针刺对严重脑损伤患者脑血流灌注及脑功能活动的影响  

Effect of acupuncture on the blood stream perfusion and functional activities of brain in paitents with severe brain injury

作　　者：单爱军[1] 尹卫[2] 王照康[3] 贾少微[2] 

机构地区：[1]暨南大学医学院第二附属医院神经外科,广东省深圳市518020 [2]北京大学深圳医院神经外科,广东省深圳市518020 [3]东莞市太平人民医院外科,广东省东莞市523761

出　　处：《中国临床康复》2004年第25期5312-5313,共2页Chinese Journal of Clinical Rehabilitation

基　　金：深圳市卫生科技计划项目(200004049);广东省自然科学基金项目(990962);国家中医药管理局中医药科学技术研究基金项目(00-01LP12)~~

摘　　要：目的:应用单光子发射型计算机体层摄影术(singlephotonemissioncom-puterizedtomography,SPECT)观察针刺对患者脑血流灌注和脑功能活动的影响,为临床应用提供量化数据。方法:严重脑损害昏迷患者17例,以韩氏穴位神经刺激仪电针患肢合谷、曲池、足三里和三阴交穴。使用SiemensECAM/ICONSPECT系统,同一患者同体位下,40min之内连续接受针刺前和电针状态下2次SPECT脑灌注显像。用可视化分析和BFCR%数学模型半定量分析,比较针刺前后脑病灶血流灌注和功能活动的改变。结果:17例电针治疗后病灶都有不同程度的缩小,BFCR%增高。电针刺时病灶与对侧相应区域脑/全脑比值分别为(9.84±2.02),(12.93±3.43)差异有非常显著性意义(t=4.22,P<0.01)、电针时与针刺前病灶侧脑/全脑比值(7.40±2.08)比较差异有非常显著性意义(t=9.06,P<0.01)。对侧相应区域脑/全脑比值较电针前(12.68±2.44)亦有增高,但差异无显著性意义(t=0.663,P>0.05)结论:针刺治疗可以改善病灶区的脑血流灌注和脑细胞的功能,激发脑细胞活性。AIM:To observe the effects of acupuncture therapy in ameliorating blood stream perfusion and functional activities of brain in patients with severe brain damage by single photon emission computerized tomography(SPECT),so as to provide quantitative data for clinical application. METHODS:Seventeen unconscious patients with severe brain damage were treated with electroacupuncture at hegu(LI 4),quchi(LI 11),zusanli(St 36) and sanyinjiao(Sp 6) acupoints by using the Han acupoint neurostimulation machine.The twice SPECT brain perfusion images within 40 minutes before and during acupuncture were analyzed quantitatively by using the Siemens ECAM/ICON SPECT in the same patient without changing posture.The changes of focal blood stream and functional activities of brain before and after acupuncture therapy were analyzed both visually and BFCR%modeling semi-quantitatively. RESULTS:After electroacupuncture,the focuses were decreased to different degree,and BFCR%was increased in all the 17 cases.During electroacupuncture,the ratio of focal brain to the whole brain(9.84±2.02) had very significant difference from the ratio of the counterpart brain of the other side to the whole brain(12.93±3.43) (t=4.22,P< 0.01).The ratio of focal brain to the whole brain during electroacupuncture was very significantly different from that before acupuncture(7.40±2.08)(t=9.06,P< 0.01).The ratio of the counterpart brain of the other side to the whole brain was also increased insignificantly as compared with that before acupuncture(12.68±2.44) (t=0.663, P >0.05). CONCLUSION:Acupuncture therapy can improve the brain blood stream perfusion and cell function of focal area, and stimulate the activity of brain cells.

关 键 词：针刺 严重脑损伤 脑血流灌注 脑功能活动 单光子发射型计算机体层摄影术 

分 类 号：R269.511.5[医药卫生—中西医结合] R245[医药卫生—中医外科学]