针刺胃经穴治疗功能性消化不良的^(18)F-FDG PET/CT研究  

^(18)F-FDG PET/CT Study on the Treatment of Functional Dyspepsia with Acupuncture at Stomach Meridian Points

作　　者：方莉[1] 马婷婷[2] 曾芳[3] 周思远[3] 邓竹青[3] 梁繁荣[3] 

机构地区：[1]浙江中医药大学附属第三医院,杭州310005 [2]成都中医药大学第一附属医院,成都610075 [3]成都中医药大学,成都610075

出　　处：《上海针灸杂志》2013年第3期157-161,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家重点基础研究发展计划(2006CB504501);浙江省"重中之重"学科建设经费资助[浙教高科(2008)255号]

摘　　要：目的采用PET/CT脑功能成像技术观察针刺胃经特定穴与胃经非特定穴治疗对功能性消化不良患者脑葡萄糖代谢的影响,探讨两种不同取穴针刺治疗的中枢响应机制。方法将18例功能性消化不良患者随机分为胃经特定穴组和胃经非特定穴组,每组9例。两组均采用电针治疗,每日1次,5次为1个疗程,疗程间休息2 d,共治疗4个疗程。所有患者均在治疗前后接受PET/CT脑功能成像检查,所采集的图像运用SPM5软件包进行处理和分析。结果胃经特定穴组针刺治疗后异常增高的边缘系统-大脑多个脑区的葡萄糖代谢全面降低(P<0.01);胃经非特定穴组针刺治疗后只有部分异常增高脑区的葡萄糖代谢出现了降低(P<0.01)。胃经特定穴组针剌治疗后与病情相关的所有重点脑区的异常激活均有显著的抑制(P<0.05);胃经非特定穴组针刺后只有左侧前扣带回和双侧小脑的异常激活出现了显著的抑制(P<0.05)。结论与胃经非特定穴针刺相比,胃经特定穴针刺能唤起内脏感觉运动网络、情绪网络、认知网络三大脑功能网络协同和一致的响应,针对与病情密切相关的重点脑区具有更强的靶向性调节。Objective To explore the mechanism of central response to acupuncture with two different point selections by comparing the effects of acupuncture at specific versus non-specific stomach meridian points on cerebral glucose metabolism using PET/CT functional brain imaging in functional dyspepsia patients. Methods Eighteen functional dyspepsia patients were randomly allocated to specific and non-specific stomach meridian points groups, 9 cases each. Both group received electroacupuncture once daily, five times as a course, for a total of four courses with an interval of two days between. All the patients underwent PET/CT functional brain imaging before and after treatment. The images were processed and analyzed using the SPM5 software package. Results After acupuncture treatment, the abnormally enhanced glucose metabolism in many areas of the limbic system and cerebral cortex decreased in all of the areas in the specific stomach meridian points group （P〈0.01） and only in part of the areas in the non-specific stomach meridian points groups （P〈0.01）. After acupuncture treatment, the abnormal activation was significantly inhibited in all disease-related key brain regions （P〈0.05） and only in the left anterior cingulate gyms and bilateral cerebellar regions in the non-specific stomach meridian points groups （P〈0.05）. Conclusion In comparison with acupuncture at non-specific stomach meridian points, acupuncture at specific stomach meridian points can evoke the synergistic and consistent responses of the three large brain functional networks： visceral sensory-motor network, emotion network and recognition network and make obvious regulation targeted at disease-related key brain regions.

关 键 词：针刺疗法 胃经 消化不良 正电子发射断层成像 

分 类 号：R246.1[医药卫生—针灸推拿学]