运用静息态功能连接方法研究针灸治疗脑梗死的作用机制

Mechanism of acupuncture treatment of cerebral infarction by resting state functional connectivity

目的:观察针灸对改善脑梗死患者运动功能和生活能力的疗效,及其在静息态下对大脑网络功能连接的影响,探讨针灸治疗脑梗死的中枢作用机制。方法:将30例脑梗死患者随机分为针灸治疗组和常规治疗组,每组各15例,另选15名健康人作为健康对照组。收集患者治疗前后NIHSS评分、Barthel指数评分以及针灸治疗组的大脑静息态功能磁共振数据,运用相关软件分析静息态功能磁共振数据,探讨针灸改善脑梗死患者运动功能的中枢作用机制。结果:与常规治疗组比较,针灸组NIHSS评分均减低,Barthel指数评分提高(P<0.05,P<0.01);与健康对照组比较,针灸治疗组脑梗死患者患侧大脑运动中枢与小脑功能连接加强,与健侧中央前回功能连接减弱(P<0.05);经过针灸治疗后,脑梗死患者患侧大脑运动中枢与健侧中央前回功能连接减弱的范围缩小,与小脑的功能连接接近正常人。结论:针灸配合常规治疗改善脑梗死患者功能的疗效显著;针灸起效的机制可能与改善大脑患侧运动中枢与小脑及健侧中央前回之间的功能连接有关。

Objective：To evaluate acupuncture＇s effects of improving motor function and self-care ability of patients with cerebral infarction,explore the effect of acupuncture treatment on the connective function of brain＇s network in patients at resting-state,and approach the central mechanisms of acupuncture treatment of cerebral infarction.Methods：According to the inclusion criteria,30 patients with cerebral infarction were randomly divided into acupuncture group and routine treatment group,with 15 patients in each group.15 healthy persons were selected as the control group.NIHSS scale and Barthel index score before and after the treatment and magnetic resonance data of the acupuncture group at the resting state were collected.Related software were used for analyzing data from resting state functional magnetic resonance imaging（f MRI） and the central mechanism of acupuncture treatment of motor function of the patients with cerebral infraction were approached.Results：The score of NIHSS scale in acupuncture group was lower compared to the conventional treatment group,but the Barthel index score was increased（P〈0.05,P〈0.01）.Compared with control group,the connection of network function between the motor center of af ected brain and contralateral medial frontal gyrus was weakened in patients but the connectivity to cerebellar function was strengthened（P〈0.05）.After the acupuncture treatment,it was found that the encephalic region decreased with reduced functional network connectivity between ipsilateral cerebral motor cortex,and contralateral precentral gyrus area was smaller and the functional connection to cerebellum was closer to healthy people.Conclusion：The effect of acupuncture combined with conventional treatment on patients with cerebral infarction is significant.The effective mechanism of acupuncture may relate to improved functional connection of the motor center of af ected brain to cerebellum and contralateral medial frontal gyrus.