基于低频振幅技术探讨头针联合康复训练治疗缺血性脑卒中运动功能障碍的fMRI脑功能机制  

Study on the Mechanism of Scalp Acupuncture Combined with Conventional Rehabilitation Therapy in Ischemic Stroke Based on Amplitude of Low-Frequency Fluctuation

作　　者：温泽迎[1] 陈杰[2] 宋晓磊[1] 高晓贺 赵敏[4] WEN Zeying;CHEN Jie;SONG Xiaolei(Department of Radiology,The First Affiliated Hospital of Henan University of CM,Zhengzhou,Henan Province 450000,P.R.China)

机构地区：[1]河南中医药大学第一附属医院放射科,郑州450000 [2]河南中医药大学第一附属医院超声科,郑州450000 [3]河南中医药大学第一附属医院康复科,郑州450000 [4]河南中医药大学第一附属医院脑病科,郑州450000

出　　处：《临床放射学杂志》2023年第8期1227-1232,共6页Journal of Clinical Radiology

基　　金：国家重点研发计划项目(编号:2022YFC3501103)。

摘　　要：目的利用静息态功能磁共振成像(rs-fMRI)的低频振幅(ALFF)技术探讨头针联合康复训练改善脑卒中后运动功能障碍的中枢机制。方法70例缺血性卒中合并运动功能障碍的患者随机分为联合治疗组和对照组,联合治疗组予以头针联合康复训练进行干预,对照组除不予以头针干预外,其他均与联合治疗组保持一致,4周为一疗程。所有患者均于治疗前后行肢体运动功能评分(FMA)、改良Barthel指数(MBI)评分及rs-fMRI扫描,比较两组患者治疗后临床疗效及脑区ALFF的差异。结果两组患者治疗后FMA及MBI评分均高于治疗前,差异有统计学意义(P<0.05),且治疗组改善程度优于对照组(P<0.05)。fMRI结果显示:经4周治疗后,组间差异脑区主要位于双侧中央后回、辅助运动区、右侧丘脑及左侧小脑半球等。结论头针联合康复训练可明显改善脑卒中运动功能障碍,增强运动相关脑区的功能,且这些脑区可能是头针的靶效应脑区。Objective To investigate the clinical efficacy and mechanism of scalp acupuncture combined with conventional rehabilitation therapy in ischemic stroke based on amplitude of low-frequency fluctuation.Method A total of 70 patients were recruited and randomly allocated into the combination treatment group and control group.These patients in the combination treatment group received scalp acupuncture combined with conventional rehabilitation intervention whereas that in the control group were treated with the conventional rehabilitation intervention.The changes of limb motor function score(FMA),modified Barthel index(MBI)and fMRI data were collected before and after 4-week treatment,respectively.Results After 4 weeks of treatment,the FMA and MBI scores in both group were significantly higher than before(P<0.05),and the increase in the combination treatment group was significantly higher than that in the control group(P<0.05).Additionally,after 4-week treatment,compared with control group,the increased ALFF were detected in the bilateral precentreal gyrus,bilateral supplementary motor area,right thalamus,and left cerebellum.Conclusion Scalp acupuncture combined with rehabilitation therapy exerted a curative effects scalp on motor dysfunction in stroke patients,ant its mechanism effects may be achieved by regulating the sensorimotor network of brain.

关 键 词：缺血性脑卒中 运动功能障碍 头针康复训练 静息态功能磁共振成像 比率低频振幅 

分 类 号：R743.3[医药卫生—神经病学与精神病学]