电针影响交感神经活动的脑功能磁共振初步研究  

A primary Functional MRI Study of Electroacupuncture Modulate the Sympathetic Activities

作　　者：张俊海[1] 冯晓源[1] 李克[1] 李霁[2] 曹小定[3] 刘含秋[1] 姚振威[1] 

机构地区：[1]复旦大学附属华山医院放射科,上海市200040 [2]复旦大学附属华山医院针灸科,上海市200040 [3]复旦大学上海医学院针剌原理研究所,上海市200040

出　　处：《中国医学计算机成像杂志》2008年第2期94-99,共6页Chinese Computed Medical Imaging

基　　金：上海市卫生局青年科研基金(2006Y7)~~

摘　　要：目的:本研究采用脑fMRI方法观察电针穴位对交感神经活动的可能影响。材料和方法:12例左侧腰腿痛患者,针刺左侧足少阳胆经的阳陵泉(GB34)和悬钟穴(GB39)。全脑fMRI扫描采用Block设计,电针刺激与静息交替进行,每次2min,共持续10min;每隔5min,记录患者电针及fMRI扫描时受试者掌心皮温的变化,作为判断交感神经活动的指标。功能图像后处理分析得出不同掌心皮温变化者在电针时的平均脑功能图像并进行比较(Z阈值为2.3,P<0.05)。结果:12位受试者中有9例在接受电针后掌心皮温呈持续升高,3例掌心皮温呈明显下降趋势。皮温升高组与皮温降低组相同的脑激活区包括:右侧SI区、右侧SII区、双侧岛叶、双侧ACC(BA24)、双侧丘脑、双侧颞上回、双侧小脑、PAG等。对比发现,皮温升高组双侧尾状核头部及右侧豆状核、PAG区明显激活;而皮温降低组其双侧ACC、岛叶、SI以及双侧额叶眶回、双侧视皮质及双侧海马、杏仁核激活明显。结论:电针穴位能够对患者交感神经的活动产生影响;电针可能通过改变交感神经活动而影响镇痛效果。Purpose： To investigate the possible needling effect on sympathetic activities by using functional MRI（fMRI） . Materials and Methods： Twelve patients with left lower extremity pain were enrolled in this study. Each was given deep needling at GB34 （yanglingquan） and GB39 （xuanzhong） simultaneously. Each subject got the strong Deqi sensation by manipulating the needles and EA was lasted for thirty minutes before fMRI scan. Then fMRI scan were performed by scanning the whole brain with five blocks lasting 2 min each. The palm skin temperature was tested every five minutes from beginning of the EA as index of sympathetic activities. Functional images were processed by using FEAT software at different levels including the simple single subject analysis, multisubjects group mean analysis, multisubjects unpaired two difference analysis（Z≥2.3, P 〈 0.05） . Results： Nine of twelve subjects, their palm temperature were found increased gradually but other three decreased. In comparison of two different skin temperature groups, there was more significant activation over bilateral caudate head, right lentiform and PAG in temperature - increased group, but temperature - decreased subjects showed more significant activation over bilateral ACC, insula, SI, orbitofrontai cortex, visual cortex, hippocampus and amygdala formation. Conclusion： EA at acupoints may affect the subjects＇ sympathetic activities and show different brain responses and this change maybe correlated with the analgesia effects.

关 键 词：针刺镇痛 功能磁共振成像 脑 交感神经 

分 类 号：R245.97[医药卫生—针灸推拿学]