针灸治疗对脑梗死后运动功能和皮质脊髓束损伤效果的神经影像学观察

doi:10.3969/j.issn.1006-9771.2021.11.011

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (11): 1312-1317.doi: 10.3969/j.issn.1006-9771.2021.11.011

针灸治疗对脑梗死后运动功能和皮质脊髓束损伤效果的神经影像学观察

杨福霞¹,侯冬梅²,高进云¹(),古媚³,赵波沣¹(),曾旭梅¹,詹敏敏¹,谢敏娇¹,谢耀钦⁴

1.深圳市中医院,广东深圳市 518033
2.济南市人民医院,山东济南市 271100
3.深圳市人民医院,广东深圳市518001
4.中国科学院深圳先进技术研究院,广东深圳市 518001

收稿日期:2021-02-06 修回日期:2021-09-13 出版日期:2021-11-25 发布日期:2021-12-03
通讯作者: 高进云,赵波沣 E-mail:274117273@qq.com;zhaobf@126.com
作者简介:杨福霞(1976-),女,汉族,山东济南市人,博士,副主任医师,主要研究方向：针灸治病的临床与机制研究。
基金资助:
1. 国家中医药管理局全国老中医药专家学术经验继承工作项目(No. 国中医药人教发[2017]29号);2. 广东省自然科学基金项目(2018A030313975);3. 深圳市"医疗卫生三名工程"项目(SZSM201612001)

Effects of Acupuncture on Motor and Corticospinal Tract Impairment after Cerebral Infarction: Using Diffusion Tensor Imaging and Tractography

YANG Fu-xia¹,HOU Dong-mei²,GAO Jin-yun¹(),GU Mei³,ZHAO Bo-feng¹(),ZENG Xu-mei¹,ZHAN Min-min¹,XIE Min-jiao¹,XIE Yao-qin⁴

1. Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong 518033, China
2. Ji'nan People's Hospital, Ji'nan, Shandong 271100, China
3. Shenzhen People's Hospital, Shenzhen, Guangdong 518001, China
4. Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, Guangdong 518001, China

Received:2021-02-06 Revised:2021-09-13 Published:2021-11-25 Online:2021-12-03
Contact: GAO Jin-yun,ZHAO Bo-feng E-mail:274117273@qq.com;zhaobf@126.com
Supported by:
National Administration of Traditional Chinese Medicine Senior Chinese Medicine Experts Academic Experience Inheritance (No. [2017]29);Natural Science Foundation of Guangdong(2018A030313975);Shenzhen 3-Famous Project for Medical and Health Services(SZSM201612001)

摘要/Abstract

摘要：

目的观察调任通督针法对脑梗死皮质脊髓束(CST)损伤及肢体功能的影响。方法 2017年2月至2020年12月,深圳市中医院就诊脑梗死患者54例分层随机分为对照组(n = 27)和针刺组(n = 27),每组再根据CST受损分级分为1、2、3级亚组,每亚组各9例。两组均行常规药物治疗,针刺组加调任通督针法。治疗前和治疗4周后,采用Fugl-Meyer评定量表(FMA)和改良Barthel指数(MBI)进行评定,采用磁共振弥散张量成像及其纤维束成像获取梗死灶区CST损伤分级、DTI获取各向异性分数(FA)和健患侧FA比(rFA)。结果治疗后,两组各亚组FMA和MBI评分,FA和rFA均增加(t > 2.841, P < 0.05);针刺组各亚组FMA和MBI评分差值,FA和rFA差值均高于对照组对应亚组(t > 2.140, P < 0.05)。结论调任通督针法可促进脑梗死患者CST损伤恢复,从而促进运功功能恢复。

关键词: 脑梗死, 针刺, 弥散张量成像, 弥散张量纤维束成像, 运动, 皮质脊髓束

Abstract:

Objective To explore the effects of Tiaoren Tongdu Acupuncture on motor function and corticospinal tract (CST) remodeling after cerebral infarction.Methods From February, 2017 to December, 2020, 54 patients with cerebral infarction were randomly divided into control group (n = 27) and acupuncture group (n = 27), each group was divided into subgroups 1, 2 and 3 according to the impairment of corticospinal tract, with nine cases for each subgroup. All the patients received routine medicine, while the acupuncture group received Tiaoren Tongdu Acupuncture, for four weeks. They were assessed with Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) before and after treatment, and scanned with diffusion tensor imaging and diffusion tensor tractography, to obtain the fractional anisotropy (FA) and the bilateral FA ratio (rFA).Results The scores of FMA and MBI, and FA and rFA increased in both groups (t > 2.841, P < 0.05) after treatment, and increased more in the acupuncture group than in the control group (t > 2.140, P < 0.05).Conclusion Tiaoren Tongdu Acupuncture can promote the recovery of CST to improve motor function for patients with cerebral infarction.

Key words: cerebral infarction, acupuncture, diffusion tensor imaging, diffusion tensor tractography, motor, corticospinal tract

杨福霞,侯冬梅,高进云,古媚,赵波沣,曾旭梅,詹敏敏,谢敏娇,谢耀钦. 针灸治疗对脑梗死后运动功能和皮质脊髓束损伤效果的神经影像学观察[J]. 《中国康复理论与实践》, 2021, 27(11): 1312-1317.

YANG Fu-xia,HOU Dong-mei,GAO Jin-yun,GU Mei,ZHAO Bo-feng,ZENG Xu-mei,ZHAN Min-min,XIE Min-jiao,XIE Yao-qin. Effects of Acupuncture on Motor and Corticospinal Tract Impairment after Cerebral Infarction: Using Diffusion Tensor Imaging and Tractography[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(11): 1312-1317.

图/表 15

表1

表2

表3

表4

表5

表6

表7

表8

表9

表10

表11

表12

表13

图1

图2

参考文献 31

[1]	PARK E, LEE J, CHANG W H, et al. Microstructural integrity in white matter tracts and motor recovery following stroke based on brain-derived neurotrophic factor genotype[J]. Neural Plast, 2020, 2020:5742421.
[2]	杨福霞, 杨卓欣, 周玉梅, 等. 杨卓欣教授"调任通督"法治疗中风病撷要[J]. 中医药学报, 2020, 48(5):39-41.
	YANG F X, YANG Z X, ZHOU Y M, et al. Summary of stoke treated by professor YANG Zhuoxin with Tiaoren Tongdu Manipulation[J]. Acta Chin Med Pharmacol, 2020, 48(5):39-41.
[3]	UMAROVA R M, BEUME L, REISERT M, et al. Distinct white matter alterations following severe stroke: longitudinal DTI study in neglect[J]. Neurology, 2017, 88:1546-1555. doi: 10.1212/WNL.0000000000003843
[4]	凌晴, 胡世红, 王田尧, 等. 镜像疗法促进脑卒中上肢功能恢复和皮质脊髓束重塑的弥散张量成像研究[J]. 中国康复理论与实践, 2021, 27(1):31-36.
	LING Q, HU S H, WANG T R, et al. Effects of mirror therapy on upper limb motor function and corticospinal tract remodeling after stroke: a diffusion tensor imaging study[J]. Chin J Rehabil Theory Pract, 2021, 27(1):31-36.
[5]	中华神经科学会, 中华神经外科学会. 各类脑血管疾病诊断要点[J]. 中华神经科杂志, 1996, 29(6):379-380.
	Chinese Society of Neurology, Chinese Neurosurgical Society. Diagnosis of Cerebral Vascular Diseases[J]. Chin J Neurol, 1996, 29(6):379-380.
[6]	中华医学会神经病学分会脑血管病学组. 中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014[J]. 中华神经科杂志, 2015, 48(4):258-273.
	Neurology Division of Chinese Medical Association. Chin J Neurol, 2015, 48(4):258-273.
[7]	杨福霞. 杨卓欣教授"调任通督"针法理论在中风病中的应用[J]. 世界中医药, 2020, 15(15):2308-2311.
	YANG F X. Application of professor YANG Zhuoxin's acupuncture theory of "Regulating Conception Vessel and Unblocking Governor Vessel" in treating stroke[J]. World Chin Med, 2020, 15(15):2308-2311.
[8]	阮锦荣, 牛鹏, 彭永军, 等. 磁共振DTI及DTT评估脑梗塞皮质脊髓束损伤的临床应用研究[J]. 现代医用影像学, 2017, 26(3):559-563.
	RUAN J R, NIU P, PENG Y J, et al. Correlation study between prognosis and corticospinal tract injury of cerebralinfarction assessed by diffusion tensor imaging (DTl) and diffusion tensor teactography (DTT)[J]. Modern Med Imageol, 2017, 26(3):559-563.
[9]	KOCH P J, HUMMEL F C. Toward precision medicine: tailoring interventional strategies based on noninvasive brain stimulation for motor recovery after stroke[J]. Curr Opin Neurol, 2017, 30(4):388-397. doi: 10.1097/WCO.0000000000000462
[10]	QUANDT F, BÖNSTRUP M, SCHULZ R, et al. The functional role of beta-oscillations in the supplementary motor area during reaching and grasping after stroke: a question of structural damage to the corticospinal tract[J]. Hum Brain Mapp, 2019, 40(10):3091-3101.
[11]	CHULZ R, KOCH P, ZIMER M, et al. Parietofrontal motor pathways and their association with motor function after stroke[J]. Brain, 2015, 138(Pt 7):1949-1960. doi: 10.1093/brain/awv100
[12]	BOYD L A, HAYWARD K S, WARD N S, et al. Biomarkers of stroke recovery: consensus-based core recommendations from the stroke recovery and rehabilitation roundtable[J]. Neurorehabil Neural Repair, 2017, 31(10-11):864-876. doi: 10.1177/1545968317732680
[13]	PUIG J, BLASCO G, SCHLAUG G, et al. Diffusion tensor imaging as a prognostic biomarker for motor recovery and rehabilitation after stroke[J]. Neuroradiology, 2017, 59(4):343-351. doi: 10.1007/s00234-017-1816-0
[14]	DOBKIN B H, DORSCH A. New evidence for therapies in stroke rehabilitation[J]. Curr Atheroscler Rep, 2013, 15:331. doi: 10.1007/s11883-013-0331-y
[15]	CRAMER S C, SUR M, DOBKIN B H, et al. Harnessing neuroplasticity for clinical applications[J]. Brain, 2011, 134:1591-1609. doi: 10.1093/brain/awr039
[16]	KOLB B, TESKEY G C, GIBB R. Factors influencing cerebral plasticity in the normal and injured brain[J]. Front Hum Neurosci, 2010, 4:204.
[17]	GROISSER B N, COPEN W A, SINGHAL A B, et al. Corticospinal tract diffusion abnormalities early after stroke predict motor outcome[J]. Neurorehabil Neural Repair, 2014, 28(8):751-760. doi: 10.1177/1545968314521896
[18]	NAKASHIMA A, MORIUCHI T, MITSUNAGA W, et al. Prediction of prognosis of upper-extremity function following stroke-related paralysis using brain imaging[J]. J Phys Ther Sci, 2017, 29:1438-1443. doi: 10.1589/jpts.29.1438
[19]	OEY N E, SAMUEL G S, LIM J K, et al. Whole brain white matter microstructure and upper limb function: longitudinal changes in fractional anisotropy and axial diffusivity in post-stroke patients[J]. J Cent Nerv Syst Dis, 2019, 11:1179573519863428.
[20]	ZOLKEFLEY M K I, FIRWANA Y M S, HATTA H Z M, et al. An overview of fractional anisotropy as a reliable quantitative measurement for the corticospinal tract (CST) integrity in correlation with a Fugl-Meyer Assessment in stroke rehabilitation[J]. J Phys Ther Sci, 2021, 33(1):75-83. doi: 10.1589/jpts.33.75
[21]	MADHAVAN S, KRISHNAN C, JAYARAMAN A, et al. Corticospinal tract integrity correlates with knee extensor weakness in chronic stroke survivors[J]. Clin Neurophysiol, 2011, 122(8):1588-1594. doi: 10.1016/j.clinph.2011.01.011
[22]	QIU M, DARLING W G, MORECRAFT R J, et al. White matter integrity is a stronger predictor of motor function than BOLD response in patients with stroke[J]. Neurorehabil Neural Repair, 2011, 25(3):275-284. doi: 10.1177/1545968310389183
[23]	王诗卉, 翟建, 朱超, 等. DTI在脑梗死患者住院治疗前后的应用研究[J]. 中国CT和MRI杂志, 2020, 18(6):18-21.
	WANG S H, ZHAI J, ZHU C, et al. Application of DTI in patients with cerebral infarction before and after hospitalization[J]. Chin J CT MRI, 2020, 18(6):18-21.
[24]	杨福霞, 杨卓欣, 于海波, 等. 调任通督针法治疗脑梗塞恢复期患者的临床观察[J]. 针灸临床杂志, 2012, 27(4):48-49.
	YANG F X, YANG Z X, YU H B, et al. Regulating and Unblocking Acupuncture Therapy in the treatment of patients with convalescent cerebral infarction[J]. J Clin Acup Moxib, 2012, 27(4):48-49.
[25]	陈艳萍. 调任通督针法治疗脑梗塞恢复期患者的临床观察[J]. 光明中医, 2015, 30(2):324-326.
	CHEN Y P. Regulating and Unblocking Acupuncture Therapy in the treatment of patients with convalescent cerebral infarction[J]. Guangming J Chin Med, 2015, 30(2):324-326.
[26]	杨卓欣, 于海波, 杨福霞, 等. 应用逆转录病毒pLXSN-EGFP示踪观察电针任脉对MCAO大鼠SVZ区NSC增殖的影响[J]. 中华中医药学刊, 2010, 28(1):10-12.
	YANG Z X, YU H B, YANG F X, et al. Study on the effects of electroacupuncture at the Ren channel on proliferation of neural stem cells in the subventricular zone by retrovirus plasmid pLXSN-EGFP tracer technique in brain ischemia rats[J]. Chin Arch Chin Med, 2010, 28(1):10-12.
[27]	杨福霞, 杨卓欣, 于海波, 等. 电针任脉对脑缺血后大鼠神经干细胞增殖影响的研究[J]. 中国中医药科技, 2010(3):188-189.
	YANG F X, YANG Z X, YU H B, et al. Study on effect of electro-acupuncture on Ren channel on neural stem cells proliferation of in rats with cerebral ischemia[J]. Chin J Trad Med Sci Technol, 2010(3):188-189.
[28]	王娇予, 张海峰. 针刺督脉经穴为主对缺血性脑卒中皮质脊髓束重塑及康复的影响[J]. 新中医, 2019, 51(7):228-231.
	WANG J Y, ZHANG H F. Clinical observation on effect of acupuncture at channel points of Governor Vessel on ischemic stroke and corticospinal tract remodeling and rehabilitation[J]. J New Chin Med, 2019, 51(7):228-231.
[29]	刘建华, 魏清川, 胡秀茹, 等. 弥散张量成像各向异性分数与缺血性脑卒中患者上肢运动功能的相关性[J]. 中国康复理论与实践, 2020, 26(7):749-752.
	LIU J H, WEI Q C, HU X R, et al. Relationship between fractional anisotropy of diffusion tensor imaging and motor function after ischemic stroke[J]. Chin J Rehabil Theory Pract, 2020, 26(7):749-752.
[30]	王云柯. 磁共振弥散张量成像在评估脑梗死患者运动功能康复治疗效果中的应用价值[J]. 影像技术, 2020, 32(1):42-44.
	WANG Y K. Application value of magnetic resonance diffusion tensor imaging in evaluating rehabilitation effect of motor function in patients with cerebral infarction[J]. Imag Technol, 2020, 32(1):42-44.
[31]	郭龙军, 陈忠伟, 滕佳岐, 等. 磁共振DTI技术在评估脑梗死患者运动功能康复治疗效果中的研究[J]. 中国CT和MRI杂志, 2017, 15(2):1-3.
	GUO L J, CHEN Z W, TENG J Q, et al. A study on magnetic resonance DTI technique in evaluating the effect of motor function rehabilitation in patients with cerebralinfarction[J]. Chin J CT MRI, 2017, 15(2):1-3.

组别	n	性别(男/女, n)	年龄(岁)	病程(d)	偏瘫侧(左/右, n)	利手(右/左, n)
对照组	27	15/12	61.24±16.51	55.64±23.01	16/11	24/3
针刺组	27	14/13	63.36±19.07	65.23±25.04	14/13	25/2
χ²/t值		0.074	0.435	0.701	0.300	0.220
P值		0.785	0.664	0.486	0.584	0.639

组别	n	治疗前	治疗后	治疗前后差	t值^a	P值^a
对照组	9	75.9±12.7	93.3±5.4	15.5±3.5	17.330	< 0.001
针刺组	9	77.8±8.4	94.9±5.4	19.0±3.5	19.331	< 0.001
t值		0.377		2.140
P值		0.711		0.048

组别	n	治疗前	治疗后	治疗前后差	t值^a	P值^a
对照组	9	64.1±18.9	74.4±21.7	11.6±2.2	4.793	0.004
针刺组	9	62.8±19.3	84.6±23.3	14.1±2.6	12.810	< 0.001
t值		0.154		2.163
P值		0.879		0.046

组别	n	治疗前	治疗后	治疗前后差	t值^a	P值^a
对照组	9	35.06±7.91	44.53±15.83	5.27±2.42	3.085	0.015
针刺组	9	39.26±9.15	45.53±13.56	10.47±3.57	6.788	< 0.001
t值		1.042		3.617
P值		0.313		0.002

组别	n	治疗前	治疗后	治疗前后差	t值^a	P值^a
对照组	9	74.0±12.5	90.0±8.5	13.1±5.1	16.560	< 0.001
针刺组	9	76.9±11.2	92.2±8.8	18.2±5.0	18.840	< 0.001
t值		0.159		2.155
P值		0.731		0.047

针灸治疗对脑梗死后运动功能和皮质脊髓束损伤效果的神经影像学观察

Effects of Acupuncture on Motor and Corticospinal Tract Impairment after Cerebral Infarction: Using Diffusion Tensor Imaging and Tractography

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 15

参考文献 31

相关文章 15

Metrics

本文评价

推荐阅读 0

组别	n	治疗前	治疗后	治疗前后差	t值^a	P值^a
对照组	9	61.5±11.9	73.3±14.8	12.7±3.8	13.001	< 0.001
针刺组	9	60.6±10.4	78.3±14.3	16.8±4.3	14.880	< 0.001
t值		0.160		2.154
P值		0.875		0.046

组别	n	治疗前	治疗后	治疗前后差	t值^a	P值^a
对照组	9	36.54±9.53	45.33±15.92	7.58±2.45	6.831	< 0.001
针刺组	9	37.75±12.57	47.59±10.59	11.05±4.03	11.380	< 0.001
t值		0.230		2.207
P值		0.820		0.042

组别	n	治疗前	治疗后	治疗前后差	t值^a	P值^a
对照组	9	0.63±0.24	0.71±0.22	0.08±0.02	6.240	< 0.001
针刺组	9	0.63±0.25	0.74±0.23	0.11±0.03	7.709	< 0.001
t值		0.017		2.250
P值		0.986		0.039

组别	n	治疗前	治疗后	治疗前后差	t值^a	P值^a
对照组	9	0.50±0.28	0.56±0.32	0.05±0.02	4.453	0.006
针刺组	9	0.51±0.31	0.58±0.30	0.08±0.03	6.650	< 0.001
t值		0.022		2.153
P值		0.982		0.047

组别	n	治疗前	治疗后	治疗前后差	t值^a	P值^a
对照组	9	0.30±0.17	0.33±0.18	0.03±0.01	2.841	0.022
针刺组	9	0.31±0.16	0.34±0.18	0.04±0.02	4.882	0.001
t值		0.026		2.229
P值		0.979		0.041

组别	n	治疗前	治疗后	治疗前后差	t值^a	P值^a
对照组	9	0.70±0.20	0.84±0.28	0.13±0.02	12.250	< 0.001
针刺组	9	0.71±0.25	0.87±0.19	0.17±0.03	21.530	< 0.001
t值		0.056		2.325
P值		0.955		0.034

组别	n	治疗前	治疗后	治疗前后差	t值^a	P值^a
对照组	9	0.559±0.201	0.635±0.259	0.077±0.022	5.678	< 0.001
针刺组	9	0.558±0.274	0.661±0.174	0.102±0.026	8.267	< 0.001
t值		0.009		2.202
P值		0.993		0.043

组别	n	治疗前	治疗后	治疗前后差	t值^a	P值^a
对照组	9	0.347±0.162	0.376±0.176	0.035±0.012	3.944	0.004
针刺组	9	0.341±0.139	0.397±0.169	0.050±0.017	8.397	< 0.001
t值		0.084		2.163
P值		0.933		0.046

[1]	周治宁, 周容, 肖燕文, 王博文, 吕娇娇, 刘宇. 多靶区经颅直流电刺激对健康成年人工作记忆-姿势控制双任务表现的影响[J]. 《中国康复理论与实践》, 2024, 30(1): 21-28.
[2]	林娜, 高菡璐, 卢惠苹, 陈燕清, 郑军凡, 陈述荣. 虚拟现实技术对脑卒中上肢功能影响的弥散张量成像研究[J]. 《中国康复理论与实践》, 2024, 30(1): 61-67.
[3]	陈珺雯, 陈谦, 陈程, 李淑月, 刘玲玲, 吴存书, 龚翔, 鲁俊, 许光旭. 改良八段锦身体活动对脑卒中患者心肺功能、运动功能和日常生活活动能力的效果[J]. 《中国康复理论与实践》, 2024, 30(1): 74-80.
[4]	魏梦力, 钟亚平, 周易文, 桂辉贤, 关烨明, 于婷婷. 单侧前交叉韧带重建患者步行双侧下肢肌肉协同模式差异[J]. 《中国康复理论与实践》, 2024, 30(1): 95-104.
[5]	张冠聪, 黄秋晨, 顾蕊, 刘四海, 胡春英, 刘克敏. 不同神经肌肉训练方法对早期膝骨关节炎患者疼痛和运动功能效果的比较[J]. 《中国康复理论与实践》, 2023, 29(9): 1090-1097.
[6]	孙藤方, 任梦婷, 杨琳, 王耀霆, 王红雨, 闫兴洲. 高压氧治疗联合重复外周磁刺激干预脑卒中患者踝运动功能和平衡能力的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 875-881.
[7]	王亚楠, 刘西花. 脑卒中偏瘫患者主观和客观平衡功能测量的相关性及预测效能[J]. 《中国康复理论与实践》, 2023, 29(8): 890-895.
[8]	魏晓微, 杨剑, 魏春艳, 贺启令. 学校环境下适应性体育课程促进智力与发展性残疾儿童心理运动发展的系统综述[J]. 《中国康复理论与实践》, 2023, 29(8): 910-918.
[9]	王海云, 王寅, 周信杰, 何爱群. 基于“中枢-外周-中枢”理论的经颅直流电刺激结合针刺干预脑卒中患者中枢及上肢功能的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 919-925.
[10]	陈怡婷, 王倩, 崔慎红, 李映彩, 张思鈺, 魏衍旭, 任慧, 冷军, 陈斌. 双侧序贯重复经颅磁刺激干预脑卒中患者上肢运动功能的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 926-932.
[11]	武广艳, 张冉, 王璐, 于歌, 陈亚平. 核心肌群运动控制训练对产后腹直肌分离的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 948-953.
[12]	陈渔, 郭峰, 郭建瑞, 董彤彤, 夏雪莲. 镜像视觉反馈训练中大脑运动皮质激活的脑电特征研究[J]. 《中国康复理论与实践》, 2023, 29(8): 967-976.
[13]	李子怡, 宋为群, 杜巨豹, 曹光磊, 张艳明, 李冉. 运动表象训练对膝关节单髁置换术后膝关节功能的效果[J]. 《中国康复理论与实践》, 2023, 29(7): 745-749.
[14]	唐流泉, 彭兴云. 血流限制下运动对绝经后慢性阻塞性肺疾病患者脆性骨折部分危险因素的疗效[J]. 《中国康复理论与实践》, 2023, 29(7): 761-769.
[15]	韩亚兵, 刘少青, 李新通, 梁馨文, 罗敬, 李婷, 潘玮敏. 髋部神经肌肉训练对女子足球运动员前交叉韧带损伤风险的影响[J]. 《中国康复理论与实践》, 2023, 29(7): 770-776.