Effect of “Hand and Foot Acupuncture with Twelve Needles” on the Functional Connection between Primary Motor Areas of the Brain and Cerebellum in Patients with Hemiplegia after Ischemic Stroke

CHEN Tianzhu; ZOU Yihuai; DU Zhongming; WANG Yahui; CHEN Chen; LU Mengxin; WANG Yue; SHI Xinyue; LIU Ruoyi

doi:10.13288/j.11-2166/r.2021.17.010

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Effect of “Hand and Foot Acupuncture with Twelve Needles” on the Functional Connection between Primary Motor Areas of the Brain and Cerebellum in Patients with Hemiplegia after Ischemic Stroke

更新时间：2021-11-02

- Effect of “Hand and Foot Acupuncture with Twelve Needles” on the Functional Connection between Primary Motor Areas of the Brain and Cerebellum in Patients with Hemiplegia after Ischemic Stroke
- Journal of Traditional Chinese Medicine Vol. 62, Issue 17, Pages: 1514-1521(2021)
- 作者机构：
  
  1. 北京中医药大学东直门医院
  2. 北京中医药大学
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2021.17.010
  CLC： R246.6
- Published：2021
- 稿件说明：
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CHEN Tianzhu, ZOU Yihuai, DU Zhongming, et al. Effect of “Hand and Foot Acupuncture with Twelve Needles” on the Functional Connection between Primary Motor Areas of the Brain and Cerebellum in Patients with Hemiplegia after Ischemic Stroke[J]. Journal of Traditional Chinese Medicine2021, 62(17): 1514-1521.
DOI：

CHEN Tianzhu, ZOU Yihuai, DU Zhongming, et al. Effect of “Hand and Foot Acupuncture with Twelve Needles” on the Functional Connection between Primary Motor Areas of the Brain and Cerebellum in Patients with Hemiplegia after Ischemic Stroke[J]. Journal of Traditional Chinese Medicine2021, 62(17): 1514-1521. DOI： 10.13288/j.11-2166/r.2021.17.010.

摘要

目的探究手足十二针对缺血性脑卒中偏瘫患者大脑初级运动区(M1区)与小脑功能连接的影响。方法 22例缺血性脑卒中偏瘫患者分为轻中度组14例、重度组8例。所有患者给予手足十二针针刺干预:取双侧合谷、内关、曲池、足三里、阳陵泉、三阴交

均使用捻转平补平泻手法得气后留针30min

每日针刺1次

连续10天。针刺前后进行Fugl-Meyer量表(FMA)评分[包括上肢运动功能评分(FMA-Upper)和下肢运动功能评分(FMA-Lower)]、美国国立卫生研究院卒中量表(NIHSS)评分;并进行功能磁共振成像

选取双侧M1区、小脑后叶区(SCb区)、小脑前叶区(AICb区)为种子点

比较病灶侧与健侧M1区(iM1-cM1)、病灶侧M1区与健侧SCb区(iM1-cSCb)、病灶侧M1区与健侧AICb区(iM1-cAICb)、健侧M1区与病灶侧SCb区(cM1-iSCb)、健侧M1区与病灶侧AICb区(cM1-iAICb)的功能连接度(FC值)差异

并与FMA评分进行相关性分析。结果 22例患者针刺前后FMA-Upper、FMA-Lower、FMA总积分及NIHSS评分差异均有统计学意义(P<0.01);轻中度组FMA总积分和NIHSS评分在针刺后较针刺前差异有统计学意义(P<0.05)

重度组针刺前后FMA-Upper、FMA-Lower、FMA总积分及NIHSS评分差异均有统计学意义(P<0.05)。22例患者针刺前后运动区各配对FC值差异均无统计学意义(P>0.05);轻中度组iM1-cM1在针刺后FC值呈现较大升高(P=0.048)

且针刺后iM1-cM1 FC值差值改善明显(P=0.014)。22例患者FMA总积分与cM1-iSCb呈中等强度负相关(r=-0.453

P=0.034)

其中重度组患者FMA总积分与cM1-iSCb呈较强程度负相关(r=-0.767

P=0.026)、与cM1-iAICb呈较强程度负相关(r=-0.759

P=0.029)

且其FMA-Upper评分与cM1-iAICb呈较强程度负相关(r=-0.822;P=0.012)。结论手足十二针对轻中度缺血性脑卒中偏瘫患者iM1-cM1功能连接改善明显

可能是改善患者运动功能障碍和神经缺损程度的作用机制之一。

Abstract

Objective To explore the effect of "hand and foot acupuncture with twelve needles" on the functional connection between primary motor areas（M1） of the brain and cerebellum in patients with hemiplegia after ischemic stroke. Methods Twenty-two patients with hemiplegia after ischemic stroke were divided into a mild to moderate group of 14 cases and a severe group of 8 cases. All the patients were given hand and foot acupuncture with twelve needles as follows: bilateral Hegu（LI 4）

Neiguan（PC 6）

Quch

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