电针通里、悬钟穴对1例皮质下失语症患者语言功能和fMRI改变的作用  

A preliminary discussion of the effect of electroacupuncture at acupoints HT5 and GB39 on lingual function and fMRI changes in a case of subcortical aphasia

作　　者：常静玲[1] 高颖[1] 张华[1] 谭中建[1] 蒋根娣[1] 

机构地区：[1]北京中医药大学东直门医院神经内科,北京100700

出　　处：《中国康复医学杂志》2007年第1期13-17,I0002,共6页Chinese Journal of Rehabilitation Medicine

基　　金：国家重点基础研究发展计划(973计划)课题编号(2003CB517102)资助

摘　　要：目的:通过对1例皮质下失语症患者针刺通里、悬钟前后的语言学评估,观察此穴位配伍的语言学疗效及探索语言功能的改善与皮质激活效应的关系和意义。方法:试验1:对1例皮质下失语症志愿者在针刺通里、悬钟前后用汉语标准失语症检查表进行语言学评价。试验2:分别电针左、右通里、悬钟,试验采用组块设计模式,静息阶段与刺激阶段交替;运用fMRI中的BOLD技术及SPM2软件分析方法来显示脑皮质功能区的激活情况。结果:电针左侧通里、悬钟后出现右侧颞上回、颞横回、额下回、岛叶、海马旁回、中央前后回、小脑扁桃体等部位的激活,电针右侧通里、悬钟后左侧颞上回、颞下回、海马旁回、角回、岛叶、顶上小叶、顶下小叶、中央后回等脑区出现激活;其中电针左侧的通里、悬钟后出现双侧颞叶的皮质激活效应。结论:针刺通里、悬钟可以激活脑语言功能区,从而证实针刺此组穴位可以改善失语症患者的语言功能。通过观察针刺单侧穴位后的侧别交叉激活和双侧皮质激活推测语言功能的双侧性。Objective：To observe the effect of electroacupuncture at acupoints HT5（Tongli） and GB39（Xuanzhong） on lingual function and fMRI changes in a case of subcortical aphasia, and to explore the relationship and significance of lingual function improvement and cortical activation by fore-and-aft linguistics evaluation. Method：Examination 1： Applied clinical rehabilitation research center aphasia examination before and after electroacupuncture at acupoints Tongli and Xuanzhong. Examination 2： Applied electroacupuncture at acupoints left and right Tongli and Xuanzhong, adopted block design and alternated the course of rest and stimulation;by BOLD fMRI and SPM2 software to analyse the activation of cortical function. Result：Under left Tongli and Xuanzhong electroacupuncture stimulation, superior temporal gyrus （R/L）,transverse temporal gyrus （RFL）,inferior frontal gyrus（R）,insula lobus（R）, parahippocampal gyrus （R）,precentral gyros （R）,postcentral gyrus （R）,cerebellar tonsil （R） and so on were activated, Under right Tongli and Xuanzhong electroacupuncture stimulation,superior temporal gyrus（L）,inferior frontal gyms（L）, parahippocampal gyrus（L）, angular gyms（L）, insula lobus（L）,superior parietal lobule （L） , inferior parietal lobule （L）, postcentral gyrus （L） were activated. Condusion：Tongli and Xuanzhong electroacupuncture stimulation could activate cerebral lingual function area,so this group of acupoints may improve language function of aphasia patient. It is reasoned that lingual function have both sides effects which were proved in this study by the observation of single-side electroacupuncture stimulation resulting the opposite side activation and both sides cortical activation.

关 键 词：电针 通里穴 悬钟穴 失语症 语言功能 功能性磁共振成像 

分 类 号：R246[医药卫生—针灸推拿学] R743.3[医药卫生—中医临床基础]