摘要
目的探讨“形神共调”针法对中风后肢体麻木患者的临床疗效及其中枢作用机制。方法对中风后遗症期伴单侧肢体麻木患者(中风麻木组)24例及健康对照者(健康对照组)14名进行“形神共调”针刺治疗,每周3次,连续4周。采用视觉模拟评分法(VAS)观察中风麻木组治疗前后肢体麻木程度。受试者于治疗前后进行静息态功能磁共振扫描,采用DPABI等软件进行数据处理分析,得到大脑皮层的局部一致性(ReHo)数据,分别比较针刺前组间、针刺前后组内ReHo差异。提取中风麻木组针刺前后差异脑区的平均ReHo值与VAS评分进行相关性分析。结果中风麻木组针刺后VAS评分较针刺前明显降低(P<0.05)。针刺前,中风麻木组较健康对照组右侧中央前回、左侧中央后回、左侧岛盖部额下回、左侧颞上回ReHo值增强,右侧颞中回ReHo值减弱。与针刺前比较,健康对照组针刺后右侧中央前回、右侧顶上回、右侧额中回、左侧中央后回、左侧中央前回、左侧额中回、左侧舌回ReHo值均增强,右侧颞上回、左侧额上回、右侧辅助运动区ReHo值减弱;中风麻木组针刺后右侧中央后回、右侧小脑3区、右侧丘脑、右侧海马旁回、右侧颞上回、右侧岛叶、小脑蚓部4_5区ReHo值增强,左侧顶上回、右侧小脑crus2、左侧眶部额上回、右侧小脑crus1 ReHo值减弱。中风麻木组针刺前后差异脑区右侧丘脑、右侧岛叶、右侧小脑、右侧中央后回ReHo值均与VAS评分呈负相关。结论“形神共调”针法可有效改善中风后肢体麻木患者的临床症状,其机制主要涉及丘脑、岛叶、小脑、小脑蚓部、中央后回等脑区神经元活动ReHo的增强,从而提高患者感觉运动功能及认知控制能力。
Objective To explore the clinical efficacy and central mechanism of action of“co-regulation of the body and the spirit”acupuncture on the patients with limb numbness after stroke.Methods Totally 24 patients with unilateral limb numbness after stroke and 14 healthy controls were treated with“co-regulation of the body and the spirit”acupuncture 3 times a week for 4 weeks.The degree of limb numbness in the stroke numbness group before and after treatment was observed by visual analogue scale(VAS).All subjects underwent resting-state fMRI scans before and after treatment,and DPABI and other software were used to process and analyze the data to obtain the regional homogeneity(ReHo)data of the cerebral cortex.The differences in ReHo between the two groups before acupuncture and within the two groups before and after acupuncture were compared.The average ReHo value and VAS score of the different brain regions before and after acupuncture in the stroke numbness group were extracted for correlation analysis.Results The score of VAS after acupuncture of patients significantly lower than that before acupuncture(P<0.05).Before acupuncture,the ReHo values in patients increased in right precentral gyrus,left postcentral gyrus,left inferior frontal gyrus and left superior temporal gyrus,but decreased in right middle temporal gyrus.After acupuncture,the ReHo values in healthy controls increased in right precentral gyrus,the right superior parietal gyrus,the right middle frontal gyrus,the left postcentral gyrus,the left precentral gyrus,the left middle frontal gyrus and the left lingual gyrus,but decreased in right superior temporal gyrus,left superior frontal gyrus and right supplementary motor area.After acupuncture,the ReHo values in patients increased in the right postcentral gyrus,right cerebellum 3,right thalamus,right parahippocampal gyrus,right superior temporal gyrus,right insula and the vermis 4_5,but decreased in the left superior parietal gyrus,right cerebellum crus2,left superior orbital gyrus and right cerebellum crus1.The ReHo values of right thalamus,right insula,right cerebellum and right postcentral gyrus were negatively correlated with VAS scores.Conclusion“Co-regulation of the body and the spirit”acupuncture can effectively improve the clinical symptoms of patients with limb numbness after stroke.The mechanism is mainly involved in the enhancement of regional homogeneity of neuronal activity in brain regions in the thalamus,insula,cerebellum,vermis,postcentral gyrus and other brain regions,which can improve the patients’sensorimotor function and cognitive control ability.
作者
彭景
邹忆怀
宋蕾
吕秋艺
钱勋琦
宿家铭
张华
陈星
PENG Jing;ZOU Yihuai;SONG Lei;LYU Qiuyi;QIAN Xunqi;SU Jiaming;ZHANG Hua;CHEN Xing(Beijing University of Chinese Medicine,Beijing 100029,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《中国中医药信息杂志》
CAS
CSCD
2022年第11期109-114,共6页
Chinese Journal of Information on Traditional Chinese Medicine
基金
国家自然科学基金(81904285)。
关键词
静息态功能磁共振成像
针刺
形神共调
麻木
局部一致性
resting-state functional magnetic resonance imaging
acupuncture
co-regulation of the body and the spirit
numbness
regional homogeneity
