基于fNIRS探讨分期针刺治疗缺血性脑卒中后偏瘫的疗效及机制研究  

Effect and Mechanism of Staging Acupuncture in Treatment of Ischemic Stroke Based on fNIRS

作　　者：郑苏[1] 穆敬平[1] 代轶楠 谢谨[1] ZHENG Su;MU Jingping;DAI Yinan;XIE Jin(Taihe Hospital of Shiyan City,Shiyan 442000,China;Hubei University of Chinese Medicine,Wuhan 430061,China)

机构地区：[1]十堰市太和医院,湖北十堰442000 [2]湖北中医药大学,湖北武汉430061

出　　处：《针灸临床杂志》2024年第10期11-16,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家中医药管理局项目,编号:2022ZYLCYJ11-4;湖北省中医药科研立项项目,编号:ZY2021Q015;福建中医药大学临床专项校管项目,编号:XB2021233;十堰市太和医院院级项目,编号:2021JJXM077、2022JJXM095、2023JJXM093。

摘　　要：目的:观察分期针刺治疗缺血性脑卒中后偏瘫的临床疗效,并采用fNIRS探讨其可能的机制。方法:将偏瘫患者随机分为两组,试验组29例采取分期针刺治疗,对照组29例采取传统针刺治疗。治疗5个疗程后进行疗效评定,观察两组患者FMA、MBI、NIHSS及fNIRS评估。结果:治疗后,两组患者的FMA和MBI评分均较前明显提升,NIHSS明显降低(P<0.05);组间比较,分期针刺评分改善更明显,差异有统计学意义(P<0.05)。fNIRS比较,治疗后试验组在通道ch28、ch32、ch34、ch35、ch36及ch39均被激活,差异有统计学意义(P<0.05),其中ch28通道显著激活;对照组在通道ch28被激活,差异有统计学意义(P<0.05);组间比较:试验组在患侧M1区积分值比对照组明显增高,差异有统计学意义(P<0.05)。结论:分期针刺能提高缺血性脑卒中患者的运动功能,改善日常生活能力,降低神经功能缺损,激活脑神经功能。Objective:To observe the clinical effect of staging acupuncture in treatment of ischemic stroke,and to explore its possible mechanism by using fNIRS.Methods:58 patients with ischemic stroke were randomly divided into the study group and the control group,with 29 patients in each group.The study group was treated with staging acupuncture,and the control group was treated with traditional acupuncture.After 5 courses of treatment,the therapeutic effect was evaluated,the scores of FMA,MBI and NIHSS and the indexes of functional near-infrared spectroscopy(fNIRS)were observed in the two groups.Results:The scores of FMA and MBI were increased,and the score of NIHSS was decreased after the treatment compared with those before the treatment in the two groups(P<0.05);of which the improvements were more significant in the study group(P<0.05).In terms of fNIRS,ch28,ch32,ch34,ch35,ch36 and ch39 were all activated in the study group after the treatment compared with those before the treatment(P<0.05),in which ch28 channel was significantly activated.Channel ch28 was activated in the control group after the treatment compared with that before the treatment(P<0.05).The M1 score was significantly higher in the study group than that in the control group after the treatment(P<0.05).Conclusion:Staging acupuncture can improve motor function,improve ability of daily living,reduce nerve function defect and activate brain nerve function in patients with ischemic stroke.

关 键 词：近红外脑功能成像 分期针刺 缺血性脑卒中 机制研究 

分 类 号：R246.6[医药卫生—针灸推拿学]