基于颅脑磁共振弥散张量成像检测的头电针治疗脑卒中后认知障碍研究  

Assessment of the efficacy of cephalic electroacupuncture in treating post-stroke cognitive impairment utilizing cranial DTI technique

作　　者：王小飞 张照庆 余超超 周玉梅 葛映红 Wang Xiaofei;Zhang Zhaoqing;Yu Chaochao(Department of Rehabilitation,Wuhan Third Hospital,Tongren Hospital of Wuhan University,Wuhan 430074,China)

机构地区：[1]武汉市第三医院康复医学科,武汉430074 [2]华中科技大学同济医学院附属协和医院康复科,武汉430000

出　　处：《中国康复》2025年第2期78-82,共5页Chinese Journal of Rehabilitation

基　　金：国家自然青年基金项目(82205271);武汉市卫健委青年基金项目(WZ21Q09)。

摘　　要：目的:基于磁共振弥散张量成像(DTI)技术研究头电针疗法治疗脑卒中后认知障碍(PSCI)的疗效及可能机制。方法:共招募64例PSCI患者,分为研究组和对照组各32例。对照组给予认知功能康复训练治疗,研究组加用头电针治疗。比较2组患者治疗后的临床疗效、治疗前后的蒙特利尔认知评估量表(MoCA)和简易智力状态检查量表(MMSE)、日常生活能力量表(ADL)的差异性,同时采用DTI观察PSCI患者枕叶、额叶、基底节区脑白质纤维束的变化,并对相关功能区弥散纤维束的FA值与MoCA、MMSE的关系采用Pearson检验法进行相关性分析。结果:治疗8周后,2组患者MoCA、MMSE和ADL评分均较治疗前显著提高(P<0.05),且研究组更高于对照组(P<0.05)。2组患者枕叶、额叶、基底节区经分数各项异性(FA)值与MoCA、MMSE评分均成正比(P<0.01)。研究组总有效率为78.13%,高于对照组的65.62%(P<0.05)。结论:头电针可显著改善和提高脑卒中后认知障患者认知能力、日常生活能力,基于DTI技术,头电针改善PSCI患者认知功能可能与其参与脑认知功能区脑白质纤维束结构变化有关。Objective:To study the efficacy of cephalic electroacupuncture therapy for post-stroke cognitive impairment(PSCI)based on magnetic resonance diffusion tensor imaging(DTI).Methods:A total of 64 patients with PSCI were randomly divided into two groups:32 cases in the experimental group and 32 in the control group.The control group and the treatment group received conventional cognitive function rehabilitation training,and the treatment group was given electroacupuncture therapy additionally.The clinical efficacy of the two groups was compared,and cognitive function as well as the ability to perform activities of daily living was sessed using the Montreal Cognitive Assessment Scale(MoCA),the Mini-Mental State Examination(MMSE),and the Activities of Daily Living(ADL)score.Changes in the white matter fiber bundles of the occipital lobe,frontal lobe,and basal ganglia in PSCI patients were observed using magnetic resonance DTI.The FA values of diffuse fiber bundles in relevant functional areas were correlated with MoCA and MMSE scores using the Pearson test.Results:After treatment,the MoCA,MMSE,and ADL scores in both groups showed significant improvement compared to before treatment,with higher scores in the experimental group.The difference was statistically significant(P<0.05).The FA values of the occipital lobe,frontal lobe,and basal ganglia regions detected by DTI were positively correlated with MoCA(P<0.0001)and MMSE(P<0.0001)in both groups,with a statistically significant difference(P<0.05).The total effective rate of the experimental group was 78.13%,which was significantly higher than that in the control group(65.62%,P<0.05).Conclusion:Cephalic electroacupuncture significantly improves cognitive function and the ability to perform daily living activities in patients with post-stroke cognitive impairment.Based on DTI imaging,the improvement in cognitive function may be related to structural changes in cerebral white matter fiber bundles in the relevant cognitive function areas.

关 键 词：脑卒中后认知障碍 电针 头皮针 弥散张量成像 脑白质纤维 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]