基于fMRI脑功能成像分析电针刺激健康人通里穴的临床研究  

fMRI Analysis on Electroacupuncture on Tongli Acupoint in Healthy People

作　　者：陆琳 杨万章[1] 秋云海[2] 叶丽萍 李琳玲[2] LU Lin;YANG Wanzhang;QIU Yunhai;YE Liping;LI Linling(Shenzhen Nanshan People ＇s Hospital,Shenzhen,Guandong 518052,Chino;Shenzhen Institutes of Advanced Technology,Chinese Academy of Science,Shenzhen,Guandong518000,China)

机构地区：[1]深圳市南山区人民医院,广东深圳518052 [2]中国科学院深圳先进技术研究院,广东深圳518000

出　　处：《康复学报》2018年第3期16-21,26,共7页Rehabilitation Medicine

基　　金：深圳市科技计划重点项目(201101017)

摘　　要：目的:运用功能磁共振成像(f MRI)研究电针刺激健康人右侧通里穴是否存在语言区的激活,探索电针通里穴的临床作用机制。方法:将入组24例健康志愿者按照非随机自身对照设计分为实验组和对照组。实验组电针右侧通里穴,对照组电针自身右侧通里穴旁开假穴。2组实验间隔1周,采用组块设计方案。实验结束后应用SPM8软件处理产生脑区激活图像,分析比较2组脑区激活分布、体素、强度。结果:图片命名任务时2组激活脑区一致性较好,为视觉、语言、认知相关脑区,包括双侧矩状裂、小脑、梭状回、舌回、枕叶、中央前回、补充活动区,左侧额下回,右侧颞下回等。2组激活区域有重叠部分。实验组强于对照组的激活脑区包括第1次电针任务时有左侧扣带回后部、中央后回、中央前回,右侧额中回、背外侧额上回(P<0.01);第2次电针任务时有双侧罗兰多壳盖,左侧岛叶、枕中回、颞上回,右侧扣带回前部、额下回(P<0.01)。结论:语言表达过程可能与多个相关脑区组成的网络连接有关,右侧半球参与了正常语言的产生过程。基于图片命名任务激活的脑区,与对照组比较,电针右侧通里穴能明显激活双侧语言相关脑区,如Broca's镜像区(右侧BA45区)和边缘系统(扣带回、海马)等,可能是电针通里穴在临床应用上起效的作用机制。Objective：To investigate the effect and mechanism of electroacupuncture on Tongli acupoint on the right hand of normal subjects that may activate brain language area by functional magnetic resonance imaging（fM RI）. Methods：Twenty-four healthy volunteers were recruited and divided into treatment group and control group. The subjects of the treatment group were stimulated by the electroacupuncture on Tongli acupoint of the right hand, while the subjecs of the control group were stimulated on a fake acupoint beside Tongli with one week time interval and block design scheme. The data were analyzed by SPM8 to generate the image of active brain area. The distribution, voxel and intensity of active areas were compared between the two groups. Results：The active brain area images of both groups include vision, language and cognition areas, such as bilateral calcarine, cerebellum, fusiform, lingual, occipital,precentral gyrus, supplementary motor area, left gyrus frontalis inferior, right gyrus temporalis inferior, etc. There were some overlap of the active areas between the two groups, but the intensities of the active brain areas in the treatment group were higher than the control group. During the first electroacupuncture task, the higher intensities of the treatment group included left cingulum post, posterior central gyrus, precentral gyrus, right middle frontal gyrus, and dorsolateral superior frontal gyrus（P〈0.01）. In the second task, the areas,including bilateral loran shell, left insula, middle occipital gyrus, superior temporal gyrus, right cingulum post, and gyrus frontalis inferior, had higher intensities in the treatment group than the control group（P〈0.01）. Conclusion：Language expression might connect with various neural networks which were related to brain regions. The right hemisphere was participated to produce the normal language. Results showed that the bilateral language areas, including BA45 area and cingulum post, were activated when the Tongli acupoint on the right hand was st

关 键 词：电针 通里穴 语言功能区 功能磁共振成像 

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