谷川痴呆量表、日常生活活动量表、社会功能活动调查等量表进行测评，评分结果进行统计学处理。结果：百会、神门能够改善VD患者记忆、定向、反应、固执、恍惚等方面的症状，百会长于帮助患者理解、计算、适应社会；水沟则偏重于针对VD 患者喜睡嗜卧、反应迟钝、神思恍惚、记忆等症状的改善;百会、水沟、神门3穴联合运用,对于VD患者的智力水平、社会适应能力有着较为全面的改善。结论:百会、水沟、神门3穴在改善VD 患者临床症状和智力水平方面各有其相对特异性,3穴联合运用疗效最佳。

目的：观察电针对实验性血管性痴呆(VD)大鼠学习记忆能力和脑组织细胞凋亡的影响。方法：实验中用4-血管阻断模型，用Morris水迷宫测定大鼠学习记忆能力，并用Tunel法检测鼠脑皮质和海马细胞凋亡情况。结果：模型大鼠表现明显的学习记忆障碍，在定位航行实验中，与假手术组相比，潜伏期显著延长；在空间探索试验中，在原平台象限跨越平台次数与其余三个象限无显著差异；其顶叶皮层及海马有大量的凋亡细胞出现。而电针能显著缩短定位航行试验的潜伏期。在空间探索试验中，在原平台象限跨越平台次数显著多于其余三个象限，与假手术组无显著差异；其顶叶皮层及海马CA1区的凋亡细胞数显著减少，受损程度明显轻于模型组。结论：电针能改善VD大鼠学习记忆能力，有拮抗脑组织细胞凋亡的作用。