基于功能性磁共振成像技术研究针刺得气脑机制  

Study on brain mechanism of bring about the desired sensation in acupuncture treatment based on RS-fMRI technique

作　　者：史宇[1] 吴文[1] 张珊珊[1] 刘自平[1] 郭世贵[1] 杨建明[1] 赵红炜[2] 

机构地区：[1]南方医科大学附属珠江医院,广州510282 [2]佛山市南海区第二人民医院,佛山528200

出　　处：《中华中医药杂志》2016年第2期445-450,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81473769)~~

摘　　要：目的:利用静息态功能磁共振成像(rs-f MRI)技术,探讨针刺委中穴得气状态下的脑网络变化及针刺镇痛机制。方法:采用飞利浦3.0T Achieva磁共振成像仪分别采集16名健康志愿者在正常状态及针刺右委中穴得气状态下f MRI数据。利用静息态f MRI数据处理助手软件计算受试者在正常及得气状态下脑功能连接图像,用种子相关分析法,以后扣带回为种子点(ROI),分析其与全脑的功能连接图谱,比较得气与正常状态之间的差异。结果:针刺状态下明显出现酸痛、酸感、压感、麻木等得气感觉;针刺得气状态下在默认模式网络(前额叶、后扣带回、角回),疼痛矩阵(第二躯体感觉区、岛叶、前扣带回、额叶、顶叶)产生了较强而广泛的功能连接降低,另外苍白球、豆状核、尾状核、左小脑后叶也出现功能连接降低,而后扣带回与右小脑扁桃体、左脑海马旁回区、丘脑、辅助运动区功能连接增强[P<0.05,false discovery rate(FDR)<0.05]。结论:针刺委中穴产生明显得气感觉,在此状态下默认模式网络及"疼痛矩阵"产生广泛的功能连接减弱效应,推测该效应是通过边缘叶-旁边缘叶-新皮层系统这一内在的脑功能网络发挥调节作用,这可能与针刺得气镇痛中枢机制有关。Objective：To investigate the changes of brain network and analgesia mechanism in patients in the desired sensation brought about by acupuncturing in Weizhong（BL40） by using resting-state functional magnetic resonance imaging（RSfMRI）.Methods：The fMRI data of 16 cases of healthy volunteers in normal condition and desired sensation brought about by acupuncturing in Weizhong（BL40） were collected by Philips magnetic resonance imagers（3.0T）.The brain functional images of trial volunteers in normal state and desired sensation brought about by acupuncturing in Weizhong（BL40） were calculate by data processing assistant for resting-state fMRI（DPARSF） and functional connection images were analyzed by interest correlation analysis method with posterior cingulate cortex（PCC） as the regions of interest（ROI）.Difference between normal state and desired sensation brought about by acupuncturing in Weizhong（BL40） was analyzed and compared.Results：During the treatment of acupuncture,the desired sensations as aching pain,oppressing sensation and numbness emerged.The functional connectivity in the default mode networks（prefrontal lobe,posterior cingulate,angular convolution） and the pain matrix networks（secondary somesthetic area,insular lobe,anterior cingulate,frontal lobe and parietal lobe） were decreased widely and intensely.The functional connectivity of globus pallidus,lentiform nucleus,caudate nucleus and left posterior lobe of cerebellum were also decreased,while the functional connectivity of posterior cingulate,right tonsil of cerebellum,left parahippocampal gyrus,thalamus and supplementary motor area were increased（P〈0.05,FDR〈0.05）.Conclusion：The desired sensation brought about by acupuncturing in Weizhong（BL40） was remarkable,and in this sensation,the functional connectivity in default mode networks and pain matrix networks were decreased widely and intensely.It is supposed that this effect might be played its regulative role in the internal effective connectiv

关 键 词：针刺 得气 默认模式网络 疼痛矩阵 静息态功能性磁共振 

分 类 号：R445.2[医药卫生—影像医学与核医学]