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

Abstract

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

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.

Figures/Tables 15

References 31

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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

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

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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

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