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中华针灸电子杂志 ›› 2020, Vol. 09 ›› Issue (03) : 121 -124. doi: 10.3877/cma.j.issn.2095-3240.2020.03.012

所属专题: 文献

文献研究

针刺激活脑卒中后运动功能障碍的脑功能连接研究
李泽宇1, 詹逸珺1, 裴建1,()   
  1. 1. 200032 上海中医药大学附属龙华医院针灸科
  • 收稿日期:2020-04-30 出版日期:2020-08-15
  • 通信作者: 裴建
  • 基金资助:
    上海市科委科研重点项目(16401970300,18401970500); 国家自然科学基金青年基金资助项目(81603697); 上海市中医药新兴交叉学科资助计划项目(Shxxjcxk201709); 上海市卫计委针灸特色诊疗项目(ZJ2016001,2016LP041); 上海市卫健委海派中医传承工程项目(ZY(2018-2020)-CCCX-1006)

Review on acupuncture activation of brain functional connectivity in patients with motor dysfunction after stroke

Zeyu Li1, Yijun Zhan1, Jian Pei1,()   

  1. 1. Department of Acupuncture, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
  • Received:2020-04-30 Published:2020-08-15
  • Corresponding author: Jian Pei
  • About author:
    Corresponding author: Pei Jian, Email:
引用本文:

李泽宇, 詹逸珺, 裴建. 针刺激活脑卒中后运动功能障碍的脑功能连接研究[J/OL]. 中华针灸电子杂志, 2020, 09(03): 121-124.

Zeyu Li, Yijun Zhan, Jian Pei. Review on acupuncture activation of brain functional connectivity in patients with motor dysfunction after stroke[J/OL]. Chinese Journal of Acupuncture and Moxibustion(Electronic Edition), 2020, 09(03): 121-124.

脑卒中是导致永久性残疾的主要原因,早期诊断治疗和预防复发十分重要。针刺疗法能够安全有效地改善脑卒中后运动功能障碍。检索近10年缺血性脑卒中运动功能障碍的fMRI研究及针刺治疗缺血性脑卒中运动功能障碍的fMRI临床研究文献,通过分析文献探讨针刺治疗脑卒中后运动功能障碍的脑功能连接机制。共纳入11项基于感兴趣区域的fMRI技术观察针刺治疗脑卒中后运动功能障碍患者的临床研究,发现针刺治疗脑卒中后运动功能障碍的中枢机制主要是激活患者的初级运动皮层、后扣带回、楔前叶等脑区的功能连接。表明初级运动皮层等脑区的功能连接增强可能是针刺改善脑卒中后运动功能障碍的中枢机制。

Stroke is the main cause of permanent disability. Early diagnosis, treatment and prevention of recurrence are very important. Acupuncture therapy can safely and effectively improve motor dysfunction after stroke. In this paper, fMRI studies on motor dysfunction in ischemic stroke and fMRI clinical studies on acupuncture in the treatment of motor dysfunction in ischemic stroke in the past 10 years were searched, and the brain functional connection mechanism of acupuncture in the treatment of motor dysfunction in ischemic stroke was discussed by analyzing the literature. A total of 11 ROI-based fMRI were included to observe the clinical studies of acupuncture in the treatment of patients with motor dysfunction after stroke. It was found that the central mechanism of acupuncture in the treatment of motor dysfunction after stroke was mainly to activate the functional connections of primary motor cortex, posterior cingulate gyrus, precuneus and other brain regions. It suggests that the enhancement of functional connectivity in primary motor cortex may be the central mechanism of acupuncture in improving motor dysfunction after stroke.

表1 针刺治疗缺血性脑卒中患者的fMRI研究
作者 年份 样本(例) 分组(例) 穴位 研究设计 状态 脑区改变
Li Y等[12] 2017 31 西药:9
针刺+西药:8
健康:14
百会、风池、悬钟、曲池、合谷、足三里、三阴交 治疗前及8周治疗后采集静息态fMRI数据 静息态 双侧运动皮层、辅助运动区、中央后回连接增强
Ning Y等[13] 2017 40 脑卒中:20
健康:20
阳陵泉 被动手指运动定种子点;针刺前后获得静息态fMRI数据,针刺1 min 静息+任务态 针刺前与健康人相比卒中患者两侧运动皮层之间功能连接显著降低;针刺后该区域功能连接显著增加;
Fu CH等[14] 2017 36 中风:19
正常:17
阳陵泉 针刺前后获得静息态fMRI数据,针刺3 min 静息态 突显网络(包括前脑岛、前扣带回)、左额顶面网络,前默认模式网络、视觉网络、感觉运动网络连接增强
Xie Z等[15] 2014 17 脑卒中:9
健康:8
阳陵泉 针刺前后扫描8 min静息态fMRI数据,针刺1 min,被动手指运动确定种子点; 静息+任务态 卒中患者尾状核和小脑连通性较低,针刺后中央前回和中央后回被激活
Zhang Y等[16] 2014 18 脑卒中:8
健康:10
阳陵泉 针刺前后扫描8 min静息态fMRI数据,针刺1 min 静息态 后扣带皮质和前扣带皮质连接增强
Chen J[17] 2014 18 针刺穴位组:10针刺非穴位组:8 外关 起始2′42″扫描基线静息态数据,随后进行假针刺与真实针刺,扫描持续进行,真假针刺间隔6′2″ 静息+任务态 左基底节区、右中额回;右运动区与左中后回;右中额回和左丘脑;右小脑与右基底节连接增强
Qi J等[18] 2014 16 针刺穴位组:8针刺非穴位组:8 外关 起始3 min扫描基线静息态数据,随后针刺6 min,同时继续fMRI扫描 静息+任务态 右顶叶、右颞叶、右边缘叶和双侧枕叶连接增强;与假针刺相比,真穴位针刺抑制健侧Brodmann 5区
Huang Y等[19] 2013 10 未分组 外关 全程fMRI扫描,依次进行6 min假针刺与真针刺,真假针刺间隔5 min 静息+任务态 真实针刺前后对比,激活同侧前突神经,顶下小叶,颞中回,后扣带皮质,对侧下额叶回,颞中回;真针刺与假针刺比,激活中央前后回,额内侧回
Li MK等[20] 2015 10 得气组:5
未得气组:5
外关 起始3 min扫描基线静息态数据,随后6′30″针刺,fMRI继续扫描 静息+任务态 得气组:左颞上回、小脑右前叶、左丘脑。未得气组:右额叶的内侧额回,右边缘叶和左额叶
Bai L等[23] 2013 17 脑卒中:9
健康:8
阳陵泉 被动手指运动扫描定种子点;针刺行针1 min,休息1 min,针刺后获得fMRI数据。得气量表评价针刺效果 静息+任务态 同侧运动皮质(前运动皮质、补充运动区、后中央皮质)
Cho SY等[24] 2013 21 脑卒中:11
健康:10
左侧曲池、足三里 全程进行fMRI扫描,依次针刺曲池、足三里;每个穴位针刺3 min 静息+任务态 脑卒中患者在针刺曲池穴时激活右下顶叶;针刺足三里时激活两侧下顶叶和小脑
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