针刺治疗潜在性神经损伤疗效的电生理学分析

Electrophysiological analysis on curative effect of acupuncture on latent nerve injury

目的观察针刺治疗下肢神经潜在性损伤前后的神经传导参数的定量变化,探讨针刺刺激在末梢神经再生和修复中所起的作用。方法以30名韩国志愿者为对象,检测其腓神经和胫神经的复合肌肉动作电位(CMAP),进而挑选出远端波幅或运动传导速度(MCV)小于其置信区(x珋-s)下限的神经,或潜伏期大于置信区(x珋+s)上限的神经,分组进行实验。治疗组进行针刺治疗,腓神经选取阳陵泉、解溪穴;胫神经选取委中、昆仑穴1,个月后复查并比较2组间前期和后期的神经传导参数。结果被挑选的腓神经为20根,胫神经为17根。腓神经远端波幅及近端波幅平均值治疗后高于治疗前(P<0.05),胫神经的传导参数平均值则治疗前后在统计学上无显著差异(P>0.05)。结论针刺阳陵泉和解溪穴对压迫踝关节前部引起的腓神经潜在性损伤起到快速修复作用;而只有单纯的远端波幅降低的胫神经,对其针刺治疗,未见显著性的神经传导参数定量变化。

Objective To observe the quantitative changes of nerve conduction parameters before and after acupuncture treatment to latent nerve injury of lower limbs,and discuss the effects of acupuncture stimulation to the regeneration and repair of peripheral nerves.Methods In 30 Korean volunteers,the compound muscle action potential（CMAP） of peroneal nerves and tibial nerves were detected,and then the nerves,which distal amplitude（D Amp） or motor conduction velocity（MCV） were smaller than the lower limit of confidence interval（-s） or latency was larger than upper limit of confidence interval（＋s）,were selected as the objects and divided into groups in further test.The treatment group was given acupuncture in Yanglingquan（GB34）,Jiexi（ST41） of peroneal nerves and Weizhong（BL40） and Kunlun（BL60） of tibial nerves.The nerve conduction parameters were reexamined after one month and compared between two groups at earlier stage and later stage.Result There were 20 peroneal nerves and 17 tibial nerves selected for the second test.The average of D Amp and proximal amplitude（P Amp） of peroneal nerves was higher after the treatment than those before（P0.05）,while the average of conduction parameters of tibial nerves had no statistical difference before and after treatment（P0.05）.Conclusions Acupuncture in GB34 and ST41 has a rapid repair effect on peroneal latent injury induced by pressing anterior ankle joint.Compared with Japanese and Chinese Han volunteers,D Amp of tibial nerves has a simple decrease but no latent injury in Korean ones.There are no significant changes in nerve conduction parameters although acupuncture is given.