Zhang, Zhenzhen
Keywords: acupuncture, memory, blood circulation, insufficient blood supply, head acupuncture, acupoints
On a day in May 2024, 54-year-old Erica walked into my clinic, with a main complaint of dizziness, stiff neck muscles, and pain. The pain was dull, limiting her ability to turn her head, especially when driving. Through inquiry, I learned that she had experienced a severe car accident 10 years ago; although she sustained no fractures, she had suffered from long-term dizziness, headaches, and neck pain since then. Various treatments had provided some relief, but none had cured her condition. An X-ray examination one year ago revealed mild cervical spondylosis. In the past three months, her children complained that she often forgets things; notably, three days before, her daughter asked her to pick up her grandson from kindergarten in the afternoon, which she completely forgot. She believed that her dizziness prevented her from concentrating, leaving her mind foggy and unable to remember things.
A. Vascular Factors in Memory Decline
We often find that memory decline often accompanies a patients’ main complaints. Whether traditional Chinese medicine can help these patients improve their memory is sometimes uncertain to the practitioners. As TCM doctors, we always treat based on syndrome differentiation and seek the root cause of the disease. Treating according to the cause is the fundamental approach; however, when patients present with complex pathogenic factors that have already caused bodily damage, it is often impractical to start treatment solely from the root cause. In such cases, it is necessary to adopt measures that interrupt the progression and reduce or eliminate ongoing harm.
There are many causes of memory decline, for example:
- Age: Aging leads to decreased vascular elasticity and insufficient blood and oxygen supply, resulting in cognitive decline.
- Hypertension: Long-term high blood pressure can damage small cerebral vessels, leading to microinfarctions and insufficient cerebral blood supply, thus affecting memory.
- Diabetes: Accelerates vascular sclerosis and affects brain blood supply.
- Atherosclerosis: Causes narrowing of cerebral arteries, reducing blood flow and impairing cognitive function.
- Smoking: Nicotine causes cerebral vessel constriction, reducing brain blood flow and increasing the risk of stroke and memory decline.
Other chronic diseases, stress, insomnia, malnutrition, and cervical injuries from car accidents may also lead to insufficient cerebral blood supply, causing gradual memory loss.
Clinically, TCM practitioners may not be able to correct the underlying causes directly, but they can target the vascular factors to help improve memory. Memory decline due to vascular causes is often the result of circulatory disorders, where cerebral nerve cells suffer from ischemia, hypoxia, and nutrient deficiency, leading to cellular damage or death, and consequently loss of memory, thinking, or judgment ability.
In the cerebral blood circulation system, the impaired blood supply from the carotid and vertebrobasilar arteries can affect memory. Their branches—such as the posterior cerebral artery (PCA) and middle cerebral artery (MCA)—if insufficient, can impact the hippocampus, temporal lobe, frontal lobe, and posterior cingulate cortex, leading to deficits in long-term, spatial, working, and language memory; insufficient blood supply to the cerebellum can impair motor memory.
Early signs of memory impairment include forgetting recent events while clearly recalling past events, along with scattered attention and slow thinking; later stages may progress to vascular dementia (VaD).
Besides the use of herbal medicine, TCM treatment for memory decline also includes acupuncture methods, as described below:
B. Acupuncture Treatment Methods
1. Scalp/Head Acupuncture
This method aims to stimulate brain functional areas to increase local blood flow and promote the recovery of neural function.
1.1 “Jin San Zhen” (Jin’s Three-Needle Therapy): These are commonly used combinations with three closely located points that produce a synergistic effect, developed by the contemporary acupuncturist professor Jin Rui. For memory loss the appropriate point groups are:
“Mind Three Needles/Zhi San Zhen”: Shenting GV24 (singular) and Benshen GB13 (bilateral). These three points correspond to the frontal lobe, which plays a key role in regulating emotion and intelligence and is closely related to cognition. Acupuncture at these points may enhance blood flow to the prefrontal cortex and improve behavioral disturbances related to emotion and intelligence. According to TCM, Benshen GB13 connects with the Yangwei vessel, maintaining the body’s yang channels, and is used to treat forgetfulness, senile dementia, and vascular dementia.
“Temporal Three Needles”: The points are located approximately two cun above the earlobe along the hairline, one point in line with the center of the ear, or lateral to GV20, and one on each side a cun to the front nd back; these correspond to the temporal lobe, which includes the hippocampus and are related to memory and other cognitive functions.
**“Cranial Three Needles”：**It includes Naohou DU 17, about 2.5 inches directly above the middle of the posterior hairline, and on both sides of Naokong GB19, the outer side of the upper edge of the external occipital protuberance, about 2.5 inches lateral to the midline of the head. These correspond to the occipital lobe, associated with visual information processing and improving visual memory.
1.2 Other Scalp Acupuncture Points：
**- Baihui GV20 and Sishencong：**Located at the vertex, these points promote cerebral circulation, improve cognitive function, enhance concentration, and improve memory. Acupuncture at Baihui GV20 plus Sishencong has been shown (via fMRI studies) to improve cognitive function in Alzheimer’s patients.
**- Yintang：**Located between the eyebrows in the frontal lobe, it may improve attention and memory.
**- Fengchi GB20：**Located below the occipital bone at the back of the neck; the deep muscles in this area contain the vertebral artery, which can improve cerebral blood supply and alleviate dizziness and forgetfulness.
Furthermore, studies on points such as Xuanlu GB5 and Xuanli GB6 (corresponding to the frontal lobe), Qubin GB7, Shuai gu GB8 and Fubai GB10 (corresponding to the temporal lobe), indicate that needling these points is associated with improvements in cognitive function.
2. Systemic Point Selection：
Based on the individual’s condition, a syndrome-differentiated selection of points throughout the body is performed, with emphasis on points that research has shown to improve cerebral blood supply and cognitive ability, including memory. For example:
**-Neiguan PC6：**Relieves anxiety and regulates cardiac and spleen-stomach functions, thereby enhancing cognitive function.
**-Qihai CV6：**Known as the “Sea of Qi,” it improves overall blood and qi circulation, aiding in oxygen and blood supply to the brain.
**-Hegu LI4：**Regulates the flow of qi and blood throughout the body, improving cerebral operational efficiency.
**-Taichong LV3：**Improves vascular elasticity, enhances brain oxygenation, stabilizes mood and cognitive function; studies show that needling Hegu LI4 and Taichong LV3 can modulate the sympathetic nervous system and increase cerebral blood perfusion.
**-Yongquan KD1：**Improves neurotransmitter function, enhances memory, nourishes the brain, and improves cognitive capacity.
**-Zusanli ST36：**Enhances endurance and promotes qi and blood circulation; it also modulates spleen-stomach function, increases immunity, and
strengthens the gut-brain axis, thereby improving cognitive function.
3. Auricular Acupuncture:
Select ear points related to stimulating the heart, spleen, kidney, liver, Shenmen, and endocrine function to achieve a brain-nourishing and intelligence-enhancing effect. In particular, using ear seeds or press balls can provide stimulation lasting 2-3 days or longer.
4. Electroacupuncture (EA)
Research indicates that low-frequency electrical stimulation can increase cerebral blood flow and activate neurotransmitters such as acetylcholine and dopamine.
Points may include ear acupuncture points (e.g., Heart and Shenmen) as well as Yintang, Baihui GV20 plus Sishencong, among others.
5. Moxibustion
Adding moxibustion can enhance vascular dilation, improve microcirculation, and thereby increase cerebral blood flow.
C. Clinical Example
Taking Erica as an example, a specific treatment protocol might involve selecting the following points: “Zhi San Zhen” (Shenting GV24 with Benshen GB13 bilateral), “Temporal Three Needles,” Baihui GV20, Fengchi GB20, Dazhui GV14, Zusanli ST36, Taichong LV3, and Sanyinjiao SP6. Treatment is administered twice weekly for 8 weeks, then gradually reduced to once weekly or once every two weeks.
Adjunct methods: Occasionally, add electroacupuncture at Yintang plus Baihui GV20 for 30 minutes per session, or perform warm needle moxibustion at Baihui GV20 and Fengchi GB20 for 10 minutes, or use moxibustion at Shenting GV24 and Zusanli ST36 to enhance blood circulation.
Outcome: After the first two months of treatment, the patient’s dizziness and headache completely disappeared, the stiffness of the cervical spine was significantly relieved, the pain was greatly reduced, and no serious amnesia occurred. The treatment lasted for 5 months, and the effect was still good, so the treatment was terminated.
Lifestyle guidance is also crucial, including daily self-relaxation exercises for the head and neck muscles and reducing screen time, etc.
Summary
Memory decline is not limited to the elderly; many young people may also be affected, though it is more common in older adults. There are many causes of memory decline. This article emphasizes that cerebral circulatory disorders can lead to ischemia and hypoxia in brain nerve cells, resulting in cognitive decline and forgetfulness. TCM practitioners can effectively intervene with non-pharmacological methods such as acupuncture and herbal medicine. This article, based on the author’s clinical experience and related literature, introduces several specific acupuncture points effective for improving memory. The proposed simple and practical treatment protocol is provided for clinical reference and validation by peers.
改善記憶力的針灸穴位應用
章珍珍 中醫師 美國
**關鍵詞：**針灸，記憶力，血液循環，供血不足，頭針，穴位
2024年5月的一個中午，54歲的 Erica 走進診所，訴說最煩惱她的是頭暈、頸項強硬與疼痛。疼痛為鈍痛，限制她左右轉頭，尤其是開車時無法轉頭。通過問診得知，她10年前曾遭嚴重車禍，雖未有任何骨折，但此後長期頭暈頭痛、頸項疼痛，使用過各種療法雖有幫助，但未曾根治。一年前X光檢查發現輕度頸椎增生。近三個月來，子女抱怨她經常忘事，尤其是三天前星期一早晨，女兒託付她下午去幼稚園接外孫回家，她卻完全忘了。她認為是頭暈使她無法專注，頭腦昏沉而難以記住事物。
A、記憶力減退的血管因素
其實，如果多留意，就會發現病人的主訴中常伴有記憶力減退。中醫是否能幫助這些病人改善記憶力，有時連中醫師自己也難以確定。我們中醫師總是辨證論治、治病求本，針對病因進行治療是根本手段；然而，當臨床上看到的病人因複雜致病因素已造成身體傷害時，往往難以從根本上糾正病因，此時有必要採取截斷病勢、減少或消除病程中持續傷害的應對措施。
導致記憶力減退的原因很多，例如：
- **年齡：**老化使血管彈性減弱，供血供氧不足，進而導致認知功能下降。
- **高血壓：**長期高血壓可能損害腦小血管，引發腦微梗塞，造成腦供血不足，影響記憶。
- **糖尿病：**加速血管硬化，影響腦部供血。
- **動脈粥樣硬化：**導致腦動脈狹窄，減少血流，損害認知功能。
- **吸菸：**尼古丁使腦血管收縮，減少腦部供血，增加中風和記憶衰退風險。
或其他慢性病、壓力、失眠、營養不良，以及車禍導致的頸椎傷害等。
這些因素都可能導致大腦供血不足,使記憶力逐漸減退。臨床上中醫師難以從病因根治,但可以抓住血管因素,幫助病人改善記憶。記憶力減退多因血液循環障礙,造成大腦神經細胞缺血、缺氧、營養不足,導致細胞損傷或死亡,從而喪失記憶、思維或判斷能力。
在大腦血液循環系統中,簡單來說,主要是頸動脈與椎-基底動脈供血受損,就會影響記憶。其分支如後大腦動脈(PCA)與大腦中動脈(MCA)供血不足,會影響海馬體、顳葉、額葉及後扣帶皮層,進而損害長期記憶、空間記憶、工作記憶與語言記憶;小腦供血不足則可能導致運動記憶受損。
記憶受損的早期表現:容易忘記剛發生的事情,但對過去之事仍記憶清楚,伴隨注意力分散、思維遲緩;晚期則可能發展為血管性痴呆(Vascular Dementia, VaD)。
中醫治療記憶力減退除可服用中藥外,下面介紹幾種針灸方法:
B. 針灸治療方法
1. 頭針療法
旨在通過刺激大腦相關功能區,提高局部血流量,促進神經功能恢復。
**1.1 “斬三針”：**這是我常用的三針組合療法,三個穴位相近,同時刺激能疊加效果。針對記憶力減退,可選擇:
**“智三針”：**取神庭(單側)與本神(雙側)【GB13】。這三個穴位對應大腦額葉,額葉主要負責調節情感與智力,與認知、智力密切相關。針刺“智三針”可促進前額葉血流增加,或改善情感及智力相關的行為障礙;中醫認為本神與陽維脈相會,聯絡全身陽經,調神充髓,適用於治療健忘、老年性痴呆及血管性痴呆。
**“顳三針”：**穴位組成為：從耳尖直上發際約二寸，左右各旁開一寸，對應大腦顳葉，顳葉內含海馬，與記憶等認知功能相關。
**“腦三針”：**包括腦戶，後發際正中直上約2.5寸，及雙側腦空枕外隆凸上緣外側，頭正中線旁開約2.5寸。此組穴位對應枕葉，與促進視覺信息處理及提高視覺記憶力有關。
1.2 其他頭針穴位：
**-百會穴與四神聰：**對應大腦頂葉，能促進腦部循環、改善認知功能、提高專注力及記憶力。針刺百會加四神聰可改善阿爾茨海默病患者的認知功能，提高血流灌注。且得到 fMRI 研究支持。
**-印堂穴：**位於兩眉間，對應額葉，可提高注意力與記憶力。
**-風池穴：**位於頸後枕骨下，周圍深層肌肉中含有椎動脈，可改善腦供血，緩解頭暈與健忘。
此外，懸顱、懸厓（對應額葉）、曲鬚、率谷及浮白（對應顳葉）的研究亦顯示，針刺這些穴位與改善認知功能有關。
2. 全身取穴：
根據每個病人的具體病症，進行全身辨證取穴，同時注重以下經研究證實有助於改善大腦血液供應、提高認知及記憶能力的穴位：
**-內關穴：**緩解焦慮，調節心臟與脾胃功能，有助於提高認知功能。
**-氣海穴：**為元氣之海，可改善全身氣血循環，增強大腦供氧供血。
**-合谷穴：**調節全身氣血流通，有助於提高大腦運轉效率。
**-太沖穴：**改善血管彈性，增強腦供氧，穩定情緒與認知功能；研究顯示合谷與太沖針刺可調節交感神經系統，提高大腦血流灌注。
**-涌泉穴：**改善神經遞質功能，增強記憶、營養大腦，提高認知能力。
**-足三里：**增強耐力，促進氣血運行，可調節脾胃功能，增加免疫力，加強腸-腦軸功能，從而提高認知功能。
3. 耳穴療法：
選取刺激心、脾、腎、肝、神門及內分泌等相關耳穴，以達到健腦益智效果。特別是耳穴埋豆，可使刺激持續2至3天，甚至更久，適用於針灸治療的間隔期。
4. 電針
研究表明，低頻電刺激可促進大腦血流量增加，激活神經遞質（如乙酰膽鹼、多巴胺）。
可選用耳針穴（心、神門）或印堂、百會加四神聰等穴位進行刺激。
5. 艾灸
結合艾灸可增強血管舒張，提高微循環，進而改善並增加大腦血流量。
C、治療舉例
以本文提及的Erica為例，具體治療方案：
取穴：“智三針”（神庭單側、本神雙側【GB13】）、“顳三針”、百會、風池、大椎、足三里、太沖、三陰交。每週施治2次，持續8週，之後逐漸減至每週一次或每兩週一次。
**加減方法：**有時可加用電針於印堂與百會，每次30分鐘；或溫針灸於百會與風池，溫灸10分鐘；或艾灸於神庭與足三里以增強血液循環。
**治療效果：**經過前兩個月的治療，病人的頭暈、頭痛完全消失，頸椎僵硬明顯緩解，疼痛大減，且未發生嚴重健忘事件。持續了5個月治療，效果仍然良好，終止治療。
生活指導也十分重要，包括每日進行頭頸部肌肉自我放鬆訓練、減少屏幕前時間等。
總結
記憶力減退並非僅限於老年人，許多年輕人也可能受影響，但以老年人較為常見。導致記憶力減退的原因很多，本文重點提示大腦血液循環障礙如何導致神經細胞缺血、缺氧，進而使認知功能衰退，造成功能性健忘。中醫師能夠採取的、行之有效的方法主要包括針灸與中藥等非藥物療法。本文基於作者的臨床經驗及相關文獻研究，提出一個簡便易行的治療方案，僅供同行參考與驗證。
參考文獻
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