Under The Guidance Of The Theory Of "the Combination Of Body And Spirit", Acupuncture Treatment Of DTI For Post-stroke Aphasia With Cortical Injury

Aphasiais one of the most common complication of stroke,currently the treatments varied,but the clinical tend to comprehensive treatment.Internal basic treatment plus acupuncture and language rehabilitation training are economic and effective treatment of aphasia after stroke treatment,but the curative effect mechanism is a lack of objective visual evidence.Neurolinguistics scale plays an important role in diagnosis,classification,sorting,guiding treatment and evaluation of aphasia effect.Imaging provides researchers with brain structure and function in vitro observation of brain tissue shape,size,density,structural integrity,metabolic changes and analyze the cognitive activities of the important means.Previous studies use quantitative or semi-quantitative analysis method,which has strong subjectivity,research limitations and cannot extract subtle structure change and unable to transverse comparison and other limitations.Functional Magnetic Resonance Imaging with high spatial resolution and noninvasive in vivo characteristics of structure,can accurately and visually observe physiological and pathological changes and characteristics.Among them,Diffusion Tensor Imaging not only evolute the lesions but also can provide multiple parameters of quantitative analysis,and by tracking the fiber bundle reconstruction of 3 d Imaging,can objectively present a brain damage after focal distal nerve fiber bundle to the dynamic change,integrity,and the relationship between the lesions and the fiber bundle,for the comprehensive evaluation of structure and function changes after brain injury whichprovides objective basis,visualization.Voxel--based Morphometry based on Voxel morphologyis aimed at the analysis of the magnetic resonance imaging brain structure technology,has the good comprehensive,automaticity,objectivity,and repeatability,and can be found that the conventional imaging cannot show the density of grey,white matter abnormalities,comprehensive evaluation of patients with brain structure changes of the form.And a white texture based on Interest area(Region Of Interest,ROI)statistical analysis method for the analysis Of specific changes in white matter fiber bundle provides convenient,the combination can be more real,to reflect the changes Of the brain structural network.,Integration of the body and the spirit "theory is one of TCM feature theory,which studies the relationship between spirit and form,function and structure and influence,reveals the basic features of life.This study is under the guidance of " Integration of the body and the spirit "theory,on the basis of routine medical treatment acupuncture plus language rehabilitation training for intervention,using 3 d high resolution structures like TI brain,brain imaging and dispersion tensionneurolinguistics scale to evaluate the means of analysis on stroke aphasia brain structure changes before and after the treatment,and the correlation of brain structure changes and neurolinguistics scale,exploring the cortical lesions of aphasia after stroke occurred in patients with brain injury and recovery mechanism.Objective:By observing thepatient-stroke ahasia group(PSA)and healthy control group(HC group)of changing gray volume matter and white matter fiber bundle,and connected with The Boston Aphasia classification,Western Aphasia Battery score,from language function scale and The change of The brain structural network,to discusse cortex damaged patients stroke ahasia after stroke occurrence and recovery mechanisms.Mthodes:Using prospective paired parallel control study,PSA group is given priority to with cortical damage of ischemic cerebral apoplexy aphasia patients as the research object,all into the group of patients to acupuncture and language rehabilitation training,an integrated approach to medical foundation treatment intervention for 30 days,respectively in the intervention group on the same day,30 days two point head 3 d high resolution TI structure as imaging and dispersion tension and neurolinguistics scale assessment.Scales include BDAE and WAB.Analysising neural language function score before and after the treatment,the Gray Matter Volume and white Matter fiber tracts change and explore the neural function of language score and the correlation of brain image data structure,to discussing the language function in patients with aphasia after stroke recovery mechanism.HC is equaled with PSA group cultural background,age,gender,education level that matches the healthy subjects into groups,in the day of HC group participants adopt head 3 d high resolution TI structure like and diffuse tension imaging evaluation,will be in the day’s PSA group compared with HC group brain structure imaging data analysis,to explore the mechanism of aphasia after stroke.Results:(1)After 1 month of needle treatment after the intervention,the PSA group before and after treatment of WAB scale information,fluency,understanding of score changes,difference have statistical significance;BDAE grading and WAB AQ value,named score changes in scale,significant difference(P<0.01).(2)According to the results of VBM compared with HC group,PSA groups before treatment in the brain’s gray matter structoe is part of the brain gray matter volume reduction,including the lower part of the medial frontal cover(including the olfactory bulb,island of frontal area,etc.)and some of the temporal lobe,left superior temporal gyrus,left caudate nucleus,and on the left side of the pillow in the area,such as back part of the structure of the brain gray matter volume increases at the same time,including the right precuneus and right superior temporal gyrus.Compared with HC group,ROI,according to the results of the PSA group showed extensive damage to white matter integrity,including double side outside the capsule,double side hook beam,the left side of the internal capsule forelimb,on the left side of the strap(hippocampus),on the left(3)The VBM,aceording to the results after 1 month of acupuncture comprehensive treatment after the intervention,the PSA group in the region of the lid of the right inferior frontal gyrus island in the gray matter of the structure of the brain increased significantly;ROI,according to the results after 1 month of acupuncture comprehensive treatment after the intervention,the PSA group on the left side of the corona radiata and back,the left outside,on the left side of the upper longitudinal beam,on the left side of the pillow and appeared on the fiber bundle of white matter fiber bundle rising structural integrity;Among them,on the left side of the longitudinal fasciculus,all white matter fiber tracts of frontal pillow beam structure integrity are rising.Conclusion:(1)Acupuncture and speech rehabilitation guided by the " Integration ofthe body and the spirit "theory have a certain role in improving the language function for patients with aphasia after stroke(2)Patients with aphasia after stroke have brain(?)gray matter atrophy and white matter fiber tracts of common structural integrity damaged in material basis of brain structure(3)Acupuncture and speech rehabilitation have a play in the recovery of patients with aphasia after by reducing the volume of gray matter atrophy and promoting restoration of the structural integrity of white matter fiber bundle.