摘要
目的探讨rTMS(Repeated Transcranial Magnetic Stimulation,重复经颅磁刺激)联合针刺对缺血性卒中患者血清代谢物调节作用的影响,从代谢物层面探究该治疗方法的作用特点。方法招募缺血性卒中患者,按照真实世界临床场景中患者实际接受的治疗方式,分到暴露组(rTMS联合针刺治疗)和对照组(接受针刺治疗)。两组患者每周6次治疗,持续2周。基于代谢组学平台,测定暴露组治疗前后,对照组治疗前后的血清代谢组学,得到原始谱图与原始数据。观察暴露组治疗前后、对照组治疗前后、两组治疗前、两组治疗后是否存在差异。之后通过统计分析筛选出组间差异代谢物。结果筛选缺血性卒中患者53例,纳入43例,接受首次抽血11例,拒绝二次抽血5例,其中暴露组2例,对照组3例,最终暴露组3例,对照组3例,共6例纳入统计分析。暴露组治疗前后血清代谢组学分析提示3种血清差异代谢物,其中去甲氧胆酸、β-脱氧胆酸上调,3_甲基戊酸下调。对照组治疗前后血清代谢组学分析提示3种血清差异代谢物,其中吡咯_2_羧酸上调,棕榈酸、吲哚_3_羧酸下调。对照组与暴露组治疗前差异不大,治疗后与对照组相比,暴露组血清代谢组学分析提示11种血清差异代谢物,其中葡萄糖6_磷酸、扁桃酸、吡啶甲酸、鸟苷酸、猪去氧胆酸、牛磺脱氧胆酸、12_羟基硬脂酸、熊去氧胆酸、水杨酸上调,磷酸核糖、2,3_二氨基丙酸下调。结论与单纯针刺治疗后相比,rTMS联合针刺治疗后显示出磷酸戊糖途径、糖异生/糖酵解、嘌呤代谢的主要生物标志物变化,提示rTMS联合针刺比单纯针刺治疗可能对缺血性卒中患者发挥了更多的神经保护、炎症调节与免疫调节作用。
Objective To explore the effect of repeated transcranial magnetic stimulation(rTMS) combined with acupuncture on the regulation of serum metabolites in patients with ischemic stroke, and to explore the characteristics of the treatment from the perspective of metabolites.Methods Patients with ischemic stroke were recruited.According to the treatment methods actually accepted by patients in the real-world clinical scene, patients with ischemic stroke were divided into the exposure group(rTMS combined with acupuncture) and the control group(acupuncture). The two groups were treated 6 times a week for 2 weeks. Based on metabonomics platform, the serum metabonomics of the exposure group before and after treatment and the control group before and after treatment were measured, and the original spectrogram and original data were obtained.We observed the differences before and after treatment in exposure group and control group respectively, as well as differences between the two groups both before and after treatment. After that,the different metabolites were selected by statistical analysis. Results 53 patients with ischemic stroke were selected and 43 patients were included. There were 11 patients who received the first blood drawing. 5 patients refused to take blood again, including 2 patients in the exposure group and 3 patients in the control group. Finally,there were 3 patients in the exposure group and 3 patients in the control group. A total of 6 cases were included in the statistical analysis.In the exposure group, three kinds of serum metabolites were found by serum metabonomics analysis after treatment, in which Nordeoxycholic acid and Beta_Deoxycholic acid presented up-regulated, and 3_Methylpentanoic acid presented down-regulated. Three kinds of serum metabolites were found in the control group by metabonomics analysis after treatment, Pyrrole_2_carboxylic acid presented up-regulated, Palmitelaidic acid and Indole_3_carboxylic acid presented down-regulated. At the baseline, there was no significant differen
作者
曹玉婷
杨娅婕
赵宁
Cao Yuting;Yang Yajie;Zhao Ning(Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen 518000,China;The 6th Affiliated Hospital of Shenzhen University,Shenzhen 518000,China;Hunan University of Traditional Chinese Medicine,Changsha 410000,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2021年第11期4327-4337,共11页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
国家自然科学基金委员会常规面上项目(81874499):基于胼胝体网络的头针联合rTMS改善卒中后运动功能的多模态神经影像研究,负责人:赵宁
华中科技大学协和深圳医院(南山医院)院内课题(2019004):基于核磁共振代谢组技术研究头针联合低频rTMS改善卒中后运动功能的中枢响应机制,负责人:赵宁。
关键词
缺血性卒中
经颅磁刺激
针刺
血清代谢组
Ischemicstroke
Transcranial magnetic stimulation
Acupuncture
Serum metabonomics
