“形神共调”针刺对丘脑卒中后麻木患者脑白质微观结构的影响  

Effects of “Co-regulation of the Body and the Spirit” acupuncture on the microstructure of cerebral white matter in patients with with thalamic post-stroke numbness

作　　者：宋蕾 陈星[1] 彭景 吕秋艺 钱勋琦 袁永娥 张华[1] SONG Lei;CHEN Xing;PENG Jing;LYU Qiuyi;QIAN Xunqi;YUAN Yonge;ZHANG Hua(Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《现代中西医结合杂志》2023年第7期882-889,共8页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家自然科学基金项目(81904285)。

摘　　要：目的 观察丘脑卒中后麻木患者脑白质的微观结构,探讨“形神共调”针刺对丘脑卒中后麻木患者脑白质微观结构的影响。方法 选择2020年1月—2021年12月在北京中医药大学东直门医院就诊的慢性丘脑卒中后麻木患者18例作为观察组,同期招募性别、年龄与观察组患者相匹配的健康人20例作为对照组,对2组受试者进行结构磁共振成像(SMRI)及弥散张量成像(DTI)扫描,观察组在给予12次“形神共调”针刺治疗后再次扫描,并使用改良诺丁汉感觉量表(rNSA)评价观察组患者治疗前后的感觉功能。SMRI及DTI数据使用VistaSoft软件进行预处理计算出部分各项异性指数(FA),应用自动纤维束量化追踪技术(AFQ),以约束球面反卷积法(CSD)生成具有100个离散位点的白质纤维束走行线图,并用Matlab对FA值及rNSA评分进行分析比较。结果 治疗前观察组的左侧丘脑-前额叶束、右侧丘脑-前额叶束及胼胝体中后部束的部分位点FA值较对照组低(P均<0.05);治疗后观察组的左侧丘脑-前额叶束、右侧丘脑-前额叶束的部分位点FA值和rNSA评分较治疗前明显增加(P均<0.05);观察组rNSA评分变化比例与左侧丘脑-前额叶束、胼胝体干中后部束的FA值变化比例呈正相关,且相关程度较强。结论 丘脑卒中后麻木患者双侧丘脑-前额叶束、胼胝体中后部束脑白质结构受损;“形神共调”针刺治疗可促进丘脑卒中后麻木患者感觉恢复,推测丘脑-前额叶束及胼胝体中后部束白质微观结构的重组改善可能为“形神共调”针刺改善丘脑卒中后麻木的机制之一。Absfasciculus:Objective It is to observe the microstructure of cerebral white matter in patients with thalamic post-stroke numbness,and to investigate the effects of “Co-regulation of the Body and the Spirit” acupuncture on it.Methods Eighteen patients with chronic thalamic stroke numbness who were treated at Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2020 to December 2021 were selected as the observation group,and 20 healthy people matched in gender and age of the patients in the observation group during the same period were recruited as the control group,structural magnetic resonance imaging(sMRI) and diffusion tensor imaging(DTI) scans were performed in the subjects of the two groups,the patients in the observation group were scanned again after administration of 12 times of acupuncture of “Co-regulation of the Body and the Spirit”,and their sensory function before and after treatment were evaluated by revised Nottingham Sensory Assessment Stereognosis Scale(rNSA).SMRI and DTI data were preprocessed to calculate fractional anisotropy(FA) using VistaSoft software,automatic fiber quantification(AFQ) was applied to generate fasciculusogram of white matter fasciculus with 100 discrete sites using constrainedpherical deconvolution(CSD),and FA values and rNSA scores were analyzed and compared using Matlab.Results Before treatment,the FA values at some sites in the left thalamo-prefrontal fasciculus,right thalamo-prefrontal fasciculus,and middle and posterior corpus callosum fasciculus in the observation group were lower than those in the control group(all P0.05);The FA values at some sites in the left thalamo-prefrontal fasciculus,right thalamo-prefrontal fasciculus and rNSA scores after treatment were significantly increased compared with before treatment in the observation group;The change proportion of rNSA score in the observation group was positively correlated with the change proportion of FA value in the left thalamus prefrontal fasciculus and the middle middle and post

关 键 词：丘脑卒中后麻木 “形神共调”针刺 感觉功能康复 弥散张量成像 自动纤维束量化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]