针刺头穴对中风患者大脑运动功能区糖代谢的影响

Effects of Electroacupuncture of Baihui(GV 20)-Qubin(GB 7) on Glucose Metabolism of Cerebral Motor Function Areas in Stroke Patients

目的:研究针刺百会、曲鬓穴对中风患者大脑运动功能区糖代谢的影响。方法:采用Talairach大脑立体定位法,运用PET观察运动状态下中风患者电针前后以及电针治疗3周后的大脑细胞葡萄糖代谢的变化。结果:①针刺的即刻效应:患者双侧第一躯体运动皮质区、运动前区及顶上小叶和健侧的补充运动区发生了明显的代谢功能改变,表现为糖代谢增高的区域集中于健侧,代谢减低集中于病灶侧。②3周后效应:患者第一躯体运动皮质区仍有改变,仍表现为糖代谢增高的区域集中于健侧,代谢减低集中于病灶侧。结论:电针头穴百会与曲鬓可以升高或降低双侧大脑的运动功能区域中葡萄糖的代谢,从而可能诱导与运动相关的某些区域神经组织兴奋,补偿或协助受损的神经网络,促进运动功能的重建。

Objective： To investigate the effect of electroacupuncture （EA） on glucose metabolism of the cerebral motor function regions in stroke patients. Methods： A total of 6 volunteer stroke patients with the duration of disease being 1 - 3 months were subjected into this study. Positron emission tomography （PET） and ^18F-2-fluoro-2-deoxyoD-glucose （^18F-FDG, i. v. ） were used to evaluate cerebral glucose metabolism 1 ） during fist-clenching movement and without acupuncture stimulation, 2） after EA stimulation （frequency 4 Hz, strength 4-6 mV, duration 20 min） at Baihui（GV 20）and right Qubin （GB 7）, and 3） three weeks after the acupuncture treatment. Talairach coordinates （Atlas of brain） and statistical parametric mapping （SPM） software were used to deal with the acquired imaging data. Results： a） Hypermetabolism of glucose was found mainly in precentral gyrus （PCG）, medial frontal gyrus （MFG）, superior parietal Iobule （SPL）, middle temporal gyrus （MTG）, superior temporal gyrus （STG）, cerebellum and putamen in the healthy hemisphere MFG on the affected side after EA stimulation, while hypometabolism found in PCG, median frontal gyrus （Area 6, 10）, SPL, MFG and MTG （Area 21 ）, on the affected side; b）Three weeks after EA, hypermetabolism still existed in PCG, superior frontal gyrus and STG in the healthy hemisphere; while hypornetabolism existed in POG, inferior frontal gyrus, thalamus, STG, MTG, etc. in the affected hemisphere. Conclusion： EA of Baihui （GV 20）-Qubin （GB 7） can elevate or lower glucose metabolism in cerebral structures related to motor function in the bilateral cerebral hemispheres, which may systematically induce excitement of motor nerve, expiate or assist the injured nerve network and expedite the reestablishment of the cerebral motor function.