捻针及假针刺刺激太冲穴对原发性高血压患者的脑功能磁共振成像研究  

Twisting acupuncture and sham acupuncture at Taichong(LR 3)in patients with essential hypertension:an fMRI study

作　　者：孙曌[1] 沈巍[1] 王小龙[2] 邹蓓蕾[2] 傅帅 

机构地区：[1]海南医学院中医学院,海口571199 [2]海南医学院附属医院 [3]解放军一八七医院

出　　处：《中国针灸》2014年第12期1191-1195,共5页Chinese Acupuncture & Moxibustion

基　　金：海南省卫生厅课题项目:201142;海南医学院科研培育基金项目:HY 2010-019

摘　　要：目的:运用脑功能磁共振成像技术(fMRI),观察针刺和假针刺太冲穴对原发性高血压患者的脑功能成像特点,分析太冲穴治疗原发性高血压的中枢机制。方法:将18例原发性高血压患者分为捻针组(10例)和假针刺组(8例),分别采用手法捻针和假针刺刺激右侧太冲穴,均每捻转30s,间歇30s,共操作5min,同时针刺过程中观察fMRI扫描原发性高血压病人静息态脑功能成像特点,所获得数据通过Matlab软件SPM2模块分析。结果:针刺原发性高血压患者太冲穴主要引起对侧脑区耗氧量增高,主要激活区域为左侧前扣带回(BA32)、左侧顶下小叶(BA40)、左侧颞下回(BA19)、左侧颞中回(BA37)、右额叶中央前回(BA6),激活区域与运动区、视觉、情感认知有关。假针刺太冲穴激活的脑区是右侧前扣带回(BA24)、左侧顶下小叶(BA40)、左侧额下回(BA7)。结论:太冲穴对原发性高血压患者降压作用和改善相关症状的中枢效应并非在激活传统控制血压的丘脑、延髓区域。太冲穴能激活前扣带回调节副交感神经降低血压,并且通过前扣带回加强与其他脑区的功能连接来改善长期高血压带来的认知损害。Objective With functional magnetic resonance imaging（fMRI）,cerebral function imaging of acupuncture and sham acupuncture at Taichong（LR 3）in patients with essential hypertension（EH）was observed to analyze central mechanism of Taichong（LR 3）to treat EH.Methods Eighteen EH patients were divided into a twisting acupuncture group（10 cases）and a sham acupuncture group（8 cases）,which were treated with twisting manipulation and sham acupuncture at right Taichong（LR 3）,respectively.The treatments were both given with 30-second manipulation and 30-second interval for totally 5min.During the acupuncture,fMRI was adopted to scan the cerebral function imaging of EH patients on resting state,and the acquired data were analyzed with SPM2 module in Matlab software.Results Acupuncture at Taichong（LR 3）in EH patients mainly increased opposite-side oxygen consumption,which generally activated left anterior cingulated gyrus（BA 32）,left inferior parietal lobule（BA 40）,left inferior temporal gyrus（BA 19）,left middle temporal gyrus（BA 37）and right anterior central gyrus（BA 6）.The activated areas were related to motor,vision and cognition of emotion.Stimulation region of sham acupuncture mainly included right anterior cingulated gyrus（BA 24）,left inferior parietal lobule（BA 40）and left inferior frontal gyrus（BA 7）.Conclusion The central mechanism of Taichong（LR 3）on antihypertensive effect and symptom improvement is not in thalamus and medulla that are traditionally believed to control blood pressure.Taichong（LR 3）could activate anterior cingulated gyrus to regulate parasympathetic nerve and lower blood pressure,and through anterior cingulated gyrus,the connection with the surrounding areas is strengthened to improve the cognitive impairment caused by long-term hypertension.

关 键 词：原发性高血压 功能性磁共振成像 穴 太冲 

分 类 号：R246.1[医药卫生—针灸推拿学]