电针结合运动训练对运动学习及运动皮层兴奋性的作用研究  

Effect of electroacupuncture combined with motor training on motor learning and motor cortex excitability

作　　者：李洁枚 黄键澎 刘健华[1] LI Jie-mei;HUANG Jian-peng;LIU Jian-hua(Second Clinical Medical College of Guangzhou University of CM,Guangzhou 510405,Guangdong Province,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405

出　　处：《中国针灸》2021年第12期1365-1369,共5页Chinese Acupuncture & Moxibustion

基　　金：国家重点研发计划资助项目:2019YFC1709100、2019YFC1709102;国家自然科学基金资助项目:81873381;广东省中医院中医药科学技术研究专项项目:YN2015QN19、YN2019ML12。

摘　　要：目的:比较电针、运动训练与电针结合运动训练对健康受试者运动学习及运动皮层兴奋性的影响,探讨电针结合运动训练对突触再可塑性的影响效应。方法:招募12名健康受试者,采用同体自身前后对照的方法,将其先后分配至电针组(EA组)、运动训练组(MT组)及电针结合运动训练组(EA+MT组),每组间隔至少2周的洗脱期。EA组予电针左手合谷30 min,连续波,频率2 Hz,强度0.5~1 mA;MT组进行左手运动训练,时间约30 min;EA+MT组先予电针再进行运动训练。观察EA组及EA+MT组干预前(T0)、干预后(T1)、电针后30 min(T2),MT组T0、T1时间点凹槽钉板测试(GPT)完成时间,采用经颅磁刺激技术记录受试者运动诱发电位(MEPs)平均波幅、静息运动阈值(rMT)及潜伏期。结果:与本组T0时间点比较,MT组T1时间点及EA组、EA+MT组T2时间点GPT完成时间缩短(P<0.01,P<0.05),3组T1时间点及EA组、EA+MT组T2时间点MEPs平均波幅均升高(P<0.05,P<0.01);与本组T1时间点比较,EA组、EA+MT组T2时间点GPT完成时间缩短(P<0.05,P<0.01),EA组T2时间点MEPs平均波幅均升高(P<0.05);EA+MT组T2时间点GPT完成时间短于EA组(P<0.05)。3组各时间点rMT及潜伏期比较差异均无统计学意义(P>0.05)。结论:生理状态下,电针结合运动训练对运动学习具有叠加效应,对大脑运动皮层兴奋性没有协同效应。Objective To compare the effect of electroacupuncture(EA),motor training(MT)and EA combined with MT on motor learning and motor cortex excitability in healthy subjects,and to explore the effect of EA combined with MT on synaptic metaplasticity.Methods Using self-control design,12 healthy subjects were assigned into an EA group,a motor training group(MT group)and an EA plus motor training group(EA+MT group)successively,wash-out period of at least 2 weeks was required between each group.EA was applied at left Hegu(LI 4)in the EA group for 30 min,with continuous wave,2 Hz in frequency and 0.5-1 mA in density.Motor training of left hand was adopted in the MT group for 30 min.EA and motor training were adopted in the EA+MT group successively.The time of finishing grooved pegboard test(GPT)was observed,and the average amplitude of motor evoked potentials(MEPs),the rest motor threshold(rMT)and the latency were recorded by transcranial magnetic stimulation technique before intervention(T0),after intervention(T1)and 30 min after EA(T3)in the EA group and the EA+MT group,T0 and T1 in the MT group.Results Compared with T0,the time of finishing GPT was shortened at T1 in the MT group and at T2 in the EA group and the EA+MT group(P<0.01,P<0.05),the average amplitude of MEPs was increased at T1 in the 3 groups and at T2 in the EA group and the EA+MT group(P<0.05,P<0.01).Compared with T1,the time of finishing GPT at T2 was shortened in the EA group and the EA+MT group(P<0.05,P<0.01),the average amplitude of MEPs at T2 was increased in the EA group(P<0.05).The time of finishing GPT at T2 in the EA+MT group was shorter than the EA group(P<0.05).There were no statistical differences in rMT and latency at each time point among the 3 groups(P>0.05).Conclusion In physiological state,electroacupuncture combined with motor training have a synergistic effect on motor learning,while have no such effect on excitability of cerebral motor cortex.

关 键 词：电针 运动训练 突触再可塑性 运动学习 运动皮层兴奋性 

分 类 号：R245[医药卫生—针灸推拿学]