Effect of tiaoren tongdu acupuncture method on fractional anisotropy of diffusion densor imaging and upper extremity motor function after cerebral infarction

OBJECTIVE To observe the effect of tiaoren tongdu acupuncture method (for regulating the function of the Conception Vessel and promoting the circulation of the Governor Vessel) on fractional anisotropy (FA) and upper-extremity motor function after cerebral infarction by diffusion densor imaging (DTI) technology. METHODS The patients with cerebral infarction were divided into an acupuncture group and a control group according to the random number table method, 27 cases in each group. In the control group, the basic treatment with conventional medication was used. In the acupuncture group, on the basic treatment as the control group, the tiaoren tongdu acupuncture method was provided. Main acupoints included Baihui (GV20), Shuigou(GV26), Chengjiang(CV24), Guanyuan(CV4), Qihai (CV6), Zhongwan (CV12), Shenting(GV24) and Mingmen(GV4). Supplementary points included Jianyu(LI15), Chize(LU5), Houxi (SI3), Weizhong (BL40), Zusanli (ST36) and Taichong (LR3) on the affected side. The needles were retained for 30 min. Acupuncture was given once a day, at the interval of 1 days every week, consecutively for 4 weeks. The upper extremity Fugl-Meyer assessment (UE-FMA) was used to evaluate the motor function of upper extremity before and after treatment. DTI was adopted to observe the FA values of infarct focus, posterior limb of internal capsule (PLIC) and cerebral peduncle on the affected side, as well as FA values at the corresponding parts on the healthy side in the patients of two groups. The relative differences (rFA) were calculated. RESULTS Compared with their own pretreatment, the UE-FMA value was significantly higher after treatment in either of two groups separately (P<0.05 in the control group, P<0.01 in the acupuncture group). The difference of UE-FMA before and after treatment in the acupuncture group was larger than that in the control group (P<0.05). The FA and rFA values in infarct focus were higher than those before treatment in the two groups (P<0.05). The FA and rFA differences before and after treatment in the infarct focus and PLIC on the affected side were higher in the acupuncture group as compared with the control group (P<0.05). The UE-FMA difference was positively correlated with the rFA difference of each part in either group (P<0.05), and the correlation was the strongest in PLIC on the affected side in either group (P<0.01). CONCLUSION Tiaoren tongdu acupuncture significantly improves the upper limb movement function after cerebral infarction. The rFA value of PLIC combined with UE-FMA can be used to evaluate the therapeutic effect of acupuncture on the upper extremity movement after cerebral infarction.