A Preliminary Study On The Difference Of The Effects Of The Du Meridian And Gallbladder Meridian On Lower Limb Motor Dysfunction After Ischemic Stroke Based On DTI

1 PurposeThrough clinical research,to explore whether there are differences in the clinical efficacy and central effect between the Du meridian and gallbladder meridian on lower limb motor dysfunction after CIS combined with the Diffusion Tensor Imaging(DTI)technology and the Simple Fugl-Meyer assessment of lower extremity(FMA-LE).2 MethodsA total of 40 patients with lower limb movement disorders after CIS were enrolled in this study.The 40 patients were randomly divided into the Du meridian group(20 cases)and the gallbladder meridian group(20 cases).Patients in both groups were treated with conventional drugs in the Department of encephalopathy.On this basis,the Du meridian group acupuncture Shen ting,Bai hui,Nao hu,Feng fu,Da zhui;The gallbladder meridian group needled the Tou lin qi,Cheng ling,Nao kong,Feng chi and Jian jing.Patients in the two groups received acupuncture once a day,6times a week for 6 weeks.The diffusion tensor imaging technique was used to measure the fractional anisotropy(FA)of the two groups before and after treatment,and the diffusion tensor tractography(DTT)was used to reconstruct the three-dimensional image of the corticospinal tract(CST).At the same time,patients were evaluated with FMA scale before and after treatment.Combined with the changes of clinical classical effect indexes,DTI parameter FA value and CST fiber bundle imaging,the clinical efficacy and central effect mechanism of acupuncture in patients with lower limb movement disorder after CIS were comprehensively analyzed,and the effects of acupuncture on the coronary artery and the bile channel were compared.The diffusion tensor imaging technique was used to measure the fractional anisotropy(FA)of the two groups before and after treatment,and the diffusion tensor tractography(DTT)was used to reconstruct the three-dimensional image of the corticospinal tract(CST).At the same time,the patients were evaluated by FMA scale before and after treatment,and the clinical efficacy and central effect mechanism of acupuncture on patients with lower limb movement disorders after CIS were comprehensively analyzed combined with the changes of clinical classic effect indexes,DTI parameters FA value and CST fiber tractography,and the differences between the effects of acupuncture on governor vessel and gallbladder meridian were compared.3 Results(1)Before treatment,there were no significant differences in the basic data(gender,age,course of disease,hemiplegic side and partial hand),FMA score,FA value and r FA value of each site between the two groups(P>0.05),indicating comparability.(2)the FMA score: after treatment,two groups of patients with FMA scores were significantly increased(P<0.05);After treatment compared with FMA score difference between groups before treatment,bravery by the score difference is higher than the du meridian group,but there was no statistically significant difference(P>0.05).(3)the FA value,r FA: after treatment,two groups of patients with lesions lateral infarcts,corona radiata,internal capsule hind limbs and cerebral peduncle FA value,r FA were significantly increased(P<0.05).The FA difference and r FA difference after and before treatment in the Du vein group were higher than those in the bile channel group,and the FA difference and r FA difference in the posterior limb of the internal capsule and the foci side of the infarction area were significantly different from those in the bile channel group(P<0.05).(4)DTT map: After cerebral ischemia,the nerve fiber tracts on the infarct side showed partial interruption and decreased number,and the overall structure was sparse compared with that on the healthy side.After treatment,the number and density of nerve fiber bundles on the side of infarct were increased in both groups,and the overall structure was slightly improved.(5)the correlation analysis: du meridian group and the gallbladder meridian corona radiata,cerebral peduncle FA difference,internal capsule hind legs r FA fellow FMA score difference and difference are positively correlated(P<0.05).The correlation coefficients of Du mai group were 0.474,0.806 and 0.660,respectively,indicating the strongest correlation between FA difference of the head and foot.The correlation coefficients of biliary channel group were 0.454,0.494 and 0.508,respectively,indicating that the r FA difference of the posterior limbs of the internal capsule had the strongest correlation.4 ConclusionLower limb motor function was significantly impaired after cerebral ischemia injury,and acupuncture treatment could significantly improve lower limb motor function,which may be related to the repair of cerebral white matter and corticospinal tract in infarct area by acupuncture.Both the governor vein and the bile channel have significant effect on the improvement of lower limb movement disorder after CIS,but the Du meridian has better effect on the repair of cerebral white matter and corticospinal tract in infarct area.