磁共振评价“三通针法”对脊髓损伤患者脑功能的影响  

Effect of“three-tong acupuncture”on brain function of patients with spinal cord injury based on magnetic resonance technology

作　　者：闵友江[1,2] 姚海华 孙洁 周璇 余航 孙前谱[5] 洪恩四[1] Min Youjiang;Yao Haihua;Sun Jie;Zhou Xuan;Yu Hang;Sun Qianpu;Hong Ensi(Acupuncture Department,Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330006,Jiangxi Province,China;Department of Traditional Chinese Medicine,The Eighth People’s Hospital of Shanghai,Shanghai 200235,China;Department of Acupuncture,Yingtan Hospital of Traditional Chinese Medicine,Yingtan 335000,Jiangxi Province,China;Rehabilitation Department,Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330006,Jiangxi Province,China;Radiology Department,Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330006,Jiangxi Province,China)

机构地区：[1]江西中医药大学附属医院针灸科,江西省南昌市330006 [2]上海市第八人民医院中医科,上海市200235 [3]鹰潭市中医院针灸科,江西省鹰潭市335000 [4]江西中医药大学附属医院康复科,江西省南昌市330006 [5]江西中医药大学附属医院放射科,江西省南昌市330006

出　　处：《中国组织工程研究》2021年第29期4600-4607,共8页Chinese Journal of Tissue Engineering Research

基　　金：江西省科技厅支撑计划(20132BBG70060),项目负责人:闵友江;国家自然科学基金青年项目(81904289),项目负责人:姚海华。

摘　　要：背景:研究表明,脊髓损伤后脑功能会发生改变,针灸治疗对不完全性脊髓损伤有较好的疗效,针灸能否影响脊髓损伤患者脑功能的重塑值得研究。目的:探讨“三通针法”对脊髓损伤患者脑功能的影响。方法:将符合纳入标准的20例脊髓损伤患者随机分为针灸组(n=10)和药物组(n=10)。针灸治疗取大椎、腰阳关及双侧次髎、足三里等,电针选择疏密波,持续时间30 min,每天1次;药物组予以单唾液酸四己糖神经节苷脂钠60 mg静脉注射,每天1次;4周为1疗程,疗程间隔休息7 d,共治疗2个疗程。试验于2014-03-11经江西中医药大学附属医院伦理审查委员会批准,伦理批号:2014031107。结果与结论:①两组患者治疗后感觉评分、运动评分、日常生活活动能力评分、美国脊髓损伤协会分级均较治疗前明显好转,且两组间感觉评分、运动评分、日常生活活动能力评分、美国脊髓损伤协会分级差异无显著性意义;②两组患者治疗后双侧主感觉运动皮质低频振荡振幅较治疗前明显增高,而双侧尾状核低频振荡振幅则较治疗前下降,且治疗后两组不同脑区低频振荡振幅结果接近;③两组患者治疗后双侧中央前回/中央后回与颞中回/颞下回局部一致性均较治疗前明显升高,而双侧丘脑、尾状核局部一致性较治疗前明显降低,治疗后两组上述脑区局部一致性接近;④两组患者治疗后大脑白质纤维束在内囊后肢及放射冠区各向异分数较治疗前升高,平均扩散系数较治疗前下降;除右侧放射冠外,两组其他部位各向异分数和平均扩散系数的治疗前后差值差异有显著性意义;⑤结果提示“三通针法”能改善脊髓损伤患者脑功能重塑,可能是针灸治疗脊髓损伤的作用机制之一。BACKGROUND:Studies have shown that brain function changes after spinal cord injury,and acupuncture treatment has a good effect on incomplete spinal cord injury.Whether acupuncture can affect the remodeling of brain function in patients with spinal cord injury is worth studying.OBJECTIVE:To investigate the effect of"three-tong acupuncture"on brain function in patients with spinal cord injury.METHODS:Twenty spinal cord injury patients who met the inclusion criteria were randomly divided into acupuncture treatment group(n=10)and drug treatment group(n=10).Acupoints of Dazhui,Yaoyangguan,Ciliao,Zusanli and etc.were selected and dilatation wave was selected for electroacupuncture which lasted for 30 minutes,once a day.In the drug treatment group,monosialotetrahexosyl ganglioside sodium was intravenously administered with the dose of 60 mg,once a day,4 weeks as a course,two courses in total,with an interval of 7 days.The study protocol was approved by the Ethics Committee of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,with an approval No.2014031107.RESULTS AND CONCLUSION:There was a significant improvement in scores of sensory,motor,daily activity and American Spinal Injury Association grading assessment in the two groups after treatment,but there was no significant difference between the two groups(P>0.05).The amplitude low-frequency fluctuation of bilateral main sensorimotor cortices of patients in both groups after treatment were significantly increased compared with those before treatment,and the amplitude low-frequency fluctuation of bilateral caudate nucleus after treatment was significantly lower than that before treatment,and there was no significant difference between the two groups after treatment.The regional homogeneity of bilateral anterior and posterior central gyrus and middle temporal gyrus/inferior temporal gyrus between two groups after treatment were significantly higher than those before treatment.The regional homogeneity of bilateral thalamus and caudate nucleus af

关 键 词：脊髓损伤 三通针法 电针 磁共振成像 低频振荡振幅 局部一致性 平均扩散系数 各向异分数 

分 类 号：R454[医药卫生—治疗学] R319[医药卫生—临床医学]