《中国康复理论与实践》

《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (02): 184-188.

• 临床研究 • 上一篇    下一篇

针刺百会穴改善脑卒中患者记忆力的中枢机制

林志诚1,3，杨珊莉1,3，薛偕华1,3，陶静2,3，陈立典2,3   

  1. 1.福建中医药大学附属康复医院，福建福州市350003；2.国家中医药管理局中医康复研究中心，福建福州市350003；3.福建中医药大学，福建福州市350108。
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-02-25 发布日期:2015-02-25

Central Mechanism of Acupuncture at Baihui for Memory Impairment after Stroke: A Resting- state Functional Magnetic Resonance Imaging Study

LIN Zhi-cheng, YANG Shan-li, XUE Xie-hua, TAO Jing, CHEN Li-dian   

  1. Department of Rehabilitation Medicine, Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350003, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-02-25 Online:2015-02-25

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被引次数

38

摘要： 目的探讨针刺百会穴改善脑卒中患者记忆力的中枢机制。方法将32 例脑卒中患者随机分成观察组和对照组，两组均给予神经内科常规治疗以及物理、作业康复治疗。观察组在此基础上针刺百会穴8 周，对照组针刺阳陵泉穴8 周。治疗前后两组行静息态fMRI扫描，观察左、右海马功能连接的变化；采用韦氏记忆量表对患者进行评定。对韦氏记忆量表评定结果与脑功能连接进行相关性分析。结果治疗前，两组韦氏记忆量表的各项得分和记忆商无显著性差异。观察组治疗后，记忆量表总分、记忆商改善(P<0.05)；左侧海马与右侧额下回、右侧额中回，以及右侧海马与左侧额叶、左侧顶叶连接增加。记忆商与左侧海马和右侧额中回的功能连接(r=0.56)、右侧海马和左侧额上回的功能连接(r=0.75)、右侧海马和左侧顶叶的功能连接(r=0.88)呈正相关。对照组治疗前后，记忆量表总分、记忆商无显著性差异(P>0.05)，左侧海马与右侧枕中回、右侧海马与右侧小脑后叶、左侧颞上回之间的连接减少，量表分与海马脑区功能连接无明显相关性。结论针刺百会改善脑卒中患者记忆力的中枢效应机制，可能与增加海马与额叶、顶叶之间脑网络的功能连接有关。

关键词: 脑卒中, 针刺, 百会, 记忆力, 静息态功能磁共振, 功能连接

Abstract: Objective To explore the central mechanism of acupuncture at Baihui (GV20) for memory impairment after stroke. Methods 32 stroke patients were randomized to receive acupuncture at Baihui (GV20) (as observation group) and acupuncture at Yanglingquan (GB34) (as control group) for 8 weeks. At the meantime, all participants received routine treatment including physical and occupational therapies. They were scanned with resting-state functional magnetic resonance imaging (fMRI) to find functional connectivity and assessed with Wechsler Memory Scale (WMS) before and after treatment. The results of WMS and functional connectivity were analyzed with Pearson's correlation. Results The memory scores and memory quotient improved significantly after treatment in the observation group (P<0.05). The functional connectivity significantly increased occurred in the left hippocampus to right inferior frontal gyrus, right middle frontal gyrus and left inferior frontal gyrus; and right hippocampus to left middle frontal gyrus, left superior frontal gyrus and left parietal lobe. Significant correlations were found between memory quotient and functional connectivity of hippocampus to frontal lobe and left parietal lobe in the observation group. There was no statistical significance in memory scores and memory quotient in the control group. The functional connectivity significantly decreased in left hippocampus to right middle occipital gyrus, and right hippocampus to right superior temporal gyrus and right posterior lobe of cerebellum. There was no statistical correlation between functional connectivity and results of WMS. Conclusion The acupuncture at Baihui can improves memory ability of stroke patients, which may associate with the increase of functional connectivity of hippocampus with frontal lobes and parietal lobes.

Key words: stroke, acupuncture, Baihui, memory, resting-state functional magnetic resonance imaging, functional connectivity