基于r-fMRI技术观察电针曲池、上巨虚对功能性肠病患者大脑的即刻效应  

Observation of Instant Effect of Electroacupuncture at Quchi (LI 11) and Shangjuxu (ST 37) on Functional Bowel Disorders Based on R-f MRI

作　　者：罗容[1] 石文英[1] 邝涛[1] 叶贵生[1] 潘江[1] 陈成[1] 李里[1] 李金香[1] 章薇[1] 

机构地区：[1]湖南中医药大学第一附属医院,长沙410007

出　　处：《上海针灸杂志》2018年第1期92-96,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：湖南省教育厅科学研究项目(14C0853);湖南省中医药科研计划项目(2015165;2016105);湖南省中医药科研计划重点项目(201302)

摘　　要：目的以静息态功能性磁共振成像(r-f MRI)技术观察电针曲池、上巨虚穴对功能性肠病患者大脑功能活动模式的改变,为探索曲池、上巨虚穴治疗功能性肠病发挥效应的中枢机制提供影像学依据。方法选择功能性便秘患者20例为便秘组,功能性腹泻患者20例为腹泻组。便秘组采用电针上巨虚治疗,腹泻组采用电针曲池治疗,次日两组均取相关非经非穴点进行电针治疗。采集两组电针前后的静息态功能磁共振数据,以功能连接为观察指标,以右侧岛叶为种子点,运用MATLAB、DPARSF和REST等软件得到两组与种子点存在功能连接的脑区图像,进而分析两组自身经电针刺激前后脑功能连接的差异。结果电针刺激功能性便秘患者上巨虚穴可正激活左侧小脑后叶小脑山坡、左侧枕叶舌回、左侧枕叶枕中回、右侧枕叶、右侧顶叶缘上回、右侧穹窿回扣带回、左侧顶叶楔前叶;负激活右侧额叶Sub-Gyral、右侧岛叶、左侧岛叶。电针功能性腹泻患者曲池穴有显著差异的脑区为左侧小脑后叶山顶和左侧边缘叶后扣带回。结论电针曲池、上巨虚穴可引起功能性肠病患者大脑部分内脏高敏相关脑区功能连接的变化,提示针刺对功能性肠病患者的改善效应可能与此有关。Objective By using resting-state fMRI （r-fMRI）, to observe the effect of electroacupuncture at Quchi （LI 11） and Shangjuxu （ST 37） in changing brain activity pattern in functional bowel disorders （FBD）, and to provide imaging evidence for seeking the central mechanism of Quchi （LI 11） and Shangjuxu （ST 37） in treating FBD. Method Twenty patients with functional constipation were taken as the constipation group, and 20 patients with functional diarrhea were taken as the diarrhea group. The constipation group was intervened by electroacupuncture at Shangjuxu （ST 37）, while the diarrhea group was intervened by electroacupuncture at Quchi （LI 11）. On the next day, the two groups both received electroacupuncture at the corresponding non-meridian point. The r-fMRI data of the two groups were collected before and after the interventions. With the functional connectivity taken as the observation index and right insular lobe as the seed point, MTLAB, DPARSF and REST were adopted to obtain the brain images functionally connected with the seed point, to further analyze the difference in brain functional connectivity before and after electroacupuncture. Result After electroacupuncture at Shangjuxu （ST 37）, functional constipation patients presented positive activation in left cerebellar declive, left lingual gyrus, left middle occipital gyrus, right occipital lobe, right supramarginal gyrus, right gyrus cingula and left precuneus; the right subgyrus, right insular lobe and left insular lobe were negatively evoked. After electroacupuncture at Quchi （LI 11）, patients with functional diarrhea showed significant differences in left cerebellar culmen and left posterior cingulate. Conclusion Electroacupuncture at Quchi （LI 11） and Shangjuxu （ST 37） can induce changes in brain functional connectivity related to visceral hypersensitivity in FBD patients, which is possibly associated with the effect of acupuncture in improving FBD.

关 键 词：针刺疗法 电针 穴 上巨虚 穴 曲池 功能性肠病 功能性磁共振成像 功能连接 便秘 腹泻 

分 类 号：R2-03[医药卫生—中医学]