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경도 신경인지장애(Mild neurocognitive disorder)는 정상적인 기억상실에 비해 인지기능이 저하되고 치매에 비해 인지기능의 손상이 심각하지 않으면서 일상생활 활동이 보존되는 상태다. 한국인 인구에서 신경인지장애의 유병률은 11.10%였다. 유병률이 높음에도 불구하고, 경도 신경인지장애의 주요 신경인지장애로의 진행을 중지시키기 위해 개발된 효과적인 약물은 없으며 비약물 치료로서 인지 훈련 또는 인지 재활에 대한 보고가 있다.
자하거 약침(Hominis placenta pharmacopuncture)은 자하거 추출물(Hominis placenta extract)을 특정 경혈에 주입하는 방법으로, 자하거와 침술의 효과를 결합하여 상승적인 치료 효과를 얻을 수 있는 것으로 알려져 있다. 알츠하이머 질환 동물 모델의 인지기능의 변화를 평가하기 위해 동물 실험을 수행되었다. 하지만 자하거 약침이 인지 기능 저하에 미치는 임상적 영향에 대한 보고는 없었다. 자하거 약침은 MMSE-DS, MoCA-K 및 K-DRS로 평가되는 인지기능에서 실질적인 임상 결과를 생성할 수 있는 치료 방식일 수 있다. 
이에, 2018년 10월 01일부터 2019년 02월 29일까지 경희대학교 한방병원 한방신경정신과에 방문하여 신경인지장애에 대해 자하거 약침 치료를 받은 경험이 있는 외래환자의 의무기록조회를 통해 후향적으로 데이터를 수집하여 자하거 약침 치료 전후의 신경심리검사의 변화를 살펴보고자 한다.

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Mild neurocognitive disorder (NCD) is a condition in which cognitive functions are degraded rather than normal memory loss, and cognitive function is not severe compared to dementia, and activities of daily living are preserved. Prevalence rate of mild NCD in Korean population was 11.10%. Despite its high prevalence, there is no effective drug developed to stop the progression of mild NCD to major NCD and there have been reports of cognitive training or cognitive rehabilitation as non-drug treatment.
Hominis placenta pharmacopuncture is a method of injecting Hominis placenta extract into specific acupoints and it is known that synergistic treatment effect can be achieved by combining both effect of Hominis placenta and that of acupuncture. Animal experiments were conducted to evaluate the changes in cognitive function of Alzheimer’s disease animal models. To our best knowledge, there has been no report about clinical effect of Hominis placenta pharmacopuncture on cognitive decline. Hominis placenta pharmacopuncture could be a possible treatment modality producing substantial clinical result in cognitive function which is assessed with Mini-Mental State Examination-Dementia Screening (MMSE-DS), Korean Version of Montreal Cognitive Assessment (MoCA-K), and Korean-Dementia Rating Scale (K-DRS).
From October 01, 2018 to Febraury 29, 2019, medical records will be reviewed retrospectively for patients who visited Department of Neuropsychiatry at Kyung Hee University Korean Medicine Hospital and administered Hominis placenta pharmacopuncture for Mild neurocognitive disorder. Through this, we will examine the change in the score of neuropsychological examination before and after Hominis placenta pharmacopuncture treatment.

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For patients over 50 years of age and diagnosed with Mild neurocognitive disorder based on DSM-5, changes of MMSE-DS, MoCA-K, and K-DRS neuropsychological examination test score were evaluated before and after 4 weeks of Hominis placenta pharmacopuncture treatment through a retrospective chart review while maintaining existing treatments such as drugs and herbal medicine for Mild neurocognitive disorder according to the judgment of the clinician.

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From October 01, 2018 to Febraury 29, 2019, patients who visited Department of Neuropsychiatry at Kyung Hee University Korean Medicine Hospital and administered Hominis placenta pharmacopuncture for Mild neurocognitive disorder.

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Among patients with Mild neurocognitive disorder who visited Department of Neuropsychiatry at Kyung Hee University Korean Medicine Hospital, patients who meet the selection criteria and do not meet the exclusion criteria are extracted through non-probabilistic purposive extraction methods.

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Cognitive Dysfunction (F03.615.250.700)

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Changes in the MMSE-DS Neuropsychological examination score

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Before treatment, After treatment

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Changes in the MoCA-K Neuropsychological examination score

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Before treatment, After treatment

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Changes in the K-DRS Neuropsychological examination score

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Before treatment, After treatment

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Adverse effect

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Before treatment, During the treatment period

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A 84-year old man with mild neurocognitive disorder received Hominis placenta pharmacopuncture on GV20, CV12, and bilateral ST36 for a month. The results of neuropsychological examination showed increase in scores after treatment of Hominis placenta pharmacopuncture. Before treatment, they were 15 points for MoCA-K, and 120 points for K-DRS (7.6%), but after treatment, they elevated by 21 points for MoCA-K and 137 points for K-DRS (100%). MMSE-DS score was 28 points, unchanged before and after treatment. It did not cause any side-effect.