穴位和非穴位电针镇痛的脑功能磁共振对照研究  

Functional MRI Studies of Acupoints and Non-acupoints Electroacupuncture Analgesia Modulating within Human Brain

作　　者：张俊海[1] 冯晓源[1] 李霁[2] 汤伟军[1] 黎元[1] 

机构地区：[1]复旦大学附属华山医院放射科,200040 [2]复旦大学附属华山医院针灸科

出　　处：《中国医学计算机成像杂志》2005年第1期10-16,共7页Chinese Computed Medical Imaging

摘　　要：目的用功能磁共振成像(fMRI)方法研究穴位和非穴位电针(EA)镇痛时脑功能区变化,了解穴位对电针镇痛的影响。材料和方法采用穴位深刺、非穴位深刺不同的针刺方法,分别电针20例健康右利手志愿者左侧足少阳胆经的阳陵泉(GB34)和悬钟穴(GB39),同时行全脑fMRI扫描;SPM99软件进行图像后处理,t检验(P<0.01)分析得出不同针刺方法的脑功能图像。结果20例受试者中有16例完成穴位深刺,18例完成非穴位深刺。穴位深刺与非穴位深刺引起的脑功能区的变化有显著差别。穴位深刺组表现为中脑导水管周围灰质(PAG)、双侧豆状核区等信号升高;双侧扣带前回(BA24、32区)、左侧杏仁体(NA)、双侧海马结构等信号降低。这些发生明显变化的脑功能区被认为可能与针刺镇痛有关。非穴位组双侧扣带前回(BA24、32区)等信号升高,双侧豆状核等信号降低。结论fMRI方法研究表明,穴位深刺电针镇痛的作用可能是通过抑制和兴奋与痛觉调制相关的多个脑功能区而实现的。非穴位深刺可能更多的是一种不良的刺激。穴位的准确定位对电针镇痛有明显影响。Purpose:To compare the brain response changes between acupoints and non-acupoints electroacupuncˉture(EA)using functional magnetic resonance imaging(fMRI).Materials and Methods:In this study two different EA methods were devised:acupoint EA(deep manipulation at acupoints),non-acupoint EA(deep manipulation at non-acupoints).Twenty healthy right handedness volunteers received this two different EA with consistent EA parameters at left analgesic points GB34(yanglingquan)and GB39(xuanzhong)in counter-balanced orders.Functional MRI data were obtained from scanning the whole brain.Each experimental session was composed of four blocks lasting2min each.Acquired functional data were processed by SPM99software and functional responses were established by students’group t-test analysis(P<0.01).Results:Sixteen acupoint EA,eighteen non-acupoint EA data were finally obˉtained.Evident differences of brain responses were found in two EA groups.Acupoint EA manipulation produced prominent increases of fMRI signals in periaqueductal gray(PAG),bilateral lenticula and deˉcreases of fMRI signals in bilateral anterior cingulate cortex(BA24.32),left amygdala formation,biˉlateral hippocampus etc;on the contrary,non-acupoint EA manipulation induced signal increases of biˉlateral anterior cingulate cortex(BA24.32)and signal decreases in bilateral lentiform nucleus.Concluˉsion:The therapeutic effect of acupoint EA was probably produced by activating or inhibiting multiple brain structures correlated with pain modulation.But non-acupoint EA maybe mainly leads to uncomˉfortable.So,accurate location of acupoints is important for developing EA analgesia.

关 键 词：穴位 电针镇痛 脑功能磁共振 对照研究 

分 类 号：R445.2[医药卫生—影像医学与核医学]