Objective

2

To investigate the effects of

Huayu Tongluo

(transforming stasis and unblocking collaterals) moxibustion on cognitive function and insulin resistance in patients with type 2 diabetes mellitus (T2DM) and cognitive decline.

Methods

2

Ninety patients with T2DM and cognitive decline were randomly divided into a moxibustion group (

n

=45

3 cases dropped out

2 cases were eliminated) and a waiting moxibustion group (

n

=45

2 cases dropped out). Both groups received routine hypoglycemic treatment for 12 weeks. The moxibustion group additionally received

Huayu Tongluo

moxibustion at Baihui (GV20)

Shenting (GV24)

and Dazhui (GV14). Pressing moxibustion was applied to Baihui (GV20) for 20 min

while suspended moxibustion was applied to Shenting (GV24) and Dazhui (GV14) for 20 min each. Treatments of moxibustion were administered every other day (three times per week) for 12 weeks. All patients were followed up for 12 weeks

during which their original hypoglycemic medication regimen was maintained. Before treatment

after 12 weeks of treatment

and at the 12-week follow-up

the scores of Montreal cognitive assessment (MoCA)

mini-mental state examination (MMSE)

Addenbrooke's cognitive examination Ⅲ (ACE-Ⅲ)

symbol

digit modalities test (SDMT)

and Athens insomnia scale (AIS) and the insulin resistance index (HOMA-IR) were observed in the two groups.

Results

2

Compared with before treatment

the MoCA scores

MMSE scores

ACE-Ⅲ subscale scores (attention

memory

language fluency

language

visuospatial ability) and total scores

and SDMT scores were increased (

P

<

0.01)

while the AIS scores were decreased (

P

<

0.05) in the moxibustion group after treatment and at follow-up. Compared with before treatment

the MMSE score

ACE-Ⅲ subscale scores (memory

attention) and total score after treatment

as well as the ACE-Ⅲ subscale scores (language

memory

attention) and total score

and SDMT score at follow-up were increased (

P

<

0.05

P

<

0.01) in the waiting moxibustion group. Compared with before treatment

HOMA-IR was decreased in both groups after treatment and at follow-up (

P

<

0.01). At follow-up

ACE-Ⅲ subscale scores (attention

memory)

and the total score in the moxibustion group were lower than those after treatment (

P

<

0.05

P

<

0.01)

and the ACE-Ⅲ language subscale score

total ACE-Ⅲ score

and SDMT score in the waiting moxibustion group were higher than those after treatment (

P

<

0.01

P

<

0.05). After treatment and at follow-up

compared with the waiting moxibustion group

the moxibustion group had higher MoCA scores

MMSE scores

SDMT scores

ACE-Ⅲ subscale scores (attention

memory

language fluency) and total scores (

P

<

0.05

P

<

0.01)

and lower HOMA-IR (

P

<

0.05).

Conclusion

2

Huayu Tongluo

moxibustion can effectively improve cognitive function in patients with T2DM and cognitive decline. This improvement may be associated with the reduction in insulin resistance.