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基于神经电生理技术观察眼针疗法对不完全性脊髓损伤患者运动诱发电位和体感诱发电位的影响

[Effects of eye acupuncture on motor evoked potential and somatosensory evoked potential in patients with incomplete spinal cord injury based on neuroelectrophysiological technology].

作者信息

Li Bing, Zhang Zhao-Xia, Feng Xiao-Dong, Wang Yong-Fu, Niu Qiu-Yan, Ren Ya-Feng

机构信息

School of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou 450008, China.

Rehabilitation Centre, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450099.

出版信息

Zhen Ci Yan Jiu. 2022 Apr 25;47(4):329-35. doi: 10.13702/j.1000-0607.20210196.

Abstract

OBJECTIVE

To observe the effects of eye acupuncture on motor evoked potential (MEP) and somatosensory evoked potential (SEP) in the patients with incomplete spinal cord injury so as to evaluate its clinical efficacy.

METHODS

According to the random number table, 90 patients were divided into exercise therapy group, eye acupuncture group and eye acupuncture combined exercise therapy group (combined treatment group), 30 cases in each. In the exercise therapy group, patients were treated with the routine exercise and occupational therapy. Patients of the eye acupuncture group were treated with eye acupuncture at upper jiao region, lower jiao region, liver region and kidney region bilaterally. Patients of the combined treatment group were given the routine exercise and occupational therapy combined with eye acupuncture. All the treatments were conducted once daily, 7 days as one treatment course for 4 treatment courses. Before treatment and 4 weeks after treatment, the motor function, light touch sensation and pinprick sensation, injury grade and clinical efficacy were assessed separately, using the criteria developed by the American Spinal Injury Association. The modified Barthel index(MBI) was adopted to evaluate the activities of daily livings. By monitoring SEP and MEP, the neurophysiological conditions were assessed for spinal cord injury.

RESULTS

The total effective rate was 56.7% (17/30), 66.7% (20/30) and 90.0% (27/30) in the exercise therapy group, the eye acupuncture group and the combined treatment group, respectively. The total effective rate in the combined treatment group was higher than those in the other two groups (<0.05). Compared with those before treatment, the scores of motor function, light tough sensation and pinprick sensation were all increased after treatment in three groups (<0.05), MBI score was increased in both the exercise therapy group and the combined treatment group (<0.05), and the latency of SEP (N11, N20, N23, P38) and the Cortical (hand region), Csp, Cortical (leg region) and Lsp of MEP were all shortened in the three groups separately (<0.05). After treatment, compared with the exercise therapy group, the score of motor function was increased (<0.05), MBI score decreased (<0.05) and MEP latency shortened (<0.05) in the eye acupuncture group. After treatment, compared with the exercise therapy group and the eye acupuncture group, the scores of motor function, light touch sensation and pinprick sensation, as well as MBI score were all increased (<0.05), and the latency of SEP (N11,N20,N23,P38) and MEP shortened (<0.05) in the combined treatment group.

CONCLUSION

In treatment of incomplete spinal cord injury, eye acupuncture combined with exercise therapy can significantly increase the excitability of sensory and motor nerve conduction in the spinal cord and cerebral cortex of patients, effectively promote the recovery of patients' motor and sensory function and improve the activities of daily living.

摘要

目的

观察眼针疗法对不完全性脊髓损伤患者运动诱发电位(MEP)和体感诱发电位(SEP)的影响,以评价其临床疗效。

方法

根据随机数字表将90例患者分为运动疗法组、眼针组和眼针结合运动疗法组(联合治疗组),每组30例。运动疗法组患者采用常规运动疗法和作业疗法。眼针组患者双侧取上焦区、下焦区、肝区和肾区进行眼针治疗。联合治疗组患者采用常规运动疗法和作业疗法结合眼针治疗。所有治疗均每日1次,7天为1个疗程,共治疗4个疗程。分别于治疗前和治疗后4周,采用美国脊髓损伤协会制定的标准评估运动功能、轻触觉和针刺觉、损伤分级及临床疗效。采用改良Barthel指数(MBI)评估日常生活活动能力。通过监测SEP和MEP评估脊髓损伤的神经生理状况。

结果

运动疗法组、眼针组和联合治疗组的总有效率分别为56.7%(17/30)、66.7%(20/30)和90.0%(27/30)。联合治疗组的总有效率高于其他两组(P<0.05)。与治疗前相比,三组治疗后运动功能、轻触觉和针刺觉评分均升高(P<0.05),运动疗法组和联合治疗组的MBI评分升高(P<0.05),三组的SEP(N11、N20、N23、P38)潜伏期及MEP的皮质(手部区域)、Csp、皮质(腿部区域)和Lsp均分别缩短(P<0.05)。治疗后,眼针组与运动疗法组相比,运动功能评分升高(P<0.05),MBI评分降低(P<0.05),MEP潜伏期缩短(P<0.05)。治疗后,联合治疗组与运动疗法组和眼针组相比,运动功能、轻触觉和针刺觉评分及MBI评分均升高(P<0.05),SEP(N11、N20、N23、P38)潜伏期及MEP缩短(P<0.05)。

结论

在不完全性脊髓损伤的治疗中,眼针结合运动疗法可显著提高患者脊髓和大脑皮质感觉及运动神经传导的兴奋性,有效促进患者运动和感觉功能的恢复,改善日常生活活动能力。

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