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针刺疗法对脑梗死 Wallerian 变性的弥散张量成像影响。

Effect of acupuncture therapy for postponing Wallerian degeneration of cerebral infarction as shown by diffusion tensor imaging.

机构信息

Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China.

出版信息

J Altern Complement Med. 2012 Dec;18(12):1154-60. doi: 10.1089/acm.2011.0493. Epub 2012 Sep 5.

Abstract

OBJECTIVE

One aim of this study was to investigate the effects of acupuncture on cerebral function of patients with acute cerebral infarction. Another goal was to evaluate the relationship between acupuncture treatment and motor recovery patients with stroke and to provide a foundation for using acupuncture therapy for such patients.

DESIGN

Twenty (20) patients with recent cerebral infarction were divided randomly to an acupuncture group and a control group. The infarction area in each patient was in the basal ganglia or included the basal ganglia with an area size of > 1 cm(2). Serial diffusion tensor imaging (DTI), fluid-attenuated inversion recovery (FLAIR), and T2-weighted imaging (T(2)WI) scans were performed on all patients and the results were evaluated using the National Institute of Health Stroke Scale and the Barthel Index each week. DTI images were postprocessed and analyzed. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values of abnormal signals on DTI in the infarction areas and cerebral peduncles were calculated for both groups and compared with one another.

RESULTS

(1) The ADC value of infarction lesions decreased at stroke onset; then, a significant elevation was observed after the acute stage, and a significant reduction in FA values was observed from stroke onset to the chronic stage. (2) The ADC of the bilateral cerebral peduncle was reduced on the infarction side. (3) There was a significant difference in ADC and FA values between the acupuncture and control groups. The FA value was higher in the acupuncture group than the control group.

CONCLUSIONS

ADC and FA values might correlate to patient recovery and reveal the progress of secondary degeneration. Acupuncture treatment is effective for protecting neurons and facilitating recovery.

摘要

目的

本研究旨在探讨针刺对急性脑梗死患者脑功能的影响,评估针刺治疗与脑卒中患者运动功能恢复的关系,为针刺治疗此类患者提供依据。

设计

将 20 例近期脑梗死患者随机分为针刺组和对照组,患者梗死灶均位于基底节区或基底节区包含基底节区,面积>1cm²。所有患者均行系列弥散张量成像(DTI)、液体衰减反转恢复(FLAIR)和 T2 加权成像(T2WI)扫描,每周采用美国国立卫生研究院卒中量表和 Barthel 指数对患者进行评估。对 DTI 图像进行后处理和分析,计算两组患者梗死区及大脑脚异常信号的表观扩散系数(ADC)和各向异性分数(FA)值,并进行比较。

结果

(1)脑梗死发病时梗死灶 ADC 值降低,急性期后明显升高,慢性期 FA 值明显降低。(2)患侧大脑脚双侧 ADC 值降低。(3)针刺组与对照组 ADC 和 FA 值差异有统计学意义,针刺组 FA 值高于对照组。

结论

ADC 和 FA 值与患者的恢复有关,能反映继发性退变的进展。针刺治疗可保护神经元,促进功能恢复。

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