电针联合右侧正中神经刺激对弥漫性轴索损伤患者动作运用及视运动组织障碍的影响  

Effects of Electroacupuncture Combined with Right Median Nerve Stimulation on Motor Application and Visual Motor Organizational Barriers in Patients with Diffuse Axonal Injury

作　　者：戴伟川[1] 郭协力[1] 方仲宁 蔡文华[1] 陈英贤 洪天生 田夏阳 康俏茹 DAI Weichuan;GUO Xieli;FANG Zhongning;CAI Wenhua;CHEN Yingxian;HONG Tiansheng;TIAN Xiayang;KANG Qiaoru(Jinjing Municipal Hospital,Jinjiang 362200,China)

机构地区：[1]晋江市医院,福建晋江362200

出　　处：《中国中医药信息杂志》2023年第7期151-156,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：福建中医药大学临床专项课题(XB2021147);福建省泉州市科技计划项目(2019C068R);福建省泉州市卫生计生研究资助项目(2015年、2019年)。

摘　　要：目的探索电针联合右侧正中神经刺激治疗对弥漫性轴索损伤(DAI)Ⅱ型患者动作运用及视运动组织障碍的疗效和可能的作用机制。方法采用随机数字表法将97例DAIⅡ型青少年患者分为治疗组49例和对照组48例。对照组采用西医常规治疗,连续6周。治疗组在常规治疗基础上加用电针联合右侧正中神经刺激,每次30 min,每日2次,7 d为1个疗程,共4个疗程,疗程间隔1 d。比较2组治疗前后第2版洛文斯顿作业疗法认知量表(LOTCA)动作运用及视运动组织评分、P3潜伏期和波幅;比较2组治疗前后血清脑源性神经营养因子(BDNF)、微管相关蛋白(Tau)、核因子E2相关因子2(Nrf2)及乙酰胆碱脂酶(AchE)浓度和活性。结果治疗过程中治疗组脱落4例,对照组脱落6例。与本组治疗前比较,2组治疗后LOTCA动作运用及视运动组织评分升高,P3潜伏期缩短,血清BDNF、Tau、Nrf2浓度升高,AchE浓度下降(P<0.05),P3波幅、AchE活性比较差异无统计学意义(P>0.05);2组治疗后比较,治疗组LOTCA动作运用及视运动组织评分均显著高于对照组(P<0.05),P3潜伏期显著短于对照组(P<0.05),血清BDNF、Tau、Nrf2浓度均显著高于对照组(P<0.05),AchE浓度显著低于对照组(P<0.05),P3波幅、AchE活性比较差异无统计学意义(P>0.05)。结论电针联合右侧正中神经刺激对DAIⅡ型患者动作运用及视运动组织功能障碍有明显改善作用,Tau、Nrf2、BDNF、AchE可能在其机制中发挥一定作用。Objective To explore the efficacy and possible mechanism of electroacupuncture combined with right median nerve stimulation in the treatment of motor application and visual motor organizational barriers in patients with diffuse axonal injury(DAI)typeⅡ.Methods Totally 97 adolescent patients with DAI(typeⅡ)were divided into 49 cases in the treatment group and 48 cases in the control group by random number table method.The control group was treated with conventional Western medicine for consecutive six weeks,and the treatment group was treated with electroacupuncture combined with right median nerve stimulation on the basis of the conventional treatment,twice a day,30 minutes each time;the treatment for each course was 7 days,a total of 4 courses of treatment,1 day interval between each course.The motor application and optic-motor organization score of the second version of the Loewenstein Occupational Therapy Cognitive Assessment(LOTCA)were compared between the two groups before and after treatment;the P3 latency and amplitude were compared between the two groups before and after treatment;serum BDNF,Tau,Nrf2,AchE concentration,and AchE activity of the two groups before and after treatment were compared.Results During the treatment,4 cases in the treatment group dropped out,and 6 cases in the control group dropped out.Compared with before treatment,LOTCA motor application and optic motor organization score increased,P3 latency shortened,serum BDNF,Tau,Nrf2 concentration increased,AchE concentration decreased after treatment(P<0.05),and there was no significant difference in P3 amplitude and AchE activity(P>0.05).After treatment,the LOTCA motor application and optic-motor organization score in the treatment group were significantly higher than those in the control group(P<0.05),the P3 latency was significantly shorter than that in the control group(P<0.05),serum BDNF,Tau and Nrf2 concentrations were significantly higher than those in the control group(P<0.05),AchE concentration was significantly lower than that

关 键 词：弥漫性轴索损伤 动作运用 视运动组织 电针 右侧正中神经刺激 脑源性神经营养因子 微管相关蛋白 核因子E2相关因子2 乙酰胆碱酯酶 

分 类 号：R277.751[医药卫生—中医学]