电针语言相关组穴对1例左侧颞、顶、枕交界区损伤卒中后运动性失语患者的语言学评价及影像学探讨

目的以1例左侧颞、顶、枕交界区损伤的脑卒中后失语患者为研究对象,以电针刺激通里、悬钟组穴为干预手段,采取语言学评价和功能影像学实验相结合,探索电针组穴治疗前后的语言功能变化,以及穴位刺激后的脑功能激活与语言功能变化的关联。方法使用汉语标准失语症检查表对语言功能进行评估,电针采用北京大学医学部神经科学研究所研制的韩氏穴位神经刺激仪,MRI机采用德国生产的Siemens Novus1.5T超导磁共振扫描机,功能图像采集采用BOLD脑功能图像,分析采用SPM5软件包对fMRI数据进行处理和统计。结果经过电针通里、悬钟治疗后,复述动词、听动词理解和阅读动词文字理解亚项有显著的进步,尤其是阅读动词文字理解在整体语言亚项里的分值最高,动词的恢复明显地好于名词。电针通里、悬钟组穴出现了双侧颞叶的激活,且以左侧激活脑区较右侧为多;且电针左侧目标穴位减去左侧假针的结果依然显示有左侧颞叶的激活。结论针刺通里、悬钟对卒中后失语患者的语言功能恢复有促进作用。

Electroacupuncture in language-related grouped acupoints and post-stroke anandia induced by injury of temple apical and occipital junctional zone in one case: a linguistic review and imaging investigation

Objective To investigate the changes of linguistic function before and after electroacupuncture in grouped acupoints,and relationship between the activation of cerebral function and changes of linguistic function after stimulating acupoints-Tongli(HT5) and Xuanzhong(GB39) taking one case of post-stroke anandia induced by injury of temple apical and occipital junctional zone as example and combining linguistic review and imaging investigation.Methods The linguistic function was reviewed by using Chinese standardized anandia examination table in the case.Han ’ s acupoint nerve stimulator(HANS) developed by Neuroscience Research Institure of Peking University Health Science Center was used for electroacupuncture,magnetic resonance imaging(MRI) scanner was Siemens Novus 1.5T superconducting MRI scanner made by Germany,and functional images were collected by applying BOLD technique.The data of fMRI were computed and analyzed by using SPM5 software package.Results After the treatment of electroacupuncture in Tongli(HT5) and Xuanzhong(GB39),the function of retelling verbs,listening and understanding verbs,and reading and character understanding of verbs were significantly improved,and the scores of reading and character understanding of verbs was the highest.The recovery was better in verbs than in nouns.The electroacupuncture in Tongli(HT5) and Xuanzhong(GB39) stimulated bitemporal lobes and the left was more significant than the right.The left bitemporal lobe still showed being activated after removing sham-acupuncture in acupoints.Conclusion Electroacupuncture in Tongli(HT5) and Xuanzhong(GB39) has improving effect in the recovery of linguistic function in patients with post-stroke anandia.