基于脑功能磁共振评估中医特色治疗促进上肢创伤性周围神经断伤的预后  

Evaluation of traditional Chinese medicine characteristic treatment promoting prognosis of upper limb traumatic peripheral nerve injury based on brain functional magnetic resonance imaging

作　　者：艾尔肯·热合木吐拉 周泓宇[1] 陈子豪 黎立[1,2] Aierken Rehemutula;Zhou Hongyu;Chen Zihao;Li Li(Department of Orthopedics,Afiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University,Urumqi 830001,China;Key Laboratory of Trauma Repair in Xinjiang,Urumqi 830001,China)

机构地区：[1]新疆医科大学附属中医医院骨五科,乌鲁木齐830001 [2]新疆创伤修复重点实验室,乌鲁木齐830001

出　　处：《中华手外科杂志》2024年第6期514-518,共5页Chinese Journal of Hand Surgery

基　　金：新疆维吾尔自治区自然科学基金重点项目(2021D01D24);2023年第二批“天山英才”青年科技拔尖人才项目。

摘　　要：目的基于脑功能磁共振探讨通过中医特色治疗促进周围神经断伤恢复的预后。方法我科自2022年1月至2023年6月对12例上肢正中神经断伤修复术后患者予中医特色治疗(电针、推拿、膏摩),单纯手术修复未接受中医特色治疗的患者15例作为对照组,对中医特色治疗组进行治疗前后一般临床指标检查及脑部静息态功能磁共振rs-fMRI扫描并计算体素数量、局部一致性(ReHo)、分数低频振幅(fraction of amplitude of low-frequency fluctuations,fALFF)的方法对脑功能重塑进行观察,对照组治疗终末期进行上述检查指标。结果感觉运动网络在治疗前后分布区域基本相仿,局部一致性差异无统计学意义,治疗后体素个数增多,fALFF增高,差异有统计学意义,治疗组在局部一致性、体素个数及fALFF与对照组相比差异有统计学意义。结论中医特色治疗(电针、推拿、膏摩)可通过增强传人刺激减少脑部不良重塑,促进良好重塑,促进周围神经功能的恢复,而这些特色治疗的具体作用特点、相互影响机制以及功能区细分区域的重塑特点需进一步研究。Objective To explore the prognosis of promoting peripheral nerve injury recovery through traditional Chinese medicine treatment based on brain functional magnetic resonance imaging.Methods From January 2022 to June 2023,our department provided traditional Chinese medicine(TCM)treatment(electroacupuncture,massage,and ointment massage)to 12 patients who underwent upper limb median nerve injury repair surgery.A control group of 15 patients who underwent simple surgical repair but did not receive TCM treatment were included.The general clinical indicators and resting state functional magnetic resonance(rs-fMRI)scans were performed before and after treatment in the TCM treatment group,and voxel count,local consistency(ReHo),and fraction ofamplitudeoflowfrequency fluctuations(fALFF)werecalculated to observe brain functional remodeling.The above examination indicators were performed in the control group at the end of treatment.Results The distribution area of the motor network was basically similar before and after treatment,with no statistically significant difference in local consistency.After treatment,the number of voxels increased and the fALFF increased,with statistically significant differences.The treatment group showed statistically significant differences in local consistency,voxel count,and fALFF compared to the control group.Conclusions The traditional Chinese medicine characteristic treatments(electroacupuncture,massage,and ointment massage)can reduce adverse brain remodeling by enhancing incoming stimulation,promote good remodeling,and promote the recovery of peripheral nerve function.However,the specific characteristics of these characteristic treatments,their mutual influence mechanisms,and the remodeling characteristics of functional area segmentation need further research.

关 键 词：周围神经 磁共振成像 脑功能重塑 中医特色治疗 

分 类 号：R683.41[医药卫生—骨科学]