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头针对脑梗死后脑灰质损伤干预作用的影像学研究

郎奕1,2 崔方圆2 李匡时2 谭中建2 邹忆怀2

(1.北京大学人民医院中医科, 北京 100044)
(2.北京中医药大学东直门医院脑病科, 北京 100700)

【摘要】目的 采用基于体素形态学方法,研究脑梗死患者脑灰质结构损伤变化特点及头针疗法的干预作用。方法 选取健康志愿者16名和脑梗死患者16例,将脑梗死患者随机分为头针组、对照组各8例,健康志愿者为正常组。所有患者行T1结构像扫描。采用VBM8软件包进行图像后处理,分别比较头针组、对照组治疗前后与正常组脑灰质结构差异。结果 脑梗死后患者较正常组在扣带回、楔前叶、楔叶、中央前回、脑岛等14个脑区存在脑灰质结构损伤,主要分布于患侧脑区。治疗两周后头针组较正常组在双侧舌回、后扣带回,左侧楔叶,右侧楔前叶等8个脑区仍存在灰质结构损伤,其中舌回和后扣带回2个脑区属新发脑灰质损伤。治疗两周后对照组较正常组在双侧前扣带、尾状核、楔叶、脑岛、额下回、额内侧回、楔前叶、旁中央小叶、颞上回、颞中回、舌回,右侧中央后回、后扣带回、中央前回、额中回等共计23个脑区存在脑灰质结构损伤,其中舌回、后扣带回、中央后回等9个脑区属新发脑灰质损伤。结论 脑梗死后脑灰质结构存在广泛损伤,随病程延长灰质体积可逐渐减少,联合应用头穴针刺疗法能有效抑制脑梗后脑灰质损伤的进程。

【关键词】 头针;脑梗死;体素形态学;脑灰质;

【DOI】

【基金资助】 国家自然科学基金面上项目(No.81473667); 北京高校青年英才(No.YETP0822);

Imaging Observation of Scalp Acupuncture on Brain Gray Matter Injury in Stroke Patients with Cerebral Infarction

LANG Yi1,2 CUI Fang-yuan2 LI Kuang-shi2 TAN Zhong-jian2 ZOU Yi-huai2

(1.Department of Chinese Medicine, People’s Hospital of Peking University, Beijing 100044)
(2.Department of Cerebral Disease, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700)

【Abstract】Objective To study features of brain gray matter injury in cerebral infarction patients and intervention of scalp acupuncture by using voxel-based morphology. Methods A total of 16 cerebral infarction patients were recruited in this study, and assigned to the scalp acupuncture group and the control group, 8 in each group. Another 16 healthy volunteers were recruited as a normal group. All patients received scanning of T1 structure. Images were managed using VBM8 Software package. Difference of the gray matter structure was compared among the scalp acupuncture group, the control group, and the healthy volunteers. Results Compared with healthy volunteers, gray matter injury of cerebral infarction patients mainly occurred in 14 brain regions such as cingulate gyrus, precuneus, cuneus, anterior central gyrus, insular lobe, and so on. They were mainly distributed in affected side. Two weeks after treatment when compared with healthy volunteers, gray matter injury of cerebral infarction patients in the scalp acupuncture group still existed in 8 brain regions such as bilateral lingual gyrus, posterior cingulate gyrus, left cuneus, right precuneus, and so on. New gray matter injury occurred in lingual gyrus and posterior cingulate gyrus. Two weeks after treatment when compared with healthy volunteers, gray matter injury of cerebral infarction patients in the control group existed in 23 brain regions: bilateral anterior cingulum, caudate nucleus, cuneate lobe, insular lobe, inferior frontal gyrus, medial frontal gyrus, precuneus, paracentral lobule, superior temporal gyrus, middle temporal gyrus, lingual gyrus, right postcentral gyrus, posterior cingulate gyrus, precentral gyrus, middle frontal gyrus, and so on. New gray matter injury still existed in 9 cerebral regions such as lingual gyrus, posterior cingulate gyrus, postcentral gyrus, and so on. Conclusions Brain gray matter structure is widely injured after cerebral infarction. Brain gray matter volume gradually decreased as time went by. Combined use of scalp acupuncture might inhibit the progression of gray matter in-jury more effectively.

【Keywords】 scalp acupuncture; cerebral infarction; voxel-based morphology; brain gray matter;

【DOI】

【Funds】 General Program of the National Natural Science Foundation of China (No. 81473667); Young Talents Program of Colleges and Universities in Beijing (No. YETP0822);

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This Article

ISSN:1003-5370

CN: 11-2787/R

Vol 36, No. 03, Pages 294-299

March 2016

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Abstract

  • Materials and methods
  • Results
  • Discussions
  • References