针刺冲阳、公孙组穴脑激活区f MRI研究
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摘要
目的应用功能磁共振成像(f MRI)技术探讨针刺冲阳、公孙组穴与单独针刺两穴的脑激活效应,并分析其中枢作用机制。方法搜集符合纳入标准的16名健康青年志愿者,分别采集针刺右侧冲阳、公孙组穴及其单穴f MRI数据,利用DPARSF、统计参数图(SPM12)及XJVIEW软件进行数据预处理和统计分析。结果与针刺冲阳穴比较,针刺冲阳、公孙组穴显著脑激活区:左侧额上回(BA9)、小脑后叶、额中回、枕中回、楔叶(BA17)、脑岛,右侧距状回(BA17)、小脑后叶、楔叶、后扣带回(BA30);与针刺公孙穴比较,针刺冲阳、公孙组穴显著脑激活区:左侧枕上回、尾状核、楔前叶、后扣带回、颞下回(BA37)、海马旁回,右侧距状回(BA18)、小脑后叶。结论针刺冲阳、公孙组穴与其单穴比较,脑激活区更为广泛,并非两单穴脑激活区的简单叠加;针刺冲阳、公孙组穴治疗疾病可能与多个脑功能区的参与及协调作用相关。
Objective To compare the brain activation effects of acupuncture at Chongyang,Gongsun group and single acupoints by using f MRI technique,and to analyze the central mechanism.Methods Sixteen healthy young volunteers who met the inclusion criteria were selected to collect f MRI data of right Chongyang,Gongsun group and their single acupoints.DPARSF,SPM12 and XJVIEW software were used for data preprocessing and statistical analysis.Results Compared with acupuncture at Chongyang,acupuncture at Chongyang and Gongsun groups acupoints significantly activated brain areas:left superior frontal gyrus(BA9),posterior cerebellar lobe,middle frontal gyrus,occipital gyrus,cuneiform lobe(BA17),insula,right talus gyrus(BA17),posterior cerebellar lobe,cuneiform lobe and posterior cingulate gyrus(BA30.Compared with acupuncture at Gongsun,acupuncture at Chongyang and Gongsun group acupoints significantly activated brain areas:left superior occipital gyrus,caudate nucleus,anterior wedge lobe,posterior cingulate gyrus,inferior temporal gyrus(BA37),parahippocampal gyrus,right talus gyrus(BA18),posterior cerebellar lobe.Conclusion Acupuncture at Chongyang and Gongsun group acupoints has wider brain activation areas than that at single point,which is not a simple superposition of brain activation at two single points.Acupuncture at Chongyang and Gongsun groups acupoints may be related to the participation and coordination of multiple brain functional areas in the treatment of diseases.
Objective To compare the brain activation effects of acupuncture at Chongyang,Gongsun group and single acupoints by using f MRI technique,and to analyze the central mechanism.Methods Sixteen healthy young volunteers who met the inclusion criteria were selected to collect f MRI data of right Chongyang,Gongsun group and their single acupoints.DPARSF,SPM12 and XJVIEW software were used for data preprocessing and statistical analysis.Results Compared with acupuncture at Chongyang,acupuncture at Chongyang and Gongsun groups acupoints significantly activated brain areas:left superior frontal gyrus(BA9),posterior cerebellar lobe,middle frontal gyrus,occipital gyrus,cuneiform lobe(BA17),insula,right talus gyrus(BA17),posterior cerebellar lobe,cuneiform lobe and posterior cingulate gyrus(BA30.Compared with acupuncture at Gongsun,acupuncture at Chongyang and Gongsun group acupoints significantly activated brain areas:left superior occipital gyrus,caudate nucleus,anterior wedge lobe,posterior cingulate gyrus,inferior temporal gyrus(BA37),parahippocampal gyrus,right talus gyrus(BA18),posterior cerebellar lobe.Conclusion Acupuncture at Chongyang and Gongsun group acupoints has wider brain activation areas than that at single point,which is not a simple superposition of brain activation at two single points.Acupuncture at Chongyang and Gongsun groups acupoints may be related to the participation and coordination of multiple brain functional areas in the treatment of diseases.
引文
1赵莉,阙庆辉,谢新才.原络配穴法治疗腰椎间盘突出症疗效观察[J].中国针灸,2013,33:25-28.
2余情,胡玲,李梦.原络配穴法的临床应用研究进展[J].中医药临床杂志,2017,29:963-965.
3郑振峰,石会兰.肾脏血氧水平依赖磁共振成像检测指标和测量方法进展[J].国际泌尿系统杂志,2016,36:306-309.
4 Li A,Li XL,Zhang F,et al.A functional magnetic resonance imaging study of the neuronal specificity of an acupoint:acupuncture at Rangu(KI 2)and its sham point[J].Internal Medicine Journal,2016,46:973-977.
5刘潇,李晓陵,李崖雪,等.运用原络配穴法治疗功能性消化不良临床疗效观察[J].针灸临床杂志,2017,33:56-58.
6马原,谷忠悦,白增华,等.《经络腧穴学》不同版本教材解读[J].光明中医,2016,31:1501-1502.
7赵志恒,付田昊,焦召华,等.“门”穴与脏腑经络的规律探析[J].四川中医,2015,33:15-17.
8兰蕾,吴凤,曾芳,等.国外针刺中枢效应机制的f MRI研究进展[J].中国针灸,2013,33:426-430.
9申伟,汤继芹,张永臣.《针灸大成》中申脉穴文献浅析[J].针灸临床杂志,2014,30:68-70.
10 Zhang Q,Li A,Yue J,et al.Using functional magnetic resonance imaging to explore the possible mechanism of the action of acupuncture at Dazhong(KI 4)on the functional cerebral regions of healthy volunteers[J].Internal Medicine Journal,2015,45:669-671.
11 Lida T,Komiyama O,Obara R,et al.Repeated clenching causes plasticity in corticomotor control of jaw muscles[J].Eur J Oral Sci,2014,122:42-48.
12崔聪聪,刘伟才.口腔行为变化引起大脑皮层神经重塑的研究进展[J].口腔颌面外科杂志,2015,25:307-310.
13霍梦娟,张岳,刘波,等.针刺单穴和组穴的f MRI研究[J].放射学实践,2016,31:219-223.
14张文奎,刘艳平,孙志.针刺脾经不同腧穴对2型糖尿病模型小鼠血脂水平的影响[J].江苏中医药,2015,47:74-75.
15兰蕾,常小荣,严洁,等.针刺足阳明胃经特定穴治疗功能性消化不良30例[J].湖南中医药大学学报,2010,30:66-69.
16朱小棠,冯天骄,郑璐,等.针刺“醒神益智”组穴对脑静息态功能的影响[J].北京中医药大学学报,2011,34:181-184.
17刘力,李晓陵,王丰,等.针刺足少阳胆经经穴合穴激活脑区f M-RI研究[J].中医药学报,2014,42:74-77.
18刘丹,周福庆,游涛,等.原发性闭角型青光眼患者脑网络小世界属性的f MRI研究[J].临床放射学杂志,2018,37:556-561.
19邵辉丽,杜小霞.楔前叶/后扣带皮层在静息态功能网络中起关键节点作用的研究紧张[J].磁共振成像,2011,2:215-217.
20 Fang J,Jin Z,Wang Y,et al.The salient characteristics of the central effects of acupuncture needling:Limbic-paralimbic-neocortical network modulation[J].Human Brain Mapping,2009,30:1196-1206.
21毛薇,韩春玉,孙伟,等.人脑对视觉信息变化的处理过程的事件相关电位研究[J].中国心理卫生杂志,2009,23:832-838.
22陈加良,刘国清,陈俊,等.不同针刺镇痛疗法的静息态脑功能磁共振研究[J].中国老年学杂志,2014,34:2977-2979.
23 Leung A,Zhao Y,Shukla S.The effect of acupuncture needle combination on central pain processing-an f MRI study[J].Molecular Pain,2014,10:23.
24 Brooks J,Tracey I.From nociception to pain perception:imaging the spinal and supraspinal pathways[J].Journal of Anatomy,2010,207:19-33.
25 Yang J,Zeng F,Feng Y,et al.A PET-CT study on the specificity of acupoints through acupuncture treatment in migraine patients[J].BMC Complementary and Alternative Medicine,2012,12:123.
26 Yan B,Li K,Xu J,et al.Acupoint-specific f MRI patterns in human brain[J].Neuroscience Letters,2005,383:236-240.
27霍梦娟,张岳,刘波,等.针刺单穴和组穴的f MRI研究[J].放射学实践,2016,31:219-223.
28 Vaina LM,Solomon J,Chowdhury S,et al.Functional neuroanatomy of biological motion perception in humans[J].Proc Natl Acad Sci USA,2001,98:11656-11661.
29 da Silva RO,Cheniaux E,Mezzasalma MA.Volumetric reduction of cerebellum associated with cognitive,affective and behavioral changes[J].J Neuropsychiatry Clin Neurosci,2012,24:E21.
30 De Smet HJ,Paguier P,Verhoeven J,et al.The cerebellum:Its role in language and related cognitive and affective functions[J].Brain&Language,2013,127:334-342.
31 Kong J,Kaptchuk TJ,Polich G,et al.An f MRI study on the interaction and dissociation between expectation of pain relief and acupuncture treatment[J].Neuroimage,2009,47:1066-1076.
2余情,胡玲,李梦.原络配穴法的临床应用研究进展[J].中医药临床杂志,2017,29:963-965.
3郑振峰,石会兰.肾脏血氧水平依赖磁共振成像检测指标和测量方法进展[J].国际泌尿系统杂志,2016,36:306-309.
4 Li A,Li XL,Zhang F,et al.A functional magnetic resonance imaging study of the neuronal specificity of an acupoint:acupuncture at Rangu(KI 2)and its sham point[J].Internal Medicine Journal,2016,46:973-977.
5刘潇,李晓陵,李崖雪,等.运用原络配穴法治疗功能性消化不良临床疗效观察[J].针灸临床杂志,2017,33:56-58.
6马原,谷忠悦,白增华,等.《经络腧穴学》不同版本教材解读[J].光明中医,2016,31:1501-1502.
7赵志恒,付田昊,焦召华,等.“门”穴与脏腑经络的规律探析[J].四川中医,2015,33:15-17.
8兰蕾,吴凤,曾芳,等.国外针刺中枢效应机制的f MRI研究进展[J].中国针灸,2013,33:426-430.
9申伟,汤继芹,张永臣.《针灸大成》中申脉穴文献浅析[J].针灸临床杂志,2014,30:68-70.
10 Zhang Q,Li A,Yue J,et al.Using functional magnetic resonance imaging to explore the possible mechanism of the action of acupuncture at Dazhong(KI 4)on the functional cerebral regions of healthy volunteers[J].Internal Medicine Journal,2015,45:669-671.
11 Lida T,Komiyama O,Obara R,et al.Repeated clenching causes plasticity in corticomotor control of jaw muscles[J].Eur J Oral Sci,2014,122:42-48.
12崔聪聪,刘伟才.口腔行为变化引起大脑皮层神经重塑的研究进展[J].口腔颌面外科杂志,2015,25:307-310.
13霍梦娟,张岳,刘波,等.针刺单穴和组穴的f MRI研究[J].放射学实践,2016,31:219-223.
14张文奎,刘艳平,孙志.针刺脾经不同腧穴对2型糖尿病模型小鼠血脂水平的影响[J].江苏中医药,2015,47:74-75.
15兰蕾,常小荣,严洁,等.针刺足阳明胃经特定穴治疗功能性消化不良30例[J].湖南中医药大学学报,2010,30:66-69.
16朱小棠,冯天骄,郑璐,等.针刺“醒神益智”组穴对脑静息态功能的影响[J].北京中医药大学学报,2011,34:181-184.
17刘力,李晓陵,王丰,等.针刺足少阳胆经经穴合穴激活脑区f M-RI研究[J].中医药学报,2014,42:74-77.
18刘丹,周福庆,游涛,等.原发性闭角型青光眼患者脑网络小世界属性的f MRI研究[J].临床放射学杂志,2018,37:556-561.
19邵辉丽,杜小霞.楔前叶/后扣带皮层在静息态功能网络中起关键节点作用的研究紧张[J].磁共振成像,2011,2:215-217.
20 Fang J,Jin Z,Wang Y,et al.The salient characteristics of the central effects of acupuncture needling:Limbic-paralimbic-neocortical network modulation[J].Human Brain Mapping,2009,30:1196-1206.
21毛薇,韩春玉,孙伟,等.人脑对视觉信息变化的处理过程的事件相关电位研究[J].中国心理卫生杂志,2009,23:832-838.
22陈加良,刘国清,陈俊,等.不同针刺镇痛疗法的静息态脑功能磁共振研究[J].中国老年学杂志,2014,34:2977-2979.
23 Leung A,Zhao Y,Shukla S.The effect of acupuncture needle combination on central pain processing-an f MRI study[J].Molecular Pain,2014,10:23.
24 Brooks J,Tracey I.From nociception to pain perception:imaging the spinal and supraspinal pathways[J].Journal of Anatomy,2010,207:19-33.
25 Yang J,Zeng F,Feng Y,et al.A PET-CT study on the specificity of acupoints through acupuncture treatment in migraine patients[J].BMC Complementary and Alternative Medicine,2012,12:123.
26 Yan B,Li K,Xu J,et al.Acupoint-specific f MRI patterns in human brain[J].Neuroscience Letters,2005,383:236-240.
27霍梦娟,张岳,刘波,等.针刺单穴和组穴的f MRI研究[J].放射学实践,2016,31:219-223.
28 Vaina LM,Solomon J,Chowdhury S,et al.Functional neuroanatomy of biological motion perception in humans[J].Proc Natl Acad Sci USA,2001,98:11656-11661.
29 da Silva RO,Cheniaux E,Mezzasalma MA.Volumetric reduction of cerebellum associated with cognitive,affective and behavioral changes[J].J Neuropsychiatry Clin Neurosci,2012,24:E21.
30 De Smet HJ,Paguier P,Verhoeven J,et al.The cerebellum:Its role in language and related cognitive and affective functions[J].Brain&Language,2013,127:334-342.
31 Kong J,Kaptchuk TJ,Polich G,et al.An f MRI study on the interaction and dissociation between expectation of pain relief and acupuncture treatment[J].Neuroimage,2009,47:1066-1076.