联合针刺梁丘穴和足三里穴与足三里穴和上巨虚穴的fMRI-BOLD对比研究  

Comparative fMRI-BOLD study of acupuncture at Liangqiu acupoint combined with Zusanli acupoint and Zusanli acupoint combined with Shangjuxu acupoint

作　　者：谭惠斌 熊飞 贾静 黄文才 李涵翰 游涛 王叶 高利臣 陈友三 TAN Huibin;XIONG Fei;JIA Jing;HUANG Wencai;LI Hanhan;YOU Tao;WANG Ye;GAO Lichen;CHEN Yousan(Department of Radiology,General Hospital of Central Theater Command of the PLA,Wuhan 430060,China;TCM Department,Hubei 672 Traditional Chinese and Western Orthopedic Hospital,Wuhan 430070,China;Department of Radiology,Hubei Provincial Hospital of TCM,Affiliated Hospital of Hubei University of TCM,Hubei Academy of Traditional Chinese Medicine,Wuhan 430061,China)

机构地区：[1]中国人民解放军中部战区总医院放射诊断科,湖北武汉430060 [2]湖北省672中西医结合骨科医院中医科,湖北武汉430070 [3]湖北省中医院/湖北中医药大学附属医院/湖北省中医药研究院放射科,湖北武汉430061

出　　处：《中国中西医结合影像学杂志》2024年第1期22-27,84,共7页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨同一经络内2个相邻穴位针刺的联合效应,为针刺的中枢机制和经络学说提供一定证据。方法:50例健康志愿者随机分为2组,分别行右侧梁丘穴+足三里穴和足三里穴+上巨虚穴脉冲电针治疗仪针刺。采用区块设计模式行fMRI,分析针刺过程中的脑活动模式,并比较2组的差异。记录2组针刺感觉类型和强度,评估针刺感觉与脑活动的关系。结果:梁丘穴+足三里组和足三里穴+上巨虚穴组共同激活区集中在右侧额上回眶缘、左侧额下回盖部、左侧前扣带回和左侧眶前回,2组共同负激活区则集中在右侧缘上回、右侧尾状核、右侧壳核和左侧岛叶。梁丘穴+足三里穴组在左侧额下回盖部、左侧前扣带回等区域更活跃,而足三里穴+上巨虚穴组在右侧缘上回、左侧岛叶和左侧壳核等区域更活跃。结论:同一经络内2个相邻穴位的针刺刺激可产生协同效应,不同穴位组合对大脑活动的影响也有差异。这些结果可为针刺的中枢机制和经络学说提供一定证据,为针刺方案的设计提供参考。Objective:To explore the combined effect of acupuncture at two adjacent acupoints in the same meridian,and to provide some evidences for the central mechanism and meridian theory of acupuncture.Methods:Fifty healthy volunteers were randomly divided into 2 groups,the Liangqiu acupoint combined with Zusanli acupoint acupuncture group(ST34+ST36 group)and the Zusanli acupoint combined with Shangjuxu acupoint acupuncture group(ST36+ST37 group).All volunteers underwent fMRI,and the brain activity pattern of 2 groups was analyzed and compared.The type and intensity of acupuncture sensation were recorded,and the relationship between acupuncture sensation and brain activity was evaluated.Results:The ST34+ST36 group and ST36+ST37 group had common activation regions concentrated in the right orbital gyrus,the left inferior frontal gyrus,the left anterior cingulate gyrus and the left orbital gyrus.The two groups had common negative activation regions concentrated in the right marginal gyrus,the right caudate nucleus,the right putamen and the left insula.The ST34+ST36 group was more active in the left inferior frontal gyrus and the left anterior cingulate gyrus,while the ST36+ST37 group was more active in the right margin gyrus,the left insula and the left putamen.Conclusions:Acupuncture stimulation of two adjacent acupuncture points in the same meridian can produce synergistic effect,and different acupuncture point combinations have different effects on brain activity.These results provide some evidences for the central mechanism and meridian theory of acupuncture,and also provide a reference for the design of acupuncture scheme.

关 键 词：功能性磁共振成像 穴位联合针刺 足阳明胃经 梁丘穴 足三里穴 上巨虚穴 

分 类 号：R246[医药卫生—针灸推拿学]