摘要
目的应用脑电非线性动力学分析研究针刺穴位对不同意识障碍患者脑电的影响。方法选取卒中后6个月内的意识障碍患者37例,其中最低意识状态(MCS)16例,持续植物状念(PVS)21例。针刺足三里、三阴交、太冲和涌泉穴。比较针刺前(安静闭眼状态)与针刺穴位时,两组患者不同脑区(前额、额、中央、顶、枕、前颞、中颞、后颞区)的脑电非线性指数,包括复杂度(Cx)和近似熵(ApEn)变化。结果①与针刺前比较,针刺患侧时,PVS组患侧所有脑区的Cx、ApEn值变化不明显;MCS组患侧部分脑区的Cx、ApEn值升高(P<0.05)。②针刺健侧时,与针刺前比较,PVS组健侧少部分脑区的Cx、ApEn值升高(P<0.05)。MCS组健侧大部分恼区的Cx、ApEn值升高(P<0.05,P<0.01)。③针刺前,PVS组和MCS组患侧所测脑区的Cx、ApEn值差异均无统计学意义;针刺患侧穴位时,两组患侧各脑区的Cx差异亦均无统计学意义,而MCS组的前额、前颞、中颞及后颞区的ApEn值高于PVS组(P<0.05,P<0.01)。④针刺前,两组健侧大部分脑区的Cx、ApEn值MCS组均高于PVS组(P<0.05,P<0.01);针刺健侧穴位时,健侧所有脑区的Cx、ApEn值MCS组均高于PVS组(P<0.05,P<0.01)。结论 PVS和MCS患者的皮质活动处于明显抑制状态,MCS较PVS患者皮质受抑制程度相对较轻。针刺能够引起损伤较轻的大脑皮质兴奋性增高,并被脑电非线性分析捕获。
Objective To analyze and study the effect of acupuncture on patients with different disturbance of consciousness using nonlinear dynamics of electroeneephalography （EEG）. Methods Thirtyseven patients with disturbance of consciousness within six months after stroke were enrolled in the study, of those, 16 patients were in a minimally conscious state （MCS） , and 21 were in a persistent vegetative state （PVS）. The acupuncture points Zusanli （ ST36）, Sanyinjiao （ SPr）, Taiehong （ LV3 ）, and Yongquan （KII） were stimulated by needles. The changes of nonlinear EEG indices （including complexity [Cx] and approximate entropy[ApEnI ） in different brain regions （prefrontal, frontal, central, parietal, occipital, anterior temporal, middle temporal and post-temporal regions） in both groups were compared before and during acupuncture. Results （1）As compared to the nonlinear EEG indices before the acupuncture, the values of Cx and ApEn in the affected brain regions in the PVS group did not change significantly when acupuncturing the affected sides; and those in some affected brain regions in the MCS group were increased （P 〈0. 05）. （2）As compared to the nonlinear EEG indices before acupuncture, the values of Cx and ApEn in a small number of the unaffected brain regions in the PVS group were increased when acupuncturing the unaffected sides （ P 〈 0. 05 ）, and those in the majority of unaffected brain regions in the MCS group were increased （P 〈0. 05, P 〈 0. 01 ）. （3）Before acupuncture, there was no significant difference about the values of Cx and ApEn in all the affected brain regions between the PVS and MCS groups; when acupuncturing the points on the affected sides, there was no significant difference about the values of Cx in all the affected brain regions between the two groups, but the values of ApEn in the prefrontal, anterior temporal, middle temporal and post-temporal regions in the MCS group were higher than those in the PVS group （P〈0.05, P〈0. 01 ）. （4）Before acupuncture, the values of Cx and ApEn in the majority of unaffected brain regions in the MCS group were higher than those in the PVS group （P 〈0. 05, P 〈0.01 ） ; when acupuncturing the unaffected sides, the values of Cx and ApEn in all the unaffected brain regions in the MCS group were higher than those in the PVS group （P 〈0.05, P 〈 0. 01 ）. Conclusion The cortical activities in patients with PVS and MCS were obviously in an inhibitory state. The degree of cortical inhibition was relatively milder in patients with MCS than that in patients with PVS. Acupuncture may induce the excitability of the less injured cerebral cortex, and be caught by EEG nonlinear analysis.
出处
《中国脑血管病杂志》
CAS
2009年第9期461-465,共5页
Chinese Journal of Cerebrovascular Diseases
基金
国家自然科学基金资助项目(30600186)
关键词
非线性动力学
意识障碍
针刺穴位
脑电描记术
Nonlinear dynamics
Consciousness disorders
Acupuncture points
Electroencephalography
