芒针透刺督脉组穴对脑卒中后痉挛性偏瘫患者皮质脊髓束重塑的影响OA

Objective To investigate the clinical efficacy of elongated needle acupuncture at governor vessel acupoints in the treatment of post-stroke spastic hemiplegia(PSS),as well as its effect on neural remodeling of the corticospinal tract(CST).Methods A total of 62 PSS patients were randomly divided into observation group and control group,with 31 patientsin each group,and finally 59 patients(30 in the observation group and 29 in the control group)completed the study.Both groups re-ceived basic treatment and rehabilitation training;the patients in the observation group were treated with elongated needle acu-puncture at governor vessel acupoints(with the main points of Baihui penetrating to Naohu,Dazhui penetrating to Zhiyang,Jin-suo penetrating to Xuanshu,and Mingmen penetrating to Yaoyangguan,supplemented by acupoints based on syndrome differ-entiation)for 30 minutes each time,and those in the control group were treated with conventional acupuncture(with the main points including Shuigou,Neiguan,and Sanyinjiao,supplemented by acupoints based on syndrome differentiation)for 30 mi-nutes each time;both groups were treated 5 times a week,with 10 times as one course of treatment,and both groups were treated for 3 courses.The patients were assessed based on Modified Ashworth Scale(MAS)grade,Modified Barthel Index(MBI)score,and Fugl-Meyer Assessment(FMA)score before and after treatment,and diffusion tensor imaging and diffusion tensor tractography were used to measure the fractional anisotropy(FA),relative fractional anisotropy(rFA)ratio,and fiber tract defect of the CST.Clinical outcome was also assessed.Results After treatment,both groups had significant increases in FMA and MBI scores(P＜0.05)and significant reductions in MAS score and CST fiber tract defect(P＜0.05),and compared with the control group,the observation group had significantly greater changes(P＜0.05).After treatment,both groups had significant increases in the FA and rFA values of the posterior limb of the internal capsule,the cerebral peduncle,and the pons on the affected side(P＜0.05),and the observation group had significantly greater increases than the control group(P＜0.05).The observation group had a significantly better clinical outcome than the control group(P＜0.05).Conclusion Elon-gated needle acupuncture at governor vessel acupoints has a better clinical efficacy than conventional acupuncture and can effec-tively improve muscle tone,motor function,and activities of daily living in PSS patients,possibly by promoting the neural re-modeling of the CST.