穴位电针刺激脑功能磁共振成像对脑损伤神经功能恢复的监测  

Brain fMRI to monitor nerve function recovery after traumatic brain injury with acupoints electroacupuncture

作　　者：张子军[1] 张金平[1] 崔明[1] 江世标[1] 赵霆[1] 汤永祥[1] 钱振[1] 高萍[1] 

机构地区：[1]铜陵市人民医院神经外科,244009

出　　处：《安徽医学》2009年第8期879-882,共4页Anhui Medical Journal

基　　金：铜陵市科技局项目(06KJJ1207)

摘　　要：目的探讨脑损伤患者瘫侧足三里(ST36)和风市(GB31)联合穴位电针刺激功能磁共振成像监测患侧脑激活簇偏侧指数(laterality index,LI)改变对临床神经功能缺损恢复程度的评定价值。方法对恢复期可配合检查15例脑损伤致偏瘫的住院患者,选择瘫侧足三里和风市穴位进行电针刺激功能磁共振成像,运用t检验进行统计学分析得出刺激状态与静息状态信号对比的脑功能图。15例患者相隔14～49d后再进行1次功能磁共振成像对比检查。计算出每次的针灸对侧脑激活簇偏侧指数LI影响,LI=(C-I)/(C+I),C与I分别为针灸侧的对侧与针灸侧的同侧脑激活簇数目之和。同时,计算出同期相应的临床神经功能缺损评分值S(score)。统计分析2期LI值对比变化△L(ILI2-LI1)及其与S改变△S(S1-S2)的相关性。结果15例均获得2期检查的完整资料。15例共做43次功能磁共振成像,选择其中较优质30次脑功能图做统计分析。15例LI变化均有不同程度提高,但差异无统计学意义(t=1.304,P>0.05);△LI和△S均为正值,且△LI与△S呈正相关(r=0.959,P<0.001)。结论脑损伤患者瘫侧足三里和风市穴位联合电针刺激功能磁共振成像动态监测患侧脑激活簇LI改变△LI对脑损伤神经功能缺损恢复程度具有一定的评定价值。Objective To investigate the ssessment value of nerve function damage recovery degree by the brain activated areas ＂laterality index ＂ （LI） change of the eontralateral versus eleetroacupuneture lateral by brain functional MRI （fMRI） after electroacupuncture to the hemiplegia ipsilateral acupionts Zu san li （ST36） and Feng shi （GB31） for patients with traumatic brain injury during nerve function recovery stage. Methods Fifteen cooperative patients with severe hemiplegia caused by traumatic brain injury underwent fMRI during nerve function recovery stage. All the patients had received electroacupnncture of ipsilateral acupionts Zu san li （ST36） and Feng shi （GB31 ）. After stimulaion the activated areas in brain functional BOLD maps were analyzed by t-test analysis. A comparative study was made in nineteen patients received two times of fMRI at the interval 14-49 days. A ＂ laterality index ＂ （L I） of the contralateral versus electroacupuncture lateral was calculated （LI=（C-I）/（C＋I）, C and I are the activated number in the contralateral brain and that in the ipsilateral brain respectively）. Meanwhile, the assessment score of nerve function damage was calculated for every patient too. The correlation between between LI change ALI （LI2- LI1 ） and S change △S （S1-S2） was analyzed. Results Forty-three times of fMRI were achieved in 15 patients who received 2 times examination. Thirty maps were selected for statistics analysis. Among the thirty maps, Compared with the first fMRI, the LI value increased at the different degree, but no significance difference （t=-1.304 P〉0.05）. ALI and AS are all positive, and the correlation between ALI and A S was positive （r=-0.959,P〈0.001）. Conclusion Brain fMRI to dynamicly monitor the brain activated areas LI change A LI of contrelateral versus electroacupuncture lateral after electroacupuncture to acupoints Zu san li （ST36） and Feng shi （GB31） has the assessment value of nerve function recovery degree aft

关 键 词：穴位 电针 功能磁共振成像 脑损伤 

分 类 号：R246[医药卫生—针灸推拿学] R445.2[医药卫生—中医临床基础]