摘要
目的:探讨血氧水平依赖功能磁共振成像(BOLD-fMRI)技术在评价电针治疗对缺血性中风患者静息状态下脑功能的临床应用。方法:选取2016年1月-2018年1月本院神经内科及康复科接受住院治疗的缺血性中风患者共60例,另纳入同期健康对照者20例为A组,再根据治疗方法将缺血性中风患者分为B组(n=28,采用常规治疗)和C组(n=32,采用常规治疗联合针刺治疗)。比较B、C组的神经功能缺损(CSS评分)、肢体运动功能(FMA评分)、日常生活能力(BI指数),于治疗12周采用BOLD-fMRI检测三组受检者的脑功能状态。结果:治疗第4、12周,B、C组的CSS评分、FMA评分、BI指数均较治疗前改善,且治疗第12周均优于治疗第4周,差异均有统计学意义(P<0.05);治疗第4、12周,B组的CSS评分均低于C组,FMA评分、BI指数均高于C组,差异均有统计学意义(P<0.05);B、C组脑ReHo增高值区域主要为颜下回、扣带回前部、尾状核、右额内侧回、壳核、双侧海马、苍白球、右穹窿回、小脑前叶、小脑蚓部;A、B组脑ReHo增高值区域主要为颜下回、右杏仁核双侧边缘叶、右额内侧回、壳核、双侧海马、右苍白球、右穹窿回;A、C组脑ReHo增高值区域主要为扣带回前部、尾状核、壳核、苍白球、小脑前叶、小脑蚓部。结论:电针能显著加强缺血性中风患者各个脑功能区的联系,从而改善患者的神经功能缺损程度,提高其日常生活能力。
Objective:To explore the clinical application of BOLD-fMRI in evaluating the resting brain function of patients with ischemic stroke treated by electroacupuncture.Method:A total of 60 patients with ischemic stroke who underwent hospitalization in our Department of Neurology and Rehabilitation from January 2016 to January 2018 were enrolled,another 20 healthy controls in the same period were selected as A group,according to the treatment methods,the patients with ischemic stroke were divided into B group(n=28,routine treatment)and C group(n=32,routine treatment combined with electroacupuncture treatment).The neurological deficit(CSS score),limb motor function(FMA score)and activity of daily living(BI index)were compared between B and C groups,the brain function of three groups was detected by BOLD-fMRI at 12 weeks after treatment.Result:At treatment 4th and 12th week,the CSS score,FMA score and BI index of B and C groups were improved compared with those before treatment,and the 12th week of treatment were better than those of 4th week of treatment,the differences were statistically significant(P<0.05).At treatment 4 th and 12 th week,the CSS score of B group were lower than those of C group,FMA score and BI index were higher than those of C group,the differences were statistically significant(P<0.05).The areas of increased ReHo in B and C groups were mainly inferior facial gyrus,anterior cingulate gyrus,caudate nucleus,right medial frontal gyrus,putamen,bilateral hippocampus,globus pallidus,right fornix gyrus,anterior cerebellar lobe and cerebellar vermis.The areas of increased ReHo in A and B groups were mainly inferior facial gyrus,bilateral marginal lobe of right amygdala,right medial frontal gyrus,putamen,bilateral hippocampus,right globus pallidus and right fornix gyrus.The areas of increased ReHo in A and C groups were mainly anterior cingulate gyrus,caudate nucleus,putamen,globus pallidus,anterior cerebellar lobe and vermis cerebellum.Conclusion:Electroacupuncture can significantly strengthen the connectio
作者
牛鹏
黎希年
曾纪超
NIU Peng;LI Xinian;ZENG Jichao(Yangjiang Traditional Chinese Medicine Hospital,Yangjiang 529500,China)
出处
《中国医学创新》
CAS
2019年第7期147-150,共4页
Medical Innovation of China
基金
阳江市医疗卫生科技计划项目(社发[2016]27)
