功能磁共振成像技术对针刺老年人支沟穴的中枢响应特征研究  

A fMRI Study of Acupuncturing Zhigou Point of the Elderly for Central Response Characteristics

作　　者：徐莉娜 任翱翔 李颖[2] 赵华丽[3] 韩力 Xu Lina;Ren Aoxiang;Li Ying;Zhao Huali;Han Li(Department of Acupuncture;Department of Neurology;Department of Radiology;Jing＇An District Centre Hospital of Shanghai, Shanghai, 200040;4. Department of Fraditional Chinese Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, P. R. Chin)

机构地区：[1]上海市静安区中心医院针灸科,上海200040 [2]上海市静安区中心医院神经内科,上海200040 [3]上海市静安区中心医院放射科,上海200040 [4]复旦大学附属华东医院中医科,上海200040

出　　处：《老年医学与保健》2018年第2期164-166,170,共4页Geriatrics & Health Care

摘　　要：目的观察针刺老年人支沟穴的中枢响应特征,探讨其与支沟穴治疗老年性便秘的作用有无相关性。方法本试验把17例健康右利手受试志愿者随机分为2组:试验组针刺左支沟穴组,对照组针刺左内关穴组。采用血氧水平依赖(BOLD)的功能磁共振(f MRI)成像技术,在分别针刺左支沟穴、左内关穴时进行大脑皮层区域扫描,同时与自身未针刺前的静息状态、同穴位贴皮电刺激状态进行对照。使用SPM8分析软件,根据一般线性模型方差分析(P<0.05,簇>50)得出相关激活区域。结果左支沟穴的对照序列中大脑皮层被激活:右侧前扣带回,两侧枕叶,两侧颞叶,两侧顶叶,辅助运动区,楔前叶。左支沟穴的针刺序列中大脑皮层被激活:前扣带回,两侧颞叶,右侧顶叶,左侧额上回。左支沟穴的针刺序列与对照序列相比,显著激活区域有:左侧颞叶,右侧额中回。左内关穴的对照序列中大脑皮层被激活:两侧颞叶,右侧顶叶,右侧楔前叶,右侧枕叶,岛叶。左内关穴的针刺序列中大脑皮层被激活:两侧颞叶,左侧额中回,左侧额下回,两侧顶叶,两侧枕叶。左内关穴的针刺序列与对照序列相比,显著激活区域有:两侧额中回,两侧额下回,右侧岛叶,右侧颞叶,右侧前额叶。结论针刺左支沟穴特异性激活左前扣带回,左额上回,左侧颞叶。这些区域和已知的功能性胃肠病的大脑响应区域具有一致性。支沟穴的便秘主治功能与大脑皮层的综合调控有关。Objective To observe the central response characteristics in acupuncture at Zhigou point （SJ6） of the elderly and to explore the correlation between the central response and acupuncture at Zhigou point in treating senile constipation.Methods 17 right-handed healthy volunteers were enrolled and randomly divided into 2 groups：experiment group （acupuncture at left Zhigou point） and control group [（acupuncture at left Neiguan point （PC6）];the central cortex scanning when acupuncturing the left Zhigou point and left Neiguan point was performed by blood oxygenation level dependent functional magnetic resonance imaging （BOLD-fMRI） and a contrast study was made between the resting state before acupuncture and the state of skin stimulation at the same points in each group;the relevant activated volxes were obtained through Variance Analysis with software SPM8 （P 〈 0.05,cluster size 〉 5）.Results The activated voxels of skin-stimulating left Zhigou （S J6） were：Cingulum Ant R,Occipital_L＆R,Temporal_L＆R,Parietal_L＆R,SMA_L＆R and Precunes L＆R.while the activated voxels of acupnncturing left Zhigou （SJ6） were：Cingulum Ant L＆R,Temporal_L＆R,Parietal R and Frontal Sup_L;compared with left Zhigou （SJ6）＇s skin-stimulating,the acupuncturing stimulation significantly activated Temporal_ L and Frontal_Mid_R;the activated voxels of skin-stimulating left Neiguan （PC6） were：Temporal_L＆R,Parietal_R,Precuneus_R,Occipital_R and Insula_L＆R while the activated voxels of acupuncturing left Neiguan （PC6） were：Temporal_L＆R,Frontal_Mid_L,Frontal Inf L,Parietal_L＆R and Occipital_L＆R;compared with left Neiguan （PC6）＇s skinstimulating,the acupuncturing stimulation significantly activated Frontal Mid L＆R,Frontal Inf L＆R,Insula_R,Temporal_R and Frontal_Sup_R..Conclusions Acupuncturing left Zhigou （SJ6） can specially activate Cingulum Ant L,Frontal_Sup_L and Temporal_L,where are the known cerebral response areas of functional gastrointestinal disorders;acupunc

关 键 词：针刺 支沟穴 老年性便秘 功能磁共振成像 边缘系统 前扣带回 

分 类 号：R246.1[医药卫生—针灸推拿学] R445.2[医药卫生—中医临床基础]