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1. 深圳市中医院针灸科
2. 深圳市中医院放射影像学科
3. 深圳市中医院神经内科
4. 深圳市人民医院神经内科
纸质出版日期:2021
移动端阅览
杨福霞, 高进云, 刘刚, 等. 调任通督针法对脑梗死弥散张量成像各向异性分数和上肢运动功能的影响[J]. 针刺研究, 2021,46(7):610-615.
YANG Fu-xia, GAO Jin-yun, LIU Gang, et al. Effect of tiaoren tongdu acupuncture method on fractional anisotropy of diffusion densor imaging and upper extremity motor function after cerebral infarction[J]. Acupuncture research, 2021, 46(7): 610-615.
杨福霞, 高进云, 刘刚, 等. 调任通督针法对脑梗死弥散张量成像各向异性分数和上肢运动功能的影响[J]. 针刺研究, 2021,46(7):610-615. DOI: 10.13702/j.1000-0607.20210033.
YANG Fu-xia, GAO Jin-yun, LIU Gang, et al. Effect of tiaoren tongdu acupuncture method on fractional anisotropy of diffusion densor imaging and upper extremity motor function after cerebral infarction[J]. Acupuncture research, 2021, 46(7): 610-615. DOI: 10.13702/j.1000-0607.20210033.
目的:应用磁共振扩散张量成像(DTI)技术研究调任通督针法对脑梗死各向异性分数(FA)和上肢运动功能的影响。方法:按照随机数字表法将脑梗死患者分为对照组和针刺组
每组27例。对照组予常规药物基础治疗;针刺组在对照组基础上予调任通督针法
主穴:百会、水沟、承浆、关元、气海、中脘、神庭、命门
配穴:患侧肩髃、尺泽、后溪、委中、足三里、太冲
留针30 min
每日1次
每周休息1 d
连续治疗4周。治疗前后采用Fugl-Meyer评定量表上肢部分(UE-FMA)评估上肢运动功能;采用DTI观察两组患侧梗死灶、内囊后肢、大脑脚及健侧对应部位FA值
并计算相对各项异性(rFA)。结果:治疗后两组UE-FMA值均较治疗前显著增加(对照组P<0.05
针刺组P<0.01)
且针刺组治疗前后UE-FMA差值高于对照组(P<0.05)。两组治疗后梗死灶FA、rFA值均较治疗前升高(P<0.05)
针刺组梗死灶和患侧内囊后肢治疗前后FA、rFA差值均高于对照组(P<0.05)。两组UE-FMA差值与本组各部位的rFA差值均呈正相关(P<0.05)
且均以患侧内囊后肢相关性最强(P<0.01)。结论:调任通督针法可明显改善脑梗死后上肢活动功能
内囊后肢rFA结合UE-FMA可用作评价针刺对脑梗死后上肢活动的疗效。
Objective To observe the effect of tiaoren tongdu acupuncture method(for regulating the function of the Conception Vessel and promoting the circulation of the Governor Vessel) on fractional anisotropy(FA) and upper-extremity motor function after cerebral infarction by diffusion densor imaging(DTI) technology. Methods The patients with cerebral infarction were divided into an acupuncture group and a control group according to the random number table method
27 cases in each group. In the control group
the basic treatment with conventional medication was used. In the acupuncture group
on the basic treatment as the control group
the tiaoren tongdu acupuncture method was provided. Main acupoints included Baihui(GV20)
Shuigou(GV26)
Chengjiang(CV24)
Guanyuan(CV4)
Qihai(CV6)
Zhongwan(CV12)
Shenting(GV24) and Mingmen(GV4). Supplementary points included Jianyu(LI15)
Chize(LU5)
Houxi(SI3)
Weizhong(BL40)
Zusanli(ST36) and Taichong(LR3) on the affected side. The needles were retained for 30 min. Acupuncture was given once a day
at the interval of 1 days every week
consecutively for 4 weeks. The upper extremity Fugl-Meyer assessment(UE-FMA) was used to evaluate the motor function of upper extremity before and after treatment. DTI was adopted to observe the FA values of infarct focus
posterior limb of internal capsule(PLIC) and cerebral peduncle on the affected side
as well as FA values at the corresponding parts on the healthy side in the patients of two groups. The relative differences(rFA) were calculated. Results Compared with their own pretreatment
the UE-FMA value was significantly higher after treatment in either of two groups separately(P<0.05 in the control group
P<0.01 in the acupuncture group). The difference of UE-FMA before and after treatment in the acupuncture group was larger than that in the control group(P<0.05). The FA and rFA values in infarct focus were higher than those before treatment in the two groups(P<0.05). The FA and rFA differences before and after treatment in the infarct focus and PLIC on the affected side were higher in the acupuncture group as compared with the control group(P<0.05). The UE-FMA difference was positively correlated with the rFA difference of each part in either group(P<0.05)
and the correlation was the strongest in PLIC on the affected side in either group(P<0.01). Conclusion Tiaoren tongdu acupuncture significantly improves the upper limb movement function after cerebral infarction. The rFA value of PLIC combined with UE-FMA can be used to evaluate the therapeutic effect of acupuncture on the upper extremity movement after cerebral infarction.
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