摘要
目的 基于功能磁共振成像(fMRI)技术,对比针刺阳陵泉真穴/假穴对中风偏瘫患者感觉运动网络(SMN)、背侧注意网络(DAN)功能连接的即刻效应,探讨针刺对中风偏瘫患者中枢调节机制及经穴特异性。方法 纳入中风偏瘫患者20例,间隔2周分别进行1次针刺阳陵泉真穴与假穴的fMRI扫描,应用独立成分分析提取运动相关的SMN、DAN,比较功能连接差异。结果 在SMN内,针刺阳陵泉真穴后较针刺前功能连接增强,增强的脑区有右侧中央前回、颞上回、额下回、楔叶、楔前叶,左侧颞中回、枕中回、颞上回、海马旁回、额下回、颞上回;针刺阳陵泉假穴后较针刺前功能连接增强,增强的脑区有右侧中央前回、额上回、额中回、扣带回,左侧额内侧回、前扣带回、豆状核、尾状核。在DAN中,针刺阳陵泉真穴后较针刺前功能连接增强,增强的脑区包括右侧大脑楔前叶、颞上回、颞中回、枕中回,左侧扣带回、后扣带回、楔前叶;针刺阳陵泉假穴后较针刺前功能连接增强,增强的脑区包括右侧前扣带回,左侧前扣带回、额内侧回。结论 针刺阳陵泉能激活中风偏瘫患者SMN、DAN双侧相关脑区,可能通过调节运动的启动及执行促进患者运动功能的恢复,且相较假穴更具经穴特异性。
Objective To compare the immediate effects of acupuncture at the true and false acupoints of Yanglingquan on functional connectivity in sensorimotor network(SMN)and dorsal attentional network(DAN)of stroke patients based on functional magnetic resonance imaging(fMRI)technology;To explore the central regulatory mechanism and acupoint specificity of acupuncture in stroke patients with hemiplegia.Methods Totally 20 patients with stroke and hemiplegia were included in the study.fMRI scans of acupuncture at the true and false acupoints of Yanglingquan were performed once every 2 weeks,and motion-related SMN and DAN were extracted by independent component analysis to compare the differences in functional connectivity.Results In SMN,after acupuncture at the Yanglingquan true acupoint,the functional connectivity was enhanced compared with before acupuncture.The enhanced brain areas included the right anterior central gyrus,superior temporal gyrus,inferior frontal gyrus,cuneiform lobe,and anterior cuneiform lobe,as well as the left middle temporal gyrus,occipital gyrus,superior temporal gyrus,parahippocampal gyrus,inferior frontal gyrus,and superior temporal gyrus.After acupuncture at the Yanglingquan false acupoint,the functional connectivity was enhanced compared with before acupuncture.The enhanced brain areas included the right anterior central gyrus,superior frontal gyrus,middle frontal gyrus,and cingulate gyrus,as well as the left medial frontal gyrus,anterior cingulate gyrus,lentiform nucleus,and caudate nucleus. In DAN, after acupuncture at the Yanglingquan true acupoint, the functional connectivity wasenhanced compared with before acupuncture. The enhanced brain areas included the right anterior cingulate lobe,superior temporal gyrus, middle temporal gyrus, and occipital gyrus, as well as the left cingulate gyrus, posteriorcingulate gyrus, and anterior cingulate lobe. After acupuncture at the Yanglingquan false acupoint, the functionalconnectivity was enhanced compared with before acupuncture, and the enhanced brain areas included the rightanterior cingulate gyrus, left anterior cingulate gyrus, and medial frontal gyrus. Conclusion Acupuncture atYanglingquan can activate SMN and DAN bilateral related brain regions in patients with hemiplegia, which maypromote the recovery of motor function by regulating the initiation and execution of motor activities, and has moreacupoint specificity compared with false acupoint.
作者
陈琛
李匡时
喻鑫
武琳璐
陈天竹
吴康
李媛媛
史昕玥
邹忆怀
CHEN Chen;LI Kuangshi;YU Xin;WU Linlu;CHEN Tianzhu;WU Kang;LI Yuanyuan;SHI Xinyue;ZOU Yihuai(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《中国中医药信息杂志》
CAS
CSCD
2024年第3期149-154,共6页
Chinese Journal of Information on Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81873257)。
关键词
阳陵泉
中风偏瘫
针刺
脑网络
功能磁共振
功能连接
Yanglingquan
apoplexy hemiplegia
acupuncture
brain network
functional magnetic resonance imaging
functional connection
作者简介
通讯作者:邹忆怀,E-mail:zouyihuai2004@163.com。
