中国中医药信息杂志2025，Vol.32Issue(4)：135-140,6.DOI:10.19879/j.cnki.1005-5304.202408564
基于格兰杰因果探讨缺血性卒中后偏瘫患者针刺脑效应机制
Exploration on the Brain Mechanism Underlying Acupuncture Effects in Hemiplegic Patients after Ischemic Stroke Based on Granger Causality
摘要
Abstract
Objective To discuss the effects of the"twelve needles for hands and feet"acupuncture on the brain response mechanism and acupoint specificity in hemiplegic patients after ischemic stroke using fMRI.Methods Totally 43 inpatients from Dongzhimen Hospital of Beijing University of Chinese Medicine from December 2018 to March 2023 were included.The included patients were randomly divided into a true acupoint group of 23 cases and a fake acupoint group of 20 cases using the random number table method for clinical scale evaluation and magnetic resonance scanning.The true acupoint group received"twelve needles for hands and feet"acupuncture;the fake acupoint group was treated with acupuncture by opening 1 inch next to the meridian point,once a day,for consecutive 10 d.Intervention completed,excluding subjects who fell out during the intervention process,had unsatisfactory MRI data quality and had incomplete clinical scales,and conducting data processing and analysis.Bilateral anterior central gyrus(PreCG),amygdala(AMYG),caudate nucleus(CAU),putamen lenticularis(PUT),pallidus lenticularis(PAL)and thalamus(THA)were selected as regions of interest(ROI),and the changes in Granger causality(GC)and differences in scale scores between the two groups before and after treatment were compared.Results After intervention in the true acupoint group,the GC of CAU.R → PreCG.R,AMYG.R → PAL.R was stronger than before intervention,and the GC of THA.L→PAL.L,AMYG.R→THA.R in the true acupoint group was weaker than before intervention(P<0.05);after intervention with fake acupoints,the GC of AMYG.R→PUT.L in the false acupoint group was stronger than before intervention,and the GC of THA.L→PreCG.R,AMYG.L→CAU.L was weaker than before intervention(P<0.05);the GC of THA.R→PAL.L before intervention was stronger than false acupoint group,the GC of CAU.L→PreCG.R,PUT.L→PreCG.R before intervention was weaker than fake acupoint group(P<0.05);the GC of CAU.R→PreCG.R,THA.L→PreCG.R,AMYG.R→CAU.L,THA.L→PAL.R,AMYG.L→THA.L after intervention in the true acupoint group was stronger than the false acupoint group,and the GC of AMYG.R→AMYG.L after intervention in the true acupoint group was weaker than the fake acupoint group(P<0.05).Conclusion"Twelve needles for hands and feet"acupuncture can stimulate preferential compensation of the right motor circuit,bilateral basal ganglia remodeling,and balance regulation of excitatory inhibitory effects on the thalamus in patients with radiation-induced coronary stroke,thereby improving the degree of motor dysfunction and neurological deficits;acupuncture at acupoints stimulates brain activity more than at non-acupoints,indicating acupoint specificity.关键词
卒中/偏瘫/功能磁共振/格兰杰因果/手足十二针/脑效应Key words
stroke/hemiplegia/fMRI/Granger causality/twelve needles for hands and feet/brain effects分类
医药卫生引用本文复制引用
许天骄,陆梦馨,李媛媛,张慕昭,邹忆怀,方继良..基于格兰杰因果探讨缺血性卒中后偏瘫患者针刺脑效应机制[J].中国中医药信息杂志,2025,32(4):135-140,6.基金项目
国家自然科学基金(82174331、82174282) （82174331、82174282）
