CAJ | 학술논문

目的探讨脑损伤患者瘫侧足三里(ST36)和风市(CB31)联合穴位电针刺激功能磁共振成像监测患侧脑激活簇偏侧指数(laterality index,LI)改变对临床神经功能缺损恢复程度的评定价值.方法对恢复期可配合检查15例脑损伤致偏瘫的住院患者,选择瘫侧足三里和风市穴位进行电针刺激功能磁共振成像,运用t检验进行统计学分析得出刺激状态与静息状态信号对比的脑功能图.15例患者相隔14～49d后再进行1次功能磁共振成像对比检查.计算出每次的针灸对侧脑激活簇偏侧指数LI影响.U=(C-I)/(C+D,C与I分别为针灸侧的对侧与针灸侧的同侧脑激活簇数目之和.同时,计算出同期相应的临床神经功能缺损评分值S(score).统计分析2期LI值对比变化△LI(H2-LI)及其与s改变△(S1-S2)的相关性.结果 15例均获得2期检查的完整资料.15例共做43次功能磁共振成像,选择其中较优质30次脑功能图做统计分析.15例LI变化均有不同程度提高,但差异无统计学意义(t=1.304,P>0.05);△LI和△S均为正值,且△LI与△S呈正相关(r=0.959,P<0.001).结论脑损伤患者瘫侧足三里和风市穴位联合电针刺激功能磁共振成像动态监测患侧脑激活簇LI改变△LI对脑损伤神经功能缺损恢复程度具有一定的评定价值.
목적 탐토뇌손상환자탄측족삼리(ST36)화풍시(CB31)연합혈위전침자격공능자공진성상감측환측뇌격활족편측지수(laterality index,LI)개변대림상신경공능결손회복정도적평정개치.방법 대회복기가배합검사15례뇌손상치편탄적주원환자,선택탄측족삼리화풍시혈위진행전침자격공능자공진성상,운용t검험진행통계학분석득출자격상태여정식상태신호대비적뇌공능도.15례환자상격14～49d후재진행1차공능자공진성상대비검사.계산출매차적침구대측뇌격활족편측지수LI영향.U=(C-I)/(C+D,C여I분별위침구측적대측여침구측적동측뇌격활족수목지화.동시,계산출동기상응적림상신경공능결손평분치S(score).통계분석2기LI치대비변화△LI(H2-LI)급기여s개변△(S1-S2)적상관성.결과 15례균획득2기검사적완정자료.15례공주43차공능자공진성상,선택기중교우질30차뇌공능도주통계분석.15례LI변화균유불동정도제고,단차이무통계학의의(t=1.304,P>0.05);△LI화△S균위정치,차△LI여△S정정상관(r=0.959,P<0.001).결론 뇌손상환자탄측족삼리화풍시혈위연합전침자격공능자공진성상동태감측환측뇌격활족LI개변△LI대뇌손상신경공능결손회복정도구유일정적평정개치.
Objective To investigate the ssessment value of nerve function damage recovery degree by the brain activated areas "later-ality index " (LI) change of the contralateral versus electroacupuncture lateral by brain functional MRI (fMRI) after electroacupuncture to the hemiplegia ipsilateral acupionts Zu san li (ST36) and Feng shi (GB31) for patients with traumatic brain injury during nerve function recovery stage. Methods Fifteen cooperative patients with severe bemiplegia caused by traumatic brain injury underwent fMRI during nerve function recovery stage. All the patients had received eleetroacupuncture of ipsilateral acupionts Zu san li (ST36) and Feng shi (GB31). After stimula-tion the activated areas in brain functional BOLD maps were analyzed by t-test analysis. A comparative study was made in nineteen patients re-ceived two times of fMRI at the interval 14～49 days. A "laterality index" (LI) of the contralateral versus electroaeupuncture lateral was cal-culated (LI=(C-I)/(C+I), C and I are the activated number in the eontralateral brain and that in the ipsilateral brain respectively). Meanwhile, the assessment score of nerve function damage was calculated for every patient too. The correlation between between LI change △LI (LI2-LI1) and S change △S (S1-S2) was analyzed. Results Forty-three times of fMRI were achieved in 15 patients who received 2 times ex-amination. Thirty maps were selected for statistics analysis. Among the thirty maps, Compared with the first fMRI, the LI value increased at the different degree, but no significance difference (t=1.304 P>0.05). △LI and △S are all positive, and the correlation between △ LI and △ S was positive (r=0.959,P<0.001). Conclusion Brain fMRI to dynamicly monitor the brain activated areas LI change △ LI of contrelateral versus electroacupuncture lateral after electroacupuncture to acupoints Zu san li (ST36) and Feng shi (GB31) has the assessment value of nerve function recovery degree after traumatic brain injury.