中国中西医结合影像学杂志2025，Vol.23Issue(3)：309-314,357,7.DOI:10.3969/j.issn.1672-0512.2025.03.008
基于功能连接探究絮刺拔罐改善肌张力增高的中枢机制
Investigating the central mechanisms of pricking-cupping therapy in alleviating increased muscle tone through functional connectivity analysis
摘要
Abstract
Objective:To explore the therapeutic effect and brain functional imaging mechanism of the pricking-cupping therapy through functional connectivity(FC)analysis.Methods:Thirty patients with increased muscle tone were included in the observation group,while 30 healthy subjects were included in the control group.The control group received no acupuncture interventions,while the observation group underwent pricking-cupping therapy once a week for a total of 4 weeks at Sanyinjiao(SP6),Ququan(LR8),Neiguan(PC6),Quchi(LI11).Modified Ashworth scale(MAS)scores and Fugl-Meyer motor assessment(FMA)scores for the affected upper and lower limbs were recorded before and after treatment in the observation group.Additionally,fMRI scans were conducted for the observation group both before and after treatment,as well as for the control group upon entry.The bilateral precentral gyri and supplementary motor area(SMA)were selected as seed points for FC analysis.FC values from different brain regions were extracted and correlated with the scale scores.Results:After treatment in the observation group,the MAS score grades for the upper and lower limbs decreased,the upper limb FMA and the total FMA scores decreased,the differences were statistical(all P＜0.05).Brain regions showing differences in FC values among the observation group before and after treatment and the control group included the left precentral gyrus and right insula,right superior temporal gyrus,right superior parietal gyrus;the right precentral gyrus and left postcentral gyrus;the left SMA and bilateral orbital inferior frontal gyri;the right SMA and left orbital inferior frontal gyrus.The post hoc pairwise comparisons revealed that before treatment,the observation group exhibited significantly decreased FC values between the left precentral gyrus and the right insula or right supramarginal gyrus,and between the left SMA and bilateral orbital inferior frontal gyri compared to the control group.While after treatment,the observation group demonstrated significantly increased FC values between the left precentral gyrus and right superior temporal gyrus,and between the right precentral gyrus and left postcentral gyrus,compared to pretreatment levels.Furthermore,post-treatment FC values between bilateral SMA and the left orbital inferior frontal gyrus in the observation group were significantly higher than those in the control group.Pearson analysis showed that the FC values were not correlated with MAS or FMA scores.Conclusions:The pricking-cupping therapy effectively improves symptoms of increased muscle tone.The underlying mechanism may be related to the modulation of FC between the premotor cortex and the prefrontal cortex,parts of the temporal lobe,insula,parietal lobes.关键词
缺血性中风/肌张力增高/絮刺拔罐/磁共振成像/功能连接Key words
Ischemic stroke/Hypertonia/Pricking-cupping/Magnetic resonance imaging/Functional connectivity引用本文复制引用
杨子越,李锦,杨烁慧,张莲,沈卫东,詹松华,魏翔宇..基于功能连接探究絮刺拔罐改善肌张力增高的中枢机制[J].中国中西医结合影像学杂志,2025,23(3):309-314,357,7.基金项目
国家自然科学基金青年项目(82205267) （82205267）
上海市进一步加快中医药传承创新发展三年行动计划项目(ZY[2021-2023]-0209-10). （ZY[2021-2023]-0209-10）
