头穴丛刺联合太极拳对卒中后抑郁患者脑功能连接及网络拓扑的影响

doi:10.3969/j.issn.1006-9771.2026.06.001

《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (6): 621-630.doi: 10.3969/j.issn.1006-9771.2026.06.001

头穴丛刺联合太极拳对卒中后抑郁患者脑功能连接及网络拓扑的影响

管昱杰¹, 刘可妍¹, 杨可钦², 梁玉林², 张金朋², 赵彬²()

¹ 黑龙江中医药大学研究生院，黑龙江哈尔滨市 150040
² 黑龙江中医药大学附属第二医院，黑龙江哈尔滨市 150001

收稿日期:2026-03-16 修回日期:2026-05-15 出版日期:2026-06-25 发布日期:2026-06-24
通讯作者: 赵彬， E-mail： 521zhaobin@163.com
作者简介:管昱杰(2000-)，男，汉族，山东淄博市人，硕士研究生，主要研究方向：神经康复学、中医康复学。
赵彬(1984-)，男，汉族，黑龙江大庆市人，博士，副教授、副主任医师，硕士研究生导师，主要研究方向：神经康复学、脑卒中后抑郁的诊疗。
基金资助:
黑龙江省博士后科研基金资助项目(LBH-Z22290);黑龙江省卫生健康委科研课题(20222020011074)

Effect of cluster scalp acupuncture combined with Taijiquan on brain functional connectivity and network topology for patients with post-stroke depression

GUAN Yujie¹, LIU Keyan¹, YANG Keqin², LIANG Yulin², ZHANG Jinpeng², ZHAO Bin²()

¹ Graduate School, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, China
² The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150001, China

Received:2026-03-16 Revised:2026-05-15 Published:2026-06-25 Online:2026-06-24
Contact: ZHAO Bin, E-mail： 521zhaobin@163.com
Supported by:
Heilongjiang Province Postdoctoral Research Fund(LBH-Z22290);Heilongjiang Provincial Health Commission Research Project(20222020011074)

摘要/Abstract

摘要：

目的探讨头穴丛刺联合太极拳对卒中后抑郁(PSD)患者抑郁症状、运动功能、日常生活活动能力、血清标志物及脑功能连接(FC)和网络拓扑属性的影响。
方法选取2022年9月至2023年9月于黑龙江中医药大学附属第二医院就诊的PSD患者40例，随机分为对照组(n=20)和试验组(n=20)。对照组接受头穴丛刺，试验组增加太极拳训练，共4周。治疗前后采用汉密尔顿抑郁量表17项版本(HAMD-17)、Fugl-Meyer评定量表(FMA)和Barthel指数(BI)进行评定，采用酶联免疫吸附法检测血清多巴胺(DA)、5-羟色胺(5-HT)、白细胞介素-6 (IL-6)和肿瘤坏死因子-α (TNF-α)水平，采用静息态功能磁共振成像(rs-fMRI)评估脑FC，以及网络的全局效率(Eg)和小世界属性(σ)。
结果治疗后，两组HAMD-17、FMA和BI评分均明显改善(t>2.922,P<0.01)，试验组优于对照组(t>2.517,P<0.05)；两组血清DA和5-HT水平升高(t>2.637,P<0.05)，试验组优于对照组(t>2.192,P<0.05)；试验组IL-6和TNF-α水平显著降低(t>4.059,P<0.001)，且优于对照组(t>2.154,P<0.05)。治疗后，试验组左侧额中回与右侧前扣带回、左侧海马与右侧楔前叶的FC显著高于对照组(t>3.867,P<0.001)；两组Eg和σ均升高(t>2.828,P<0.05)，试验组优于对照组(t>2.675,P<0.05)。
结论联合太极拳可进一步改善PSD患者的抑郁症状、运动功能和日常生活活动能力，可能与调节神经递质和炎症因子水平、增强前额叶-边缘系统FC、优化脑网络全局拓扑属性有关。

关键词: 卒中后抑郁, 头穴丛刺, 太极拳, 功能连接, 脑网络拓扑

Abstract:

Objective To explore the effect of cluster scalp acupuncture combined with Taijiquan training on depressive symptom, motor function, activities of daily living, serum markers, as well as brain functional connectivity (FC) and network topological properties in patients with post-stroke depression (PSD).
Methods A total of 40 PSD patients in the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from September, 2022 to September, 2023 were enrolled and randomly divided into control group (n=20) and experimental group (n=20). The control group received cluster scalp acupuncture alone, while the experimental group underwent Taijiquan training in addition, for four weeks. They were assessed with Hamilton Depression Scale-17 (HAMD-17), Fugl-Meyer Assessment (FMA) and Barthel Index (BI) before and after treatment, while the serum levels of dopamine (DA), 5-hydroxytryptamine (5-HT), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected with enzyme-linked immunosorbent assay. Resting-state functional magnetic resonance imaging (rs-fMRI) was applied to assess brain FC, as well as the global efficiency (Eg) and small-world property (σ) of brain networks.
Results The scores of HAMD-17, FMA and BI improved in both groups (t>2.922,P<0.01) after treatment, and improved more in the experimental group than in the control group (t>2.517,P<0.05). The serum levels of DA and 5-HT increased in both groups (t>2.637,P<0.05), and increased more in the experimental group (t>2.192,P<0.05). The serum levels of IL-6 and TNF-α decreased in the experimental group after treatment (t>4.059,P<0.001), and they were less than those in the control group (t>2.154,P<0.05). FC between left middle frontal gyrus and right anterior cingulate gyrus, as well as between left hippocampus and right precuneus were higher in the experimental group than in the control group after treatment (t>3.867,P<0.001), while Eg and σ increased in both groups (t>2.828,P<0.05), and they were higher in the experimental group (t>2.675,P<0.05).
Conclusion Combination of Taijiquan training is more effective on depressive symptoms, motor function and activities of daily living in PSD patients, which may be related to up-regulation of serum DA and 5-HT, reduction of inflammatory factors, enhancement of prefrontal-limbic system functional connectivity and optimization of brain network topological properties.

Key words: post-stroke depression, cluster scalp acupuncture, Taijiquan, functional connectivity, brain network topology

中图分类号:

R743.3

管昱杰, 刘可妍, 杨可钦, 梁玉林, 张金朋, 赵彬. 头穴丛刺联合太极拳对卒中后抑郁患者脑功能连接及网络拓扑的影响[J]. 《中国康复理论与实践》, 2026, 32(6): 621-630.

GUAN Yujie, LIU Keyan, YANG Keqin, LIANG Yulin, ZHANG Jinpeng, ZHAO Bin. Effect of cluster scalp acupuncture combined with Taijiquan on brain functional connectivity and network topology for patients with post-stroke depression[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(6): 621-630.

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组别	n	性别 (男/女)/n	年龄/岁	病程/d	疾病性质 (出血/梗死)/n	受教育年限/年	高血压/n	糖尿病/n	MMSE
对照组	20	7/13	66.51±8.50	35.50±11.50	4/16	9.50±2.65	19	18	28.20±1.01
试验组	20	9/11	64.50±8.50	38.50±13.90	5/15	8.50±3.59	17	16	28.75±0.85
χ²/t值		0.417	0.747	0.744	0.156	1.002	0.417	0.784	1.868
P值		0.519	0.460	0.462	0.693	0.323	0.292	0.376	0.070

组别	n	测试	$\stackrel{-}{\mathit{x}}\pm \mathit{s}$	t值	P值
对照组	20	前测	20.15±6.50	2.922	0.009
		后测	15.50±5.50
试验组	20	前测	20.90±6.73	5.047	<0.001
		后测	11.50±4.50
治疗前两组均值差			-0.75±2.10	0.357	0.723
治疗后两组均值差			4.00±1.59	2.517	0.016

组别	n	测试	$\stackrel{-}{\mathit{x}}\pm \mathit{s}$	t值	P值
对照组	20	前测	35.50±5.24	8.366	<0.001
		后测	46.27±6.50
试验组	20	前测	35.68±5.83	9.332	<0.001
		后测	52.50±8.50
治疗前两组均值差			-0.18±1.75	0.103	0.919
治疗后两组均值差			-6.23±2.39	2.604	0.013

组别	n	测试	$\stackrel{-}{\mathit{x}}\pm \mathit{s}$	t值	P值
对照组	20	前测	36.51±7.42	3.339	0.003
		后测	43.51±6.49
试验组	20	前测	38.51±6.50	4.741	<0.001
		后测	49.50±7.49
治疗前两组均值差			-2.00±2.20	0.907	0.370
治疗后两组均值差			-5.99±2.22	2.703	0.010

变量	组别	n	测试	$\stackrel{-}{\mathit{x}}\pm \mathit{s}$	t值	P值
DA/(ng·mL^-1)	对照组	20	前测	115.50±14.50	2.890	0.009
			后测	129.51±14.50
	试验组	20	前测	112.50±13.50	7.060	<0.001
			后测	142.50±15.50
	治疗前两组均值差			3.00±4.43	0.676	0.503
	治疗后两组均值差			-12.99±4.75	2.738	0.009
5-HT/(ng·mL^-1)	对照组	20	前测	58.51±6.51	2.637	0.016
			后测	64.95±7.48
	试验组	20	前测	59.50±6.49	5.146	<0.001
			后测	70.50±8.49
	治疗前两组均值差			-1.00±2.06	0.486	0.629
	治疗后两组均值差			-5.55±2.53	2.192	0.035
IL-6/(pg·mL^-1)	对照组	20	前测	19.50±5.50	1.843	0.081
			后测	15.92±5.50
	试验组	20	前测	20.50±6.50	4.245	<0.001
			后测	12.50±4.50
	治疗前两组均值差			-1.00±1.90	0.526	0.602
	治疗后两组均值差			3.42±1.59	2.154	0.038
TNF-α/(pg·mL^-1)	对照组	20	前测	25.50±6.09	1.914	0.071
			后测	21.50±5.50
	试验组	20	前测	25.50±6.50	4.059	<0.001
			后测	17.73±4.77
	治疗前两组均值差			0.00±1.99	0.001	1.000
	治疗后两组均值差			3.76±1.63	2.313	0.026

头穴丛刺联合太极拳对卒中后抑郁患者脑功能连接及网络拓扑的影响

Effect of cluster scalp acupuncture combined with Taijiquan on brain functional connectivity and network topology for patients with post-stroke depression

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变量	组别	n	测试	$\stackrel{-}{\mathit{x}}\pm \mathit{s}$	t值	P值
Eg	对照组	20	前测	0.173±0.008	4.778	0.002
			后测	0.185±0.006
	试验组	20	前测	0.177±0.006	6.511	<0.001
			后测	0.192±0.003
	治疗前两组均值差			-0.004±0.004	1.152	0.269
	治疗后两组均值差			-0.007±0.002	2.944	0.011
σ	对照组	20	前测	0.520±0.079	2.828	0.025
			后测	0.631±0.062
	试验组	20	前测	0.582±0.045	6.804	<0.001
			后测	0.723±0.074
	治疗前两组均值差			-0.062±0.032	1.948	0.072
	治疗后两组均值差			-0.092±0.034	2.675	0.018

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