静息态功能磁共振技术在针灸脑科学领域中的应用研究进展
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摘要
针灸以其独特的魅力和优势,愈来愈受到国内外的认可,针灸脑科学研究也必将成为医学研究领域的热点内容。静息态功能磁共振技术凭借其操作简单、更符合针灸治疗效能等优势,在针灸脑效应研究中有着广阔的应用前景。现就国内外文献分析静息态功能磁共振技术在针灸脑效应研究中的优势,并从生理状态及病理状态两方面对其应用现状进行总结,同时针对样本量设置、数据分析方法选择、对照组设置及图像采集时机等当前针灸脑效应研究中易出现的问题进行探讨。在今后的研究设计中,应当注意综合应用各种手段进行多模态分析,建立多中心针灸脑科学数据共享平台,以全面揭示针灸中枢响应机制。
Acupuncture,with its unique charm and superiority,is increasingly recognized at home and abroad. The study of acupuncture brain effect will also become a hot topic in the field of medical research in the future. With the advantages of simple operation,many analysis methods and more in line with the efficacy of acupuncture,resting state functional magnetic resonance imaging( rs-f MRI) has a broad application prospect in the study of acupuncture brain effect. In this study,the advantages and application of rs-f MRI in the study of acupuncture brain effect were analyzed and summarized. It also discussed the sample size,analysis methods,the design of control groups,data collecting time and other current problems in the research and design. In the future research,multi-modal analysis and multi-center data sharing platform should be applied to comprehensively reveal the mechanism of the central response of acupuncture.
Acupuncture,with its unique charm and superiority,is increasingly recognized at home and abroad. The study of acupuncture brain effect will also become a hot topic in the field of medical research in the future. With the advantages of simple operation,many analysis methods and more in line with the efficacy of acupuncture,resting state functional magnetic resonance imaging( rs-f MRI) has a broad application prospect in the study of acupuncture brain effect. In this study,the advantages and application of rs-f MRI in the study of acupuncture brain effect were analyzed and summarized. It also discussed the sample size,analysis methods,the design of control groups,data collecting time and other current problems in the research and design. In the future research,multi-modal analysis and multi-center data sharing platform should be applied to comprehensively reveal the mechanism of the central response of acupuncture.
引文
[1]杨宇洋,沈志祥,吴中朝,等.针灸学科“一带一路”发展的战略规划[J].中国针灸,2017,37(4):343-348.
[2]许晓跃,王水,陆儒,等.基于体素的静息态f MRI观察原发性失眠患者针刺治疗后全脑度中心度的改变[J].中山大学学报(医学科学版),2017,38(2):296-300.
[3]陈鑫,刘波.针刺与脑功能成像[J].中国中西医结合影像学杂志,2012,10(3):287-288.
[4] Kim SG,Richter W,U∨gurbil K. Limitations of temporal resolution in functional MRI[J]. Magnetic Resonance in Medicine Official Journal of the Society of Magnetic Resonance in Medicine,1997,37(4):631-636.
[5]孙传铸,白丽君,牛璇,等.基于脑功能影像技术的针刺机制研究探讨[J].中国中西医结合影像学杂志,2015,13(4):355-357.
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[7]田捷,秦伟,艾琳,等.基于功能磁共振的针刺机制初步研究——从问题到方法[J].首都医科大学学报,2007,28(6):683-687.
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[10]胡妮娟,林驰,李静,等.得气与针刺疗效关系的思考[J].中国针灸,2014,34(4):413-416.
[11]张贵锋,曾统军,廖伟雄,等.基于静息态f MRI观察脑默认模式网络相关脑区对内关配外关针刺得气的响应[J].中国卫生标准管理,2016,7(3):129-131.
[12]李腊梅,李学智,吕发金,等.静息态脑功能MRI观察不同敏感度体质人群的针刺镇痛效应[J].第三军医大学学报,2013,35(6):547-552.
[13]付彩红.针刺阳陵泉对中风偏瘫静息脑网络响应特征的多元Granger因果分析研究[D].北京:北京中医药大学,2016.
[14] Li Z,Zeng F,Yin T,et al. Acupuncture modulates the abnormal brainstem activity in migraine without aura patients[J]. Neuroimage:clinical,2017,15:367-375.
[15] Zheng W,Su Z,Liu X,et al. Modulation of functional activity and connectivity by acupuncture in patients with Alzheimer disease as measured by resting-state f MRI[J]. Plos One,2018,13(5):1-14.
[16]胡幼平,陈勇,邢琳,等.精神和行为障碍疾病针灸病谱研究[J].中国针灸,2011,31(10):937-940.
[17]郑成强,谭凌霄,周天秀,等.电针对创伤后应激障碍患者静息态脑功能连接网络的影响[J].中国针灸,2015,35(5):469-473.
[18] Yi Y,Xu FM,Xie HW. Correlation between the Liver Meridian and the Frontal Lobe in Depression by Needling at Taichong(LV3):A Resting-state f MRI Study[J]. Chinese Journal of Integrated Traditional&Western Medicine,2011,31(8):1044-1050.
[19]曾芳,李政杰,刘奇,等.针刺脑功能成像研究思路与展望[J].辽宁中医杂志,2013,40(2):373-375.
[20]李静.调神健脾针法治疗腹泻型肠易激综合征的临床疗效评价及脑f MRI改变的研究[D].南京:南京中医药大学,2017.
[21] Zhang S,Wang X,Yan CQ,et al. Different mechanisms of contralateral-or ipsilateral-acupuncture to modulate the brain activity in patients with unilateral chronic shoulder pain:a pilot f MRI study[J]. J Pain Res,2018,11:505-514.
[22]宋云娥,徐放明,唐成林,等.原发性痛经患者关元穴艾灸前后的静息态功能磁共振研究[J].重庆医科大学学报,2012,37(9):753-758.
[23]田瑶.针刺阳陵泉穴对中风偏瘫患者运动相关脑网络影响的研究[D].北京:北京中医药大学,2015.
[24]肖林,王娴默.利用静息态功能磁共振对腰三针治疗腰椎间盘突出症的机制研究[J].长江大学学报(自科版),2017,14(8):1-3.
[25] Desmond JE,Glover GH. Estimating sample size in functional MRI(f MRI)neuroimaging studies:Statistical power analyses[J]. Journal of Neuroscience Methods,2002,118(2):115-128.
[26] Beissner F. Functional magnetic resonance imaging studies of acupuncture mechanisms:a critique[J]. Focus on Alternative&Complementary Therapies,2015,16(1):3-11.
[27] Mayer EA,Aziz Q,Coen S,et al. Brain imaging approaches to the study of functional GI disorders:A Rome Working Team Report[J]. Neurogastroenterology&Motility,2009,21(6):579-596.
[28]徐春生,李传富,杨骏,等.样本量大小对针刺脑功能成像激活区定位的影响[J].中国中西医结合影像学杂志,2011,9(4):289-292.
[29]中国针灸学会.针灸临床研究管理规范[M].北京:中国中医药出版社,2014.
[30] Wang YJ,Zheng Y,Zhang GF,et al. Activation of different cerebral functional regions following acupuncture at both Taixiand Taichong acupoints and Taixiacupoint alone:An FMRI study[J]. African Journal of Traditional Complementary&Alternative Medicines,2015,12(5):118-126.
[2]许晓跃,王水,陆儒,等.基于体素的静息态f MRI观察原发性失眠患者针刺治疗后全脑度中心度的改变[J].中山大学学报(医学科学版),2017,38(2):296-300.
[3]陈鑫,刘波.针刺与脑功能成像[J].中国中西医结合影像学杂志,2012,10(3):287-288.
[4] Kim SG,Richter W,U∨gurbil K. Limitations of temporal resolution in functional MRI[J]. Magnetic Resonance in Medicine Official Journal of the Society of Magnetic Resonance in Medicine,1997,37(4):631-636.
[5]孙传铸,白丽君,牛璇,等.基于脑功能影像技术的针刺机制研究探讨[J].中国中西医结合影像学杂志,2015,13(4):355-357.
[6] Zhang Y,Qin W,Liu P,et al. An f MRI study of acupuncture using independent component analysis[J]. Neuroscience Letters,2009,449(1):6-9.
[7]田捷,秦伟,艾琳,等.基于功能磁共振的针刺机制初步研究——从问题到方法[J].首都医科大学学报,2007,28(6):683-687.
[8]钟治平,刘波,吴珊珊,等.足三里穴中枢神经网络作用机制的静息态脑功能磁共振成像研究[J].新中医,2014,46(4):174-177.
[9] Liu L,Chen S,Zeng D,et al. Cerebral activation effects of acupuncture at Yanglinquan(GB34)point acquired using resting-state f MRI[J].Computerized Medical Imaging&Graphics the Official Journal of the Computerized Medical Imaging Society,2018,67(17):55.
[10]胡妮娟,林驰,李静,等.得气与针刺疗效关系的思考[J].中国针灸,2014,34(4):413-416.
[11]张贵锋,曾统军,廖伟雄,等.基于静息态f MRI观察脑默认模式网络相关脑区对内关配外关针刺得气的响应[J].中国卫生标准管理,2016,7(3):129-131.
[12]李腊梅,李学智,吕发金,等.静息态脑功能MRI观察不同敏感度体质人群的针刺镇痛效应[J].第三军医大学学报,2013,35(6):547-552.
[13]付彩红.针刺阳陵泉对中风偏瘫静息脑网络响应特征的多元Granger因果分析研究[D].北京:北京中医药大学,2016.
[14] Li Z,Zeng F,Yin T,et al. Acupuncture modulates the abnormal brainstem activity in migraine without aura patients[J]. Neuroimage:clinical,2017,15:367-375.
[15] Zheng W,Su Z,Liu X,et al. Modulation of functional activity and connectivity by acupuncture in patients with Alzheimer disease as measured by resting-state f MRI[J]. Plos One,2018,13(5):1-14.
[16]胡幼平,陈勇,邢琳,等.精神和行为障碍疾病针灸病谱研究[J].中国针灸,2011,31(10):937-940.
[17]郑成强,谭凌霄,周天秀,等.电针对创伤后应激障碍患者静息态脑功能连接网络的影响[J].中国针灸,2015,35(5):469-473.
[18] Yi Y,Xu FM,Xie HW. Correlation between the Liver Meridian and the Frontal Lobe in Depression by Needling at Taichong(LV3):A Resting-state f MRI Study[J]. Chinese Journal of Integrated Traditional&Western Medicine,2011,31(8):1044-1050.
[19]曾芳,李政杰,刘奇,等.针刺脑功能成像研究思路与展望[J].辽宁中医杂志,2013,40(2):373-375.
[20]李静.调神健脾针法治疗腹泻型肠易激综合征的临床疗效评价及脑f MRI改变的研究[D].南京:南京中医药大学,2017.
[21] Zhang S,Wang X,Yan CQ,et al. Different mechanisms of contralateral-or ipsilateral-acupuncture to modulate the brain activity in patients with unilateral chronic shoulder pain:a pilot f MRI study[J]. J Pain Res,2018,11:505-514.
[22]宋云娥,徐放明,唐成林,等.原发性痛经患者关元穴艾灸前后的静息态功能磁共振研究[J].重庆医科大学学报,2012,37(9):753-758.
[23]田瑶.针刺阳陵泉穴对中风偏瘫患者运动相关脑网络影响的研究[D].北京:北京中医药大学,2015.
[24]肖林,王娴默.利用静息态功能磁共振对腰三针治疗腰椎间盘突出症的机制研究[J].长江大学学报(自科版),2017,14(8):1-3.
[25] Desmond JE,Glover GH. Estimating sample size in functional MRI(f MRI)neuroimaging studies:Statistical power analyses[J]. Journal of Neuroscience Methods,2002,118(2):115-128.
[26] Beissner F. Functional magnetic resonance imaging studies of acupuncture mechanisms:a critique[J]. Focus on Alternative&Complementary Therapies,2015,16(1):3-11.
[27] Mayer EA,Aziz Q,Coen S,et al. Brain imaging approaches to the study of functional GI disorders:A Rome Working Team Report[J]. Neurogastroenterology&Motility,2009,21(6):579-596.
[28]徐春生,李传富,杨骏,等.样本量大小对针刺脑功能成像激活区定位的影响[J].中国中西医结合影像学杂志,2011,9(4):289-292.
[29]中国针灸学会.针灸临床研究管理规范[M].北京:中国中医药出版社,2014.
[30] Wang YJ,Zheng Y,Zhang GF,et al. Activation of different cerebral functional regions following acupuncture at both Taixiand Taichong acupoints and Taixiacupoint alone:An FMRI study[J]. African Journal of Traditional Complementary&Alternative Medicines,2015,12(5):118-126.