针刺镇痛对坐骨神经痛患者脑功能成像的影响  

Influence of Acupuncture Analgesia on Cerebral Function Imaging in Sciatica Patients

作　　者：李霁[1] 张俊海[1] 董竞成[1] 

机构地区：[1]复旦大学上海医学院附属华山医院,上海200040

出　　处：《上海针灸杂志》2007年第8期3-6,共4页Shanghai Journal of Acupuncture and Moxibustion

摘　　要：目的观察12例坐骨神经痛患者脑功能磁共振信息的变化,研究电针穴位镇痛影响脑功能区的位置及其效应的变化,探索电针镇痛的作用机制与脑功能成像关系。方法选足少阳胆经的阳陵泉和悬钟穴,分别选受试者患侧和健侧下肢穴,应用血氧水平依赖(BOLD)功能性磁共振成像技术(fMRI)全脑扫描,FSL3.2软件进行图像处理,P<0.01分析得出脑功能图像。结果电针健侧和患侧肢体相同穴位后,脑激活区脑功能信号增加,包括对侧初级感觉皮层(SI)与次级感觉皮层(SII)区、双侧岛叶(Insula)、双侧扣带前回(ACC)(BA24)、双侧颞上回、双侧小脑等。电针患侧肢体穴位出现中脑导水管周围灰质(PAG)区信号明显增高,双侧尾状核及对侧豆状核(基底节核团Basal ganlia)、对侧海马信号明显升高。电针健侧肢穴位,双侧杏仁体及视皮层信号改变,针刺患侧肢体与健侧肢体,引起的脑功能区变化有显著差异,以针刺患侧肢体的脑功能变化更明显。结论肢体在病理和生理状态下,针刺肢体相同穴位对中枢神经系统调节作用不完全相同,fMRI影像适合针刺穴位镇痛的研究,且进一步说明了针刺调节具有双向性特点。Objective To observe changes in cerebral functional magnetic resonance information after the electroacupuncture load come into 12 sciatica patients, investigate the influenced positions in cerebral function areas during point electroacupuncture analgesia and the change in its effect and explore the relationship between the mechanism of the analgesic action of electroacupuncture and cerebral function imaging. Methods Points Yanglingquan（ GB 34） and Xuanzhoug（GB 39） of the Gallbladder Meridian of Foot-Shaoyang were selected, Points on the healthy and affected legs were separately selected in the subjects. The whole brain was scanned by blood oxygen level-dependent （BOLD） functional magnetic resonance imaging （fMRI） techniques. The images were processed with FSL 3.3 software. Cerebral function images were obtained by P 〈 0.01 analysis. Results After electroacupuncture of the same points on the healthy and affected legs ,cerebral activated areas （increase in cerebral function signal） included bilateral primary sensory cortex （S Ⅰ ） and secondary sensory cortex （ S Ⅱ ）, bilateral insulae, anterior cingulate gyri （ACG） （ BA24）, superior temporal gyri and cerebella. After electroacupuncture of the point on the affected legs, the signal significantly increased in periaqueductal gray （PAG）, bilateral caudate nuclei, and counterlateral putamina （basal ganglia） and hippocampus. After electroacupuncture of the point on the healthy legs, the signal changed in bilateral amygdaloid nuclei and visual corticeds. There were significant differences in changes in cerebral function areas between electroacupuncture of the healthy and affected legs. Cerebral function changed more obviously during electroacupuncture of the affected legs. Conclusion Under the physiological or pathological state of the limb, acupuncture of its same point produces a completely different regulating effect on the central nervous system. MRI imaging is suitable for investigation of point acupuncture analgesia,

关 键 词：针刺镇痛 坐骨神经痛 磁共振成像 脑 

分 类 号：R246.6[医药卫生—针灸推拿学]