单次电针与经皮穴位电刺激治疗前后体感诱发电位的比较
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摘要
目的观察电针和经皮穴位电刺激(TEAS)前后体感诱发电位(SEP)的变化。方法 2015年10月至2016年4月本科实习生10例,采用自身前后对照研究,每例受试者均随机接受电针和TEAS治疗,间隔1周。治疗前后检测SEP的N20、N9潜伏期及波幅。结果电针治疗后,刺激侧N20潜伏期明显延长(Z=-2.620,P<0.01);非刺激侧N9潜伏期延长(Z=-2.454,P<0.05),N9波幅降低(Z=-2.330,P<0.05)。TEAS治疗后,刺激侧和非刺激侧N9潜伏期均明显延长(Z>2.695,P<0.01)。两组治疗前后刺激侧及非刺激侧N20和N9潜伏期、波幅差值均无显著性差异(Z<1.817,P>0.05)。结论单次电针及TEAS治疗均可对SEP的N20、N9潜伏期及波幅产生影响,两种治疗对SEP的影响组间无明显差异。
Objective To explore the effect of electroacupuncture and transcutaneous electrical acupoint stimulation(TEAS) on somatosensory evoked potential(SEP) of the upper extremity in healthy subjects. Methods From October, 2015 to April, 2016, ten healthy young volunteers were selected. Each of the subjects was randomly treated with electroacupuncture and TEAS. Before and after treatment, the latency and amplitude of N20 and N9 of SEP were detected. Results After electroacupuncture, the latency of N20 prolonged in the stimulated side(Z=-2.620, P<0.01); the latency of N9 prolonged(Z=-2.454, P<0.05), and the amplitude of N9 decreased(Z=-2.330, P<0.05) in the non-stimulated side. After TEAS, the latencies of N9 both in the stimulated side and the non-stimulated side prolonged(Z>2.695, P<0.01).There was no significant difference in the D-value of latency and amplitude of N20 and N9 in both two sides between two treatments(Z<1.817, P>0.05). Conclusion Both electroacupuncture and TEAS could affect the latency and amplitude of N20 and N9, and no difference was found between two treatments.
Objective To explore the effect of electroacupuncture and transcutaneous electrical acupoint stimulation(TEAS) on somatosensory evoked potential(SEP) of the upper extremity in healthy subjects. Methods From October, 2015 to April, 2016, ten healthy young volunteers were selected. Each of the subjects was randomly treated with electroacupuncture and TEAS. Before and after treatment, the latency and amplitude of N20 and N9 of SEP were detected. Results After electroacupuncture, the latency of N20 prolonged in the stimulated side(Z=-2.620, P<0.01); the latency of N9 prolonged(Z=-2.454, P<0.05), and the amplitude of N9 decreased(Z=-2.330, P<0.05) in the non-stimulated side. After TEAS, the latencies of N9 both in the stimulated side and the non-stimulated side prolonged(Z>2.695, P<0.01).There was no significant difference in the D-value of latency and amplitude of N20 and N9 in both two sides between two treatments(Z<1.817, P>0.05). Conclusion Both electroacupuncture and TEAS could affect the latency and amplitude of N20 and N9, and no difference was found between two treatments.
引文
[1]李雨峰,王芸,吴莹,等.电针结合现代康复技术对脑梗死运动功能恢复的影响[J].中国康复理论与实践,2012,18(2):104-106.
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[9]Yan T,Hui-Chan CW.Transcutaneous electrical stimulation on acupuncture points improves muscle function in subjects after acute stroke:a randomized controlled trial[J].J Rehabil Med,2009,41(5):312-316.
[10]Wu MS,Chen KH,Chen IF,et al.The efficacy of acupuncture in post-operative pain management:a systematic review and Meta-analysis[J].PLo S One,2016,11(3):e0150367.
[11]Zhao W,Wang C,Li Z,et al.Efficacy and safety of transcutaneous electrical acupoint stimulation to treat muscle spasticity following brain injury:a double-blinded,multicenter,randomized controlled trial[J].PLo S One,2015,10(2):e0116976.
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[13]Liu AJ,Li JH,Li HQ,et al.Electroacupuncture for acute ischemic stroke:a Meta-analysis of randomized controlled trials[J].Am J Chin Med,2015,43(8):1541-1566.
[14]Scheffold BE,Hsieh CL,Litscher G.Neuroimaging and neuromonitoring effects of electro and manual acupuncture on the central nervous system:a literature review and analysis[J].Evid Based Complement Alternat Med,2015,2015:641742.
[15]殷钰涵,杨俊锋,王建伟.诱发电位在脊髓损伤中的应用[J].中国中医骨伤科杂志,2015,23(1):69-71.
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[17]郑正涛,陈玲,张雷,等.针刺对急性脑梗死患者上肢体感诱发电位的影响[J].中国中医急症,2010,19(10):1665-1666,1689.
[18]Zhang Y,Su YY,Xiao SY,et al.Somatosensory and brainstem auditory evoked potentials assessed between 4 and 7 days after severe stroke onset predict unfavorable outcome[J].Biomed Res Int,2015,2015:196148.
[19]Shen FF,Wu Q,Lin ZR,et al.Effects of different interference orders of electroacupuncture and exercise therapy on the therapeutic effect of hemiplegia after stroke[J].Zhongguo Zhen Jiu,2008,28(10):711-713.
[20]Nociti V,Prosperini L,Ulivelli M,et al.Effects of rehabilitation treatment of the upper limb in Multiple Sclerosis patients and predictive value of neurophysiological measures[J].Eur J Phys Rehabil Med,2016.[Epub ahead of print].
[21]Lee SY,Kim BR,Han EY.Association between evoked potentials and balance recovery in subacute hemiparetic stroke patients[J].Ann Rehabil Med,2015,39(3):451-461.
[22]Lin C,Ma L,Zhu S,et al.Applications of pain-related evoked potentials and short-latency somatosensory evoked potentials in acupuncture research:a narrative review[J].J Tradit Chin Med,2015,35(5):606-612.
[23]袁红,陈榕,黄大鹏,等.平衡针对人皮层痛觉诱发电位的影响[J].上海针灸杂志,2013,32(6):423-425.
[24]魏妮,燕铁斌,Christina WY Hui-chan,等.经皮电神经刺激穴位治疗对脑卒中患者偏瘫侧上肢体感诱发电位的影响[J].中国康复医学杂志,2007,22(10):871-873.
[25]彭源,张瑾,苏常春,等.经皮穴位电刺激对脑卒中患者上肢功能及运动诱发电位的影响[J].中国康复医学杂志,2015,30(6):547-550,571.
[2]陈瑶,田婧,谢蓓菁,等.经皮穴位电刺激在脑卒中后手功能障碍康复中的应用[J].中国康复医学杂志,2015,30(5):454-457.
[3]唐朝正,贾杰.经皮电神经刺激在脑卒中后上肢功能障碍中的应用[J].中国康复理论与实践,2014,20(4):306-310.
[4]王东山,陈月桂,金冬梅.两种经皮穴位电刺激方法对脑卒中患者体感诱发电位影响的比较[J].现代生物医学进展,2013,13(24):4710-4712.
[5]唐朝正,李春燕,张晓莉,等.低频经皮穴位电刺激对软瘫期脑卒中患者手和上肢功能的影响[J].中国康复理论与实践,2015,21(3):252-255.
[6]肖湘,黄东锋,曹黎明,等.体感诱发电位和脑卒中患者上肢运动功能结局的关系[J].中国康复医学杂志,2015,30(7):696-698.
[7]Eek E,Holmqvist LW,Sommerfeld DK.Adult norms of the perceptual threshold of touch(PTT)in the hands and feet in relation to age,gender,and right and left side using transcutaneous electrical nerve stimulation[J].Physiother Theory Pract,2012,28(5):373-383.
[8]Francis RP,Johnson MI.The characteristics of acupuncture-like transcutaneous electrical nerve stimulation(acupuncture-like TENS):a literature review[J].Acupunct Electrother Res,2011,36(3-4):231-258.
[9]Yan T,Hui-Chan CW.Transcutaneous electrical stimulation on acupuncture points improves muscle function in subjects after acute stroke:a randomized controlled trial[J].J Rehabil Med,2009,41(5):312-316.
[10]Wu MS,Chen KH,Chen IF,et al.The efficacy of acupuncture in post-operative pain management:a systematic review and Meta-analysis[J].PLo S One,2016,11(3):e0150367.
[11]Zhao W,Wang C,Li Z,et al.Efficacy and safety of transcutaneous electrical acupoint stimulation to treat muscle spasticity following brain injury:a double-blinded,multicenter,randomized controlled trial[J].PLo S One,2015,10(2):e0116976.
[12]Cox J,Varatharajan S,C?téP,et al.Effectiveness of acupuncture therapies to manage musculoskeletal disorders of the extremities:a systematic review[J].J Orthop Sports Phys Ther,2016,46(6):409-429.
[13]Liu AJ,Li JH,Li HQ,et al.Electroacupuncture for acute ischemic stroke:a Meta-analysis of randomized controlled trials[J].Am J Chin Med,2015,43(8):1541-1566.
[14]Scheffold BE,Hsieh CL,Litscher G.Neuroimaging and neuromonitoring effects of electro and manual acupuncture on the central nervous system:a literature review and analysis[J].Evid Based Complement Alternat Med,2015,2015:641742.
[15]殷钰涵,杨俊锋,王建伟.诱发电位在脊髓损伤中的应用[J].中国中医骨伤科杂志,2015,23(1):69-71.
[16]Rembado I,Castagnola E,Turella L,et al.Independent component decomposition of human somatosensory evoked potentials recorded by micro-electrocorticography[J].Int J Neural Syst,2016,1650052.[Epub ahead of print].
[17]郑正涛,陈玲,张雷,等.针刺对急性脑梗死患者上肢体感诱发电位的影响[J].中国中医急症,2010,19(10):1665-1666,1689.
[18]Zhang Y,Su YY,Xiao SY,et al.Somatosensory and brainstem auditory evoked potentials assessed between 4 and 7 days after severe stroke onset predict unfavorable outcome[J].Biomed Res Int,2015,2015:196148.
[19]Shen FF,Wu Q,Lin ZR,et al.Effects of different interference orders of electroacupuncture and exercise therapy on the therapeutic effect of hemiplegia after stroke[J].Zhongguo Zhen Jiu,2008,28(10):711-713.
[20]Nociti V,Prosperini L,Ulivelli M,et al.Effects of rehabilitation treatment of the upper limb in Multiple Sclerosis patients and predictive value of neurophysiological measures[J].Eur J Phys Rehabil Med,2016.[Epub ahead of print].
[21]Lee SY,Kim BR,Han EY.Association between evoked potentials and balance recovery in subacute hemiparetic stroke patients[J].Ann Rehabil Med,2015,39(3):451-461.
[22]Lin C,Ma L,Zhu S,et al.Applications of pain-related evoked potentials and short-latency somatosensory evoked potentials in acupuncture research:a narrative review[J].J Tradit Chin Med,2015,35(5):606-612.
[23]袁红,陈榕,黄大鹏,等.平衡针对人皮层痛觉诱发电位的影响[J].上海针灸杂志,2013,32(6):423-425.
[24]魏妮,燕铁斌,Christina WY Hui-chan,等.经皮电神经刺激穴位治疗对脑卒中患者偏瘫侧上肢体感诱发电位的影响[J].中国康复医学杂志,2007,22(10):871-873.
[25]彭源,张瑾,苏常春,等.经皮穴位电刺激对脑卒中患者上肢功能及运动诱发电位的影响[J].中国康复医学杂志,2015,30(6):547-550,571.