针灸治疗脑出血患者手运动功能障碍相关疗效的-神经疾病与精神卫生.PDFVIP

神经疾病与精神卫生2017年第17卷第1期 ·学术交流· 针灸治疗脑出血患者手运动功能障碍相关疗效的 可视化预测研究 贡志刚　张荣俊　蒋文斌　付志辉　张音 【摘要】　目的　利用纤维束成像技术预测针灸治疗高血压脑出血患者手运动功能障碍的临床疗效。 方法　三维重建21 例高血压脑出血患者中央前回手结区域的皮质脊髓束(CST) 纤维，分析在不同CST 受 损情况下，针灸康复治疗前后患者NHISS 评分以及Brunnstrom 手分级评分的变化差异。结果　CST 未受 损患者康复治疗后NHISS 评分显著低于治疗前(P ＜0.05) ，但Brunnstrom 手分级评分差异无统计学意义； CST 部分断裂患者康复治疗后两项评分均较治疗前明显改善(P ＜0.05) ；而CST 完全断裂患者康复治疗前 后两项评分差异均无统计学意义。结论　纤维束成像技术能直观显示中央前回手结相关CST 纤维受损 情况，对于CST 部分断裂的患者来讲，针灸能明显改善手的运动功能。 【关键词】　脑出血；　针灸；　皮质脊髓束；　运动功能 - doi ：10.3969/j.issn.1009 6574.2017.01.009 Visual prediction about therapeutic effect of acupuncture on hand motor dysfunction in patients with - - - intracranial hemorrhage　GONG Zhi gang ， ZHANG Rong jun ， JIANG Wen bin ， et al. Department of Neuro- surgery ， Suzhou Affiliated Hospital of Nanjing University of Chinese Medicine ， Suzhou 215009 ， China 【Abstract 】　Objective　To investigate the therapeutic effect of acupuncture on hand motor dysfunc- tion in patients with hypertensive intracranial hemorrhage using tractography. Methods　 Corticospinal tract (CST) fibers from precentral knobs of 21 hypertensive intracranial hemorrhage patients were three-dimentionally recontructed. Furthermore ， the different changes of NHISS scores and Brunnstrom hand stage scores were an- alyzed in accordance with different damage extent of CTS. Results　In patients with undamaged CTS ， NHISS scores ， not Brunnstrom hand stage scores ， were improved significantly after acupuncture treatment (P ＜0.05). In patients with partially damaged CTS ， both NHISS scores and Brunnstrom hand stage scores were improved significantly after acupuncture treatment (P ＜0.05). However ， in patients with fully damaged CTS ， neither NHISS scores nor Brunnstrom hand stage scores were changed significantly. Conclusions　Tractography can clearly demons