头皮针刺增强急性缺血性中风患者视觉与认知运动功能网络的功能连接性。
Scalp Acupuncture Enhances the Functional Connectivity of Visual and Cognitive-Motor Function Network of Patients with Acute Ischemic Stroke.
作者信息
Liu Huacong, Chen Lanpin, Zhang Guifeng, Jiang Yijing, Qu Shanshan, Liu Songyan, Huang Yong, Chen Junqi
机构信息
School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China.
Zhaoqing Medical College, Zhaoqing, Guangdong, China.
出版信息
Evid Based Complement Alternat Med. 2020 Dec 2;2020:8836794. doi: 10.1155/2020/8836794. eCollection 2020.
DESIGN
A parallel-group randomized controlled trial. . 30 hemiplegic patients with middle cerebral artery acute infarction of the dominant hemisphere. . 30 patients were divided into 2 groups randomly. 15 patients in the treatment group (TG) were treated with ISSA, needling at the parietal midline (MS5) and left anterior/posterior parietal-temporal oblique lines (MS6 and MS7), combined with western routine treatment. While another 15 patients in the control group (CG) received routine treatment only. . (1) Functional connectivity (FC): patients received brain scan using 3.0 T MRI after the treatment for 1 week. Based on the Matlab2012a platform, SPM12 software and DPABI software were used to process the scanning data and finally the functional connectivity of the brain was obtained. (2) National Institute of Health Stroke Scale (NIHSS) score.
RESULTS
The difference in the NIHSS score between the two groups of patients before and after treatment was statistically significant (tNIHSS = 2.225; PNIHSS = 0.038), indicating that TG had a better effect. Centered to the seed region of the left supplementary motor area (SMA) (-5.32, 4.85, 61.38), FC increased at the left middle cerebellar peduncle, left cerebellum posterior lobe (uvula and declive), vermis, fusiform gyrus, lingual gyrus, inferior occipital gyrus, calcarine, cuneus, precuneus, BA7, BA18 and BA19, etc. Centered to the seed region of the left parahippocampal gyrus (PG) (-21.17, -15.95, -20.70), FC increased at the left precuneus, inside-paracingulate, inferior parietal gyrus, paracentral lobule, BA5, BA6, BA7, and BA40, right median cingulate, precuneus, BA19, BA23, and BA31, etc.
CONCLUSIONS
It is indicated that ISSA can regulate the brain functional connection in patients with middle cerebral artery acute infarction in the dominant hemisphere and specifically strengthen the connections between visual, cognitive, motor control, and planning-related brain regions, which may be related to the recovery of movement in the mechanism. This trial is registered with ChiCTR-IOR-15007672.
设计
一项平行组随机对照试验。纳入30例优势半球大脑中动脉急性梗死的偏瘫患者。将30例患者随机分为2组。治疗组（TG）15例患者采用靳三针疗法，针刺顶中线（MS5）及左侧顶颞前斜线、顶颞后斜线（MS6和MS7），并结合西医常规治疗。而对照组（CG）的另外15例患者仅接受常规治疗。（1）功能连接（FC）：治疗1周后，患者接受3.0 T磁共振成像脑部扫描。基于Matlab2012a平台，使用SPM12软件和DPABI软件处理扫描数据，最终获得大脑的功能连接。（2）美国国立卫生研究院卒中量表（NIHSS）评分。
结果
两组患者治疗前后NIHSS评分差异有统计学意义（tNIHSS = 2.225；PNIHSS = 0.038），表明治疗组效果更佳。以左侧辅助运动区（SMA）的种子区（-5.32, 4.85, 61.38）为中心，左侧小脑中脚、左侧小脑后叶（蚓垂和蚓部）、蚓部、梭状回、舌回、枕下回、距状裂、楔叶、楔前叶、BA7、BA18和BA19等区域的功能连接增加。以左侧海马旁回（PG）的种子区（-21.17, -15.95, -20.70）为中心，左侧楔前叶、内侧扣带回、顶下小叶、中央旁小叶、BA5、BA6、BA7和BA40、右侧正中扣带回、楔前叶、BA19、BA23和BA31等区域的功能连接增加。
结论
表明靳三针疗法可调节优势半球大脑中动脉急性梗死患者的脑功能连接，特异性加强视觉、认知、运动控制及计划相关脑区之间的连接，这可能在机制上与运动功能恢复有关。本试验已在中国临床试验注册中心注册，注册号为ChiCTR-IOR-15007672。
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