Preliminary research on the mechanism of electroacupuncture in improving motor dysfunction in patients with diffuse axonal injury

doi:10.3877/cma.j.issn.2095-123X.2020.04.011

Abstract

Abstract:

Objective

To analyze the changes of motor function of patients with diffuse axonal injury (DAI) (type Ⅱ) before and after electroacupuncture treatment, and to explore its possible mechanism.

Methods

Eighty-seven patients with DAI (type Ⅱ) dyskinesia admitted to the Department of Neurosurgery of Jinjiang Municipal Hospital from January 2015 to August 2020 were selected. They were divided into control group (n=42) and treatment group (n=45). The control group was treated with routine western medicine, while the treatment group was treated with electroacupuncture on the basis of routine treatment. The scores of motor function before and after treatment in the treatment group and the control group were measured by using the limb motor function Fugel-Meyer assessment(FMA) scale and the functional independence measure (FIM) scale. The concentration of serum acetylcholinesterase E (AchE) in the two groups was determined by ELISA technique, and its activity was determined by rate method. Multiple stepwise regression method was used to analyze the correlation between motor function and electroacupuncture treatment, AchE concentration and activity in the treatment group.

Results

Compared with those before treatment, the scores of FMA and FIM in control group and treatment group increased after treatment (P<0.05). The scores of FMA and FIM in the treatment group after treatment were significantly higher than those in the control group (P<0.05). There was no significant difference in AchE concentration and activity between the control group and the treatment group before treatment (P>0.05). After treatment, the level of serum AchE in treatment group was higher than that in control group (P<0.05). There was no significant difference in activity (P>0.05). The concentration of AchE was negatively correlated with the score of FMA and FIM, and the effect of concentration on the score was greater than that of activity (P<0.05). There was a linear regression relationship between motor function and electroacupuncture and AchE concentration in the treatment group. Standardized regression coefficient and partial correlation coefficient showed that electroacupuncture had the greatest effect on motor function, followed by AchE concentration [|Beta|(X1)=|0.3541|>|Beta|(X2)=|-0.2001|].

Conclusion

Electroacupuncture can improve motor dysfunction in patients with DAI, and it may play a certain role in improving the pathophysiological mechanism of cognitive motor dysfunction in patients with DAI by affecting the concentration of neurotransmitter acetylcholine.

Key words: Diffuse axonal injury, Motor dysfunction, Electroacupuncture, Acetylcholinesterase E

Weichuan Dai, Xieli Guo, Wenhua Cai, Yanfei Zheng, Yuyan Zhu, Yingxian Chen, Tiansheng Hong, Xiayang Tian. Preliminary research on the mechanism of electroacupuncture in improving motor dysfunction in patients with diffuse axonal injury[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2020, 10(04): 248-253.

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References 22

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因素		治疗组(n=45)	对照组(n=42)	χ²/t值	P值
性别				0.036	0.879
	男	23	22
	女	22	20
年龄（岁，Mean±SD）		35.47±12.31	36.12±11.29	0.495	0.619
致伤原因				0.052	0.837
	车祸伤	26	26
	坠落伤	14	13
	打击伤	5	3
教育程度				0.042	0.834
	小学	18	17
	中学	17	16
	高中（中专）	8	7
	大学及其以上	2	2
职业				0.049	0.802
	工人	14	13
	农民	12	12
	职员	9	8
	自由职业	6	6
	其他	4	3

因素		治疗组(n=45)	对照组(n=42)	χ²/t值	P值
性别				0.036	0.879
	男	23	22
	女	22	20
年龄（岁，Mean±SD）		35.47±12.31	36.12±11.29	0.495	0.619
致伤原因				0.052	0.837
	车祸伤	26	26
	坠落伤	14	13
	打击伤	5	3
教育程度				0.042	0.834
	小学	18	17
	中学	17	16
	高中（中专）	8	7
	大学及其以上	2	2
职业				0.049	0.802
	工人	14	13
	农民	12	12
	职员	9	8
	自由职业	6	6
	其他	4	3

评分	治疗组(n=41)				对照组(n=40)
评分	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
FMA评分	41.94±12.78	71.94±12.78	25.469	0.001	41.76±13.75	54.65±11.15^a	13.472	0.001
FIM评分	48.62±15.77	75.62±13.77	28.723	0.001	49.32±14.96	63.36±11.46^a	19.001	0.001
FMA+FIM评分	89.79±16.24	145.19±10.14	9.631	0.001	90.03±15.98	117.43±11.98^a	28.031	0.001

评分	治疗组(n=41)				对照组(n=40)
评分	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
FMA评分	41.94±12.78	71.94±12.78	25.469	0.001	41.76±13.75	54.65±11.15^a	13.472	0.001
FIM评分	48.62±15.77	75.62±13.77	28.723	0.001	49.32±14.96	63.36±11.46^a	19.001	0.001
FMA+FIM评分	89.79±16.24	145.19±10.14	9.631	0.001	90.03±15.98	117.43±11.98^a	28.031	0.001

项目	治疗组(n=41)				对照组(n=40)
项目	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
AchE浓度(mmol/L)	125.543±5.077	53.504±7.841	47.721	0.001	129.332±4.234	94.653±11.154^a	53.447	0.001
AchE活性[nmol/(min·mL)]	1.697±0.045	1.674±0.067	1.662	0.195	1.689±0.050	1.677±0.049	1.688	0.192

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