薄氏腹针疗法对卒中后认知功能障碍患者脑静息态fMRI影响  

Effect of Bo’s Abdominal Acupuncture Therapy on the Resting-state fMRI in Patients with Cognitive Impairment After Stroke

作　　者：俞燕丽 程梦蝶 马敏[1] 刘力 YU Yan-li;CHENG Meng-die;MA Min;LIU Li(Hangzhou Yuhang District Hospital of Traditional Chinese Medicine,Hangzhou 311106,China)

机构地区：[1]杭州市余杭区中医院,杭州311106

出　　处：《上海针灸杂志》2021年第11期1293-1298,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：杭州市卫生科技一般类计划项目(OO20190949)。

摘　　要：目的观察薄氏腹针疗法对卒中后认知功能障碍患者脑静息态功能核磁共振成像(fMRI)的影响。方法将60例卒中后认知功能障碍患者,随机分为观察组和对照组,每组30例。对照组接受常规基础治疗,观察组接受常规基础治疗联合薄氏腹针疗法。分别于治疗前、治疗2周后、治疗后、随访期(治疗后2周)使用蒙特利尔认知评估量表(MoCA)、连线测验(TMT)、中文听觉词汇学习测验(AVLT)、数字广度(DS)分别评估患者的认知功能、执行、记忆、注意力情况;分别于治疗前及治疗后经功能性磁共振(fMRI)检查,评估患者的中枢神经系统康复情况。结果两组治疗后MoCA评分升高(P<0.05),TMT时间缩短(P<0.05);两组不同时间MoCA评分和TMT变化趋势不同(P<0.05);观察组治疗后各时点MoCA评分高于对照组(P<0.05),TMT短于对照组(P<0.05)。两组治疗后AVLT增多(P<0.05),DS升高(P<0.05);两组不同时间AVLT和DS变化趋势不同(P<0.05);观察组治疗后各时点AVLT多于对照组(P<0.05),DS高于对照组(P<0.05)。与对照组治疗后比较,观察组治疗后ALFF值增高的脑区有右侧海马旁回、左侧丘脑、右侧岛叶、左侧前扣带回;ALFF值减低的脑区有左侧小脑后叶、左侧颞下回、右侧颞下回、左侧额下回、左侧颞中回、左侧枕下回、左侧顶上小叶。结论薄氏腹针疗法治疗卒中后认知功能障碍疗效显著,能够改善认知功能障碍,提高患者的执行能力,改善其记忆功能及注意力,且可调节患者多个脑区的神经活动,促进中枢神经系统康复。Objective To observe the effect of Bo’s abdominal acupuncture therapy on resting-state functional magnetic resonance imaging(fMRI)in patients with cognitive impairment after stroke.Method Sixty patients with cognitive impairment after stroke were randomly divided into an observation group and a control group,with 30 cases in each group.The control group received conventional basic treatment,while the observation group received conventional basic treatment plus Bo’s abdominal acupuncture therapy.Prior to treatment,at 2-week treatment,after treatment and at follow-up(2 weeks after treatment),Montreal Cognitive Assessment(MoCA),trail making test(TMT),Chinese auditory verbal learning test(AVLT)and digital span(DS)test were adopted to evaluate the cognitive function,implementation,memory and attention of the patients;fMRI was conducted before and after treatment to assess the recovery of central nervous system.Result The MoCA score increased(P<0.05)and the TMT time was shortened(P<0.05)with the time in both groups;the two groups differed on the changes of the MoCA score and TMT result(P<0.05);the MoCA score was higher(P<0.05)and the TMT was shorter(P<0.05)in the observation group than in the control group after treatment at each time point.Compared with the control group after treatment,the observation group showed increased amplitude of low-frequency fluctuation(ALFF)in the right parahippocampal gyrus,left thalamus,right insula and left anterior cingulate gyrus,and reduced ALFF in the left posterior cerebellar lobe,left inferior temporal gyrus,right inferior temporal gyrus,left inferior frontal gyrus,left middle temporal gyrus,left inferior occipital gyrus and left superior parietal lobule.The AVLT increased(P<0.05)over time in both groups,as well as the DS(P<0.05);there were differences in the changes of the AVLT and DS between the two groups(P<0.05);the AVLT number was larger(P<0.05)and the DS was higher(P<0.05)in the observation group than in the control group after treatment at each time point.Conclusion Bo�

关 键 词：针刺疗法 针药并用 腹针疗法 中风后遗症 认知功能障碍 

分 类 号：R246.6[医药卫生—针灸推拿学]