| Objective: The regional homogeneity derived from resting-state functional magnetic resonance imaging indexes,using to observe the effect region with puncturing three-needle acupuncture of the temple,and will be combined with behavioral indexes to observe the clinic efficacy.Method/Design: 20 healthy subjects only received a magnetic resonance scan to obtain a whole brain image.And 26 right hemiplegic stroke patients will be randomly assigned to a treatment group which will receive three-needle acupuncture of the temple or to a control group which will receive acupuncture of anterior oblique line of vertex-temporal(MS6),with 13 cases in each group.Both of the two group will also receive routine rehabilitation for 2 weeks(once a day from Monday to Friday).At the same time,we will randomly draw 6 patients in each group to receive two resting-state functional magnetic resonance imaging before and after treatment.The Fugl-Meyer Assessment,the modified Barthel Index will be used to compare the groups before and after 2 weeks of treatment.According to the magnetic resonance image analysis,firstly,the difference brain regions between the healthy subjects and the two groups of patients before treatment are selected as region of interest(ROI).The ReHo values of each group were measured.Secondly,the difference brain regions and ReHo values between the patients in pre-or post-treatment and the healthy person is observed.Thirdly,the changes of the brain regions and ReHo values in pre-and post-treatment are compared in each group,then the two groups will be compared with ReHo difference of each group.Fourthly,we will compare the behavior index to observe the clinic efficacy.Results:1.All patients with MRI scans were compared with healthy subjects before treatment: decreasing ReHo value brain areas in the left caudate and postcentral region,and the difference was statistically significant(P<0.05).Therefore,the left caudate and postcentral gyrus were used as regions of interest(ROI)to observe changes in ReHo values.There were no significant differences in ReHo values between the two groups before treatment(P>0.05).2.In the treatment group,the ROI brain area was compared with healthy subjectsbefore and after treatment: In the left caudate and postcentral gyrus,significant difference showed on ReHo values between patients before treatment and healthy subjects(P<0.05),but ReHo values after treatment was not significantly different from that of healthy subjects(P>0.05).3.In the controll group,the ROI brain area was compared with healthy subjects before and after treatment: In the left caudate nucleus,significant difference showed on ReHo values between patients before treatment and healthy subjects(P<0.05);the ReHo value after treatment was not significantly different from that of healthy subjects(P>0.05).In the left postcentral gyrus,significant difference showed on the ReHo value between patients before and after treatment and healthy subjects(P<0.05).4.Changes in brain regions before and after treatment in the treatment group: The ReHo values in the two ROI brain regions were higher than those before treatment,and the differences were statistically significant(P<0.05).After treatment,compared with the pre-treatment,ReHo values increased in the right fusiform gyrus and the left posterior cerebellum.5.Changes in the brain area of the control group before and after treatment: The difference of ReHo value in the left caudate nucleus before and after treatment was statistically significant(P<0.05);ReHo values in In the postcentral gyrus before and after treatment was no significant difference(P>0.05),but it increased after treatment,and the degree of increase was slightly smaller.Before and after treatment,ReHo values was increased in the right precentral gyrus,left medial frontal gyrus,and left precuneus.6.There were no significant differences in ReHo values between the two groups after treatment(P>0.05).However,the increase in the treatment group of the two ROI brain regions was better than the control group,which was closer to the ReHo value of healthy people.7.Comparison of FMA scores between the two groups: There was no significant difference in the FMA scores between the two groups before treatment(P>0.05).The FMA score between the two groups had significant difference in pre-and post-treatment(P<0.05).The difference between the two groups of FMA scores,the difference is Statistical significance(P<0.05),suggesting that the improvement ofupper limb motor function was different between the two groups,and the improvement of FMA score in the treatment group was slightly higher than that of the control group.8.Comparison of MBI scores between the two groups: There was no significant difference in MBI scores between the two groups before treatment(P>0.05).The MBI score between the two groups had significant difference in pre-and post-treatment(P<0.05),suggesting that both treatment methods can improve the daily living ability of the patients.But no significant difference showed on MBI index in difference values of two groups(P>0.05).9.Comparison of curative effects: The total effective rate was 84.62% in the treatment group and 61.54% in the control group(P<0.05).Two groups had a significant difference in the improvement of function,and the treatment group was better than the control group.Conclusions:1.The three-needle acupuncture of the temple or conventional scalp acupuncture combined with conventional rehabilitation can effectively improve the upper limb motor function and daily living ability of stroke patients;and the overall effect of the three-needle acupuncture of the temple is better than the conventional scalp group,it is worthy of clinical application.2.On the basis of routine rehabilitation,the three-needle can improve the local consistency of the left caudate nucleus and the left central posterior cerebral region of stroke patients with hemiplegia,and improve the abnormal activities of the corresponding neurons.3.Acupuncture on the left side of the three-needle acupuncture of the temple to make the right fusiform gyrus and the left cerebellar posterior lobe is activated,the two areas may be involved in improving the motor function of stroke patients with hemiplegia;acupuncture before the left MS6 activates the right precentral gyrus,the left upper frontal gyrus,and the left precuneus.The three regions may also participate in improving the motor function of stroke patients with hemiplegia,which deserves further study.Chinese Clinical Trial Registry: ChiCTR1800015209,Registered on March 14,2018. |
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