| Objective: To observe the effect of electroacupuncture treatment on the secondary injury of white matter fiber bundles in the internal capsule after cerebral infarction,and to discuss the relationship between the secondary changes and patients’ motor and nerve function recovery,as well as the effect and mechanism of electroacupuncture on such changes.Methods: A total of 26 patients,including 12 patients with unilateral cerebral infarction and 14 patients with bilateral cerebral infarction,were selected for the study,WHO had the first onset,course of disease within 10 days,clear consciousness,no abnormal signal areas except infarction lesions,no history of brain and spinal cord on MRI T1,T2 and DTI,and all met the diagnostic criteria for ischemic stroke established by WHO.Using the random number table method,the patients were randomly divided into the conventional group(given basic treatment combined with conventional treatment)and the experimental group(given basic treatment combined with electroacupuncture treatment).At the same time,18 healthy volunteers matched by gender and age were selected as the control group.DTI was performed at 4W before and after treatment in the conventional group and the experimental group,respectively,to measure the MD(mean dispersion)value and FA(partial heterogeneity)value of the inner capsule far away from the infarction.NIHSS,FMS and BI were used to score the neurological function of the patients 2H before the examination.Only one DTI examination was needed for the control group,and the measured sites and indexes were the same as those of the two experimental groups.Dynamic observation and comparison of the relationship between MD and FA changes and neural function changes in the two groups were conducted.Results:(1)the comparison of diffusion tensor index showed that FA and MD of patients with unilateral cerebral infarction in the two groups before treatment decreased significantly compared with those in the control group(P<0.05);The FA and MD values of the two groups of patients with unilateral cerebral infarction before and after treatment were significantly lower than those of the healthy group(P<0.05);The FA value of ipsilateral internal capsule was significantly increased in patients with unilateral cerebral infarction before and after treatment in both groups(P<0.05);Before and after treatment,the MD value of the internal capsule of patients with unilateral cerebral infarction in the two groups was significantly increased(P<0.05);Before treatment,FA value of patients with bilateral cerebral infarction in both groups decreased significantly compared with that in the control group(P<0.01),MD value decreased significantly compared with the control group(P<0.05);Before and after treatment,the FA and MD values of the ipsilateral internal capsule of patients with bilateral cerebral infarction in the two groups were significantly increased(P<0.05).(2)comparison of scores of neurological function,motor function and daily living ability showed that NIHSS,FMS and BI scores of patients with unilateral cerebral infarction in the two groups were significantly improved after treatment compared with those before treatment(P<0.05);NIHSS and FMS scores in the experimental group were significantly improved compared with those in the conventional group(P<0.05).(3)correlation analysis between FA,MD and NIHSS,FMS and BI in patients with unilateral cerebral infarction: FA and NIHSS were negatively correlated before and after treatment in the conventional group(r<0,P<0.05),were positively correlated with FMS and BI(r<0,p<0.05);There was a negative correlation between FA and NIHSS(r<0,P<0.05),were positively correlated with FMS and BI(r<0,p<0.05).There was a negative correlation between FA and NIHSS(r<0,P<0.05),were positively correlated with FMS and BI(r<0,p<0.05);There was a negative correlation between FA and NIHSS(r<0,P<0.05),were positively correlated with FMS and BI(r<0,p<0.05).(4)correlation analysis between FA,MD and NIHSS,FMS and BI in patients with bilateral cerebral infarction: FA and NIHSS before and after treatment on the left side of the conventional group were negatively correlated(r<0,P<0.05),and were positively correlated with BI(r<0,p<0.05);There was a negative correlation between FA and NIHSS(r<0,P<0.05),and were positively correlated with BI(r<0,p<0.05).There was a negative correlation between FA and NIHSS(r<0,P<0.05),were positively correlated with FMS and BI(r<0,p<0.05);There was a negative correlation between FA and NIHSS before and after right treatment(r<0,P<0.05),were positively correlated with FMS(r<0,p<0.05).Conclusion:(1)after cerebral infarction,secondary damage may occur to the white matter fiber tracts of the inner capsule which are far away from the infarct on the same side.(3)electroacupuncture therapy has a positive effect on the recovery of nerve function in patients after cerebral infarction,which may be related to the improvement of the integrity of the inner white matter fiber tracts. |
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