电针刺激焦氏头穴治疗脑梗塞后下肢功能障碍的临床疗效及脑功能变化研究

Study on the Clinical Efficacy and Brain Function Changes of Electroacupuncture Stimulation of Jiao’s Head Acupoint in the Treatment of Lower Limb Dysfunction after Cerebral Infarction

摘要: 本研究旨在探讨电针刺激焦氏头穴治疗脑梗塞后下肢功能障碍的临床疗效及脑功能变化机制。采用随机对照试验设计，纳入符合标准的脑梗塞患者34例(每组17例)，A组(电针组)接受电针刺激焦氏头穴，B组(高频捻转组)接受高频捻转行针刺激焦氏头穴，两组均配合内科常规治疗。治疗前、第一疗程、第二疗程及第三疗程结束后，分别采用HBS量表、FMA量表评估神经功能与下肢运动功能，并通过静息态Fmri (磁共振成像)分析ReHo (局部一致性)变化。结果显示：治疗3个疗程后，A组HBS评分(15.2 ± 2.3 vs 28.7 ± 3.1)和FMA评分(48.6 ± 5.2 vs 29.8 ± 4.7)显著优于B组(P<0.01)；A组在运动皮层(BA4)、感觉皮层(BA1)及小脑区ReHo值显著升高(P < 0.05)，且与FMA评分呈显著正相关(r = 0.78, P < 0.01)。本研究证实电针刺激焦氏头穴可有效改善脑梗塞后下肢功能障碍，并通过调控脑功能网络重组促进神经功能恢复，为临床提供循证依据。

Abstract: This study aims to explore the clinical efficacy of electroacupuncture stimulation at the Jiao's head acupoint in treating lower limb dysfunction after cerebral infarction and the mechanisms of brain function changes. A randomized controlled trial design was employed, including 34 eligible patients with cerebral infarction (17 in each group). Group A (electroacupuncture group) received electroacupuncture stimulation at the Jiao’s head acupoint, while Group B (high-frequency twisting group) received high-frequency twisting needle stimulation at the same acupoint. Both groups also received conventional internal medicine treatment. Neurological function and lower limb motor function were assessed using the HBS scale and FMA scale before treatment, after the first, second, and third treatment courses. Additionally, changes in ReHo (regional homogeneity) were analyzed using resting-state fMRI (functional magnetic resonance imaging). The results showed that after three treatment courses, Group A had significantly better HBS scores (15.2 ± 2.3 vs 28.7 ± 3.1) and FMA scores (48.6 ± 5.2 vs 29.8 ± 4.7) compared to Group B (P < 0.01). Furthermore, the ReHo values in the motor cortex (BA4), sensory cortex (BA1), and cerebellar regions of Group A significantly increased (P < 0.05) and were positively correlated with FMA scores (r = 0.78, P < 0.01). This study confirms that electroacupuncture stimulation at the Jiao’s head acupoint can effectively improve lower limb dysfunction after cerebral infarction and promote the recovery of neurological function by regulating brain functional network reorganization, providing evidence-based support for clinical practice.