功能磁共振成像对针刺联合中医药治疗脑梗死疗效评价  

Evaluation of fMRI functional imaging in the curative effect of the acupuncture combined with traditional Chinese medicine in the treatment for patient with cerebral infarction

作　　者：赵波沣[1] 胡元明[1] 陈树平[1] 

机构地区：[1]深圳市中医院放射影像科,广东深圳518033

出　　处：《中国医学装备》2017年第7期72-75,共4页China Medical Equipment

基　　金：深圳市卫计委2015年基金项目(201501039)"fMRI功能成像对脑梗塞针药结合治疗前后对比研究"

摘　　要：目的:观察针刺联合中医药干预治疗前后脑梗死患者功能磁共振成像(f MRI)相应检测数据的变化,探讨其与临床疗效评价之间关系。方法:选取40例脑梗死患者,采用随机数表法将脑梗死患者分为常规治疗的对照组和针刺中药联合治疗的观察组,每组20例,两组患者于治疗前后分别进行病情评测及f MRI检查,使用美国国立卫生研究所脑卒中(NIHSS)评分对神经功能缺损程度进行评价,分析基底节脑梗死患者针刺联合药物治疗前后f MRI影像学表现,利用血氧水平依赖(BOLD)、f MRI及弥散张量成像(DTI)等脑功能成像技术了解患者在治疗中和治疗后相应机体功能区及其功能连接的不同脑区间在脑梗死患者针刺治疗前后的变化。结果:观察组的NIHSS评分明显少于对照组,差异有统计学意义(t=5.450,P<0.05);观察组治疗总有效率为95.0%明显高于对照组的75.0%,两组比较差异有统计学意义(x2=4.329,P<0.05);观察组激活频率、激活体积、平均表观弥散系数(ADCavg)值和各向异性分数(FA)值与对照组存在明显差异,具有统计学意义(t=5.425,t=2.760,t=3.453,t=5.513;P<0.05)。结论:针刺中药联合治疗可以有效的改善脑梗死患者的神经功能缺损,而且f MRI检查可以更好地观察患者治疗前后的临床疗效。Objective： To explore the relationship between the combinative intervention therapy and clinical curative effect, through used function magnetic resonance imaging（f MRI） to observe the change of detection data for patients with cerebral infarction pre and post-intervention therapy of acupuncture combined with traditional Chinese medicine（TCM）. Methods： 40 patients with cerebral infarction were divided into control group（20 cases, received normal treatment）and observation group（20 cases, received combinative treatment of acupuncture and TCM）. Pre and post therapy, the patients of every group received evaluation about state of illness and detection of f MRI. The score of national institute of health stroke scale（NIHSS） was used to evaluate the degree of neurologic impairment, and analyze the imaging manifestations of f MRI on patients with cerebral infarction at basal ganglia who received acupuncture combined with TCM. Some cerebral functional imaging techniques, included blood oxygenation level dependent（ BOLD）, f MRI and diffusion tensor imaging（DTI）, were used to grasp the changes of relevant functional region of brain and different brain regions connected with function region of patients with cerebral infarction before and after therapy. Results： The NIHSS score of observation group was significantly less than that of the control group（t=5.450, P〈0.05）, and the total efficiency of observation group（95%） was significantly higher than that of the control group（75%）（χ^2=4.329, P〈0.05）. And the differences of the activation frequency, activation volume, ADCavg values and the values of FA between the observation group and the control group were statistically significant（t=5.425, 2.760, 3.453, 5.513, P〈0.05）. Conclusion： Acupuncture combined with traditional Chinese medicine can efficiently improve the status of neurologic impairment for patients with cerebral infarction, and the clinical efficacy before and after treatment can preferably be observed by f

关 键 词：脑梗死 功能磁共振成像(fMRI) 针刺 中药 临床疗效 

分 类 号：R445.2[医药卫生—影像医学与核医学]