基于激活似然估计法的针刺阳明经穴治疗缺血性中风偏瘫的中枢机制研究  

Central Mechanism Study of Needling Acupoints of Yangming Meridians in Treatment of Ischemic Stroke Hemiplegia Based on Activation Likelihood Estimation Method

作　　者：罗阿呷 哈国栋 田子雷 赖宁源 唐鹏 兰蕾[1] LUO Aga;HA Guodong;TIAN Zilei;LAI Ningyuan;TANG Peng;LAN Lei(Chengdu University of TCM,Chengdu 610075,China)

机构地区：[1]成都中医药大学,四川成都610075

出　　处：《针灸临床杂志》2024年第7期65-72,共8页Journal of Clinical Acupuncture and Moxibustion

基　　金：四川省科技计划,编号:2022YFS0036。

摘　　要：目的:通过分析针刺干预卒中后运动障碍的功能性磁共振(fMRI)临床研究结果,筛选针刺阳明经穴干预该病的中枢核心、稳定核团,为针刺治疗本病的中枢作用机制提供可靠证据。方法:检索PubMed、Web of Science、中国知网、万方和维普文献数据库,收集从建库—2022年12月使用fMRI观察针刺阳明经穴治疗卒中后脑区变化情况的研究。使用Ginger-ALE 3.0.2软件计算脑区激活似然评估(ALE)分布,最后使用DPABI软件进行图像整合。结果:共有20篇文献纳入研究,包括356名患者和144名健康人。结果显示,与健康人比较,缺血性卒中患者存在异常的大脑功能活动模式,异常的脑区主要与额叶、颞叶、边缘系统以及小脑有关;针刺阳明经穴对缺血性卒中后运动障碍患者左侧顶叶和小脑后叶(具体包括:顶下小叶、缘上回、中央后回以及下半月小叶、蚓锥体和小脑扁桃体)功能活动有稳定的调制作用。结论:卒中发生后相关运动支配脑区存在损伤与功能重塑;针刺阳明经穴可以稳定调节缺血性卒中后运动障碍患者优势侧运动-感觉系统功能活动。Objective:To screen the central core and stable clusters of needling acupoints of Yangming meridians by analyzing the clinical results of functional magnetic resonance imaging(fMRI)on acupuncture intervention for post-stroke motor disorders,thus to provide reliable evidence for the central mechanism of acupuncture treatment for the disease.Methods:Studies on post-stroke changes in brain region after needling acupoints of Yangming meridians observed by fMRI were retrieved from the databases of PubMed,Web of Science,CNKI,Wanfang and VIP starting from establishments to 2022.The activation likelihood estimation(ALE)distribution of brain regions was calculated by using Ginger-ALE 3.0.2 software,and finally the images were integrated through using DPABI software.Results:A total of 20 publications were included in the study,involving 356 patients and 144 healthy people.The results showed that ischemic stroke patients had abnormal patterns of functional brain activity compared to healthy individuals,and that the abnormal brain regions were mainly associated with the frontal lobe,temporal lobe,limbic system and cerebellum.Needling acupoints of Yangming meridians had a stabilizing effect on the modulation of functional activity in the left parietal and posterior cerebellar lobes(specifically including inferior parietal lobule,supramarginal gyrus,postcentral gyrus,as well as the inferior semilunar lobule,pyramis and cerebellar tonsil)in post-ischemic stroke patients with motor disorders.Conclusion:After stroke,there is damage to and functional remodeling of the motor-dominant brain regions.Needling acupoints of Yangming meridians can effectively stabilize and regulate the activity of the motor-sensory system on the affected side in patients with post-ischemic stroke motor disorders.

关 键 词：中风 偏瘫 针刺 阳明经 功能磁共振成像 激活似然估计法 

分 类 号：R246.6[医药卫生—针灸推拿学]