宋彦澄，康立清，董红焕，陈勇.头针丛刺结合强制性运动疗法对脑梗死后手运动障碍疗效的功能性磁共振评价[J].中华物理医学与康复杂志,2017,39(2):117-121
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| 头针丛刺结合强制性运动疗法对脑梗死后手运动障碍疗效的功能性磁共振评价 |
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| DOI： |
| 中文关键词: 头针丛刺 强制性运动疗法 功能磁共振 脑梗死 |
| 英文关键词: Scalp Acupuncture Constraint-induced movement therapy Functional MRI Cerebral infarction |
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| 中文摘要: |
| 目的采用血氧水平依赖性功能磁共振成像（BOLD-fMRI）观察急性期脑梗死患者经头针丛刺及强制性运动疗法（CIMT）治疗前、后其手运动中枢激活体积、激活强度变化。 方法采用随机数字表法将30例急性期（发病至入组时间≤3d）脑梗死患者分为试验组及对照组。2组患者均给予常规药物治疗，试验组同时辅以头针丛刺及CIMT治疗，对照组则辅以体针及一般康复治疗。于入院当天及治疗14d后进行fMRI检查，观察其大脑手运动功能区改善情况，并采用Fugl-Meyer运动功能量表（FMA）上肢部分测定患者肢体功能改善情况。另外本研究同时选取15例年龄、性别相匹配的健康志愿者行单次fMRI检查，观察其相同任务下脑区激活体积与强度，并与患者组进行比较。 结果所有患者经治疗后其患肢运动时患侧感觉-运动皮质（SMC）激活体积、FMA评分均较治疗前增大（P<0.05）；试验组治疗前、后患侧手运动激活对侧SMC体积及激活强度均较对照组更明显（P<0.05）。 结论在脑梗死急性期采用头针丛刺结合CIMT治疗能进一步促进患侧大脑感觉-运动皮质功能恢复，改善患者运动功能，该联合疗法值得临床推广、应用。 |
| 英文摘要: |
| Objective To compare the effect of clustered acupuncture of the scalp combined with constraint-induced movement therapy (CIMT) with that of conventional acupuncture of the body points plus conventional rehabilitation intervention after cerebral infarction using blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI). MethodsThirty acute cerebral infarction patients with hemiplegia were equally divided into two groups at random. The test group received the clustered acupuncture of the scalp combined with CIMT, while the control group received the body point acupuncture plus conventional rehabilitation intervention. Before and after two weeks of treatment, blood oxygenation level-dependent functional magnetic resonance imaging at 3.0 T was performed during a passive digital opposition movement. The volume and intensity of the activated areas were compared. Fugl-Meyer assessment (FMA) was carried out as well. ResultsThe most pronounced activation appeared in the contralateral somatosensory motor cortex for both groups. There was no significant difference in average FMA scores between the two groups before the treatment, but after the treatment the averages were significantly different. An increase in activated volume and intensity in the contralateral SMC was observed in both groups after the treatment, but the test group showed a much larger change in both activated volume and intensity. ConclusionThe clustered acupuncture of the scalp combined with CIMT can achieve a more significant improvement in functional recovery after acute cerebral infarction than conventional acupuncture of the body points plus conventional rehabilitation intervention. Such combined therapy is worthy of application in clinical practice. |
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