胃俞募配穴针刺对胃扩张状态下受试者静息态脑功能磁共振成像低频振幅的影响
|
摘要
目的:观察胃俞募配穴与胃俞、中脘单穴针刺对胃扩张受试者大脑自发神经活动低频振荡振幅(ALFF)的影响,探讨胃俞募配穴针刺的脑内中枢整合机制。方法:17名健康受试者在不同的时间先后纳入胃俞组、中脘组和胃俞配伍中脘组,在水负荷胃扩张状态下分别接受针刺,针刺前后进行静息态脑功能磁共振成像扫描和胃电图检测,分析比较各组针刺前后和各组间ALFF与胃运动变化情况,并将针刺前后ALFF和胃运动的变化进行相关性分析。结果:与针刺前比较,3组针刺后胃电图振幅均显著降低(P<0.01),胃俞配伍中脘组低于胃俞组及中脘组(P<0.05);与针刺前比较,3组针刺后引起了不同的大脑自发神经活动ALFF值变化,俞募配穴相比单穴针刺引起了更多更广泛的脑区发生改变;与单穴针刺比较,胃俞募配穴均引起了后扣带回、丘脑、楔前叶、舌回ALFF值出现差异变化。相关性分析可见,胃俞配伍组脑岛、梭状回、海马旁回ALFF值变化与胃运动振幅变化呈正相关,额内侧回ALFF值变化与胃运动振幅变化呈负相关。结论:胃俞募配穴针刺相比胃俞、中脘单穴针刺可引起更广泛的脑区ALFF值发生改变;后扣带回、丘脑、楔前叶、舌回可能是胃俞募配穴针刺脑内整合机制的重要脑区;脑岛、梭状回、海马旁回和额内侧回参与了胃俞募配穴针刺对胃运动的调节。
Objective: To observe the effects of acupuncturing Weishu(BL21) and Zhongwan(CV12) and acupuncturing Weishu(BL21) or Zhongwan(CV12) single acupoint on amplitude of low-frequency fluctuation(ALFF) of spontaneous neural activity in the gastric distention subjects' brain, and to explore the integration mechanism of intracerebral central by acupuncturing Weishu(BL21) and Zhongwan(CV12). Methods: Seventeen healthy subjects were included in the Weishu(BL21) group, the Zhongwan(CV12) group, the Weishu(BL21) and Zhongwan(CV12) group. They were respectively acupunctured in the state of water-load gastric distention. All subjects were examined by brain resting-state functional magnetic resonance imaging(rs-f MRI) and electrogastrogram before and after acupuncture. The changes of ALFF and gastric motility in different groups were compared and analyzed before and after acupuncture, and the changes were made a correlation analysis. Results: The amplitudes of electrogastrogram in the three groups were all obviously decreased after acupuncture than that before acupuncture(P<0.01). There were significant difference in the amplitude changes of electrogastrogram in the Weishu(BL21) and Zhongwan(CV12) group, compared with the Weishu(BL21) group and the Zhongwan(CV12) group(P<0.05). The three groups' ALFF of spontaneous neural activity in the brian had different changes after acupuncture than that of before acupuncture. Acupuncturing Weishu(BL21) and Zhongwan(CV12) caused more extensive changes in the brain region than that of single acupoint acupuncture. Compared with acupuncturing the single acupoint, the ALFF value of the posterior cingulate cortex, thalamus, precuneus and lingual gyrus changed significantly than acupuncturing Weishu(BL21) and Zhongwan(CV12). Correlation analysis showed that, the ALFF changes of insula, fusiform gyrus, parahippocampal gyrus were positively correlated with the change of gastric movement amplitude, while the ALFF change in the medial frontal gyrus was negative correlated with the change of gastric movement amplitude. Conclusion: Acupuncturing Weishu(CV12) and Zhongwan(BL21) could affect more ALFF change in extensive brain regions compared with acupuncturing single Weishu(CV12) or Zhongwan(BL21), and posterior cingulate gyrus, thalamus, precuneus, and lingual gyrus may be the key brain regions for intracerebral integration mechanism by acupuncturing Weishu(CV12) and Zhongwan(BL21). The insula, fusiform gyrus, parahippocampal gyrus and medial frontal gyrus are closely related to regulating the gastric movement by acupuncturing Weishu(CV12) and Zhongwan(BL21).
Objective: To observe the effects of acupuncturing Weishu(BL21) and Zhongwan(CV12) and acupuncturing Weishu(BL21) or Zhongwan(CV12) single acupoint on amplitude of low-frequency fluctuation(ALFF) of spontaneous neural activity in the gastric distention subjects' brain, and to explore the integration mechanism of intracerebral central by acupuncturing Weishu(BL21) and Zhongwan(CV12). Methods: Seventeen healthy subjects were included in the Weishu(BL21) group, the Zhongwan(CV12) group, the Weishu(BL21) and Zhongwan(CV12) group. They were respectively acupunctured in the state of water-load gastric distention. All subjects were examined by brain resting-state functional magnetic resonance imaging(rs-f MRI) and electrogastrogram before and after acupuncture. The changes of ALFF and gastric motility in different groups were compared and analyzed before and after acupuncture, and the changes were made a correlation analysis. Results: The amplitudes of electrogastrogram in the three groups were all obviously decreased after acupuncture than that before acupuncture(P<0.01). There were significant difference in the amplitude changes of electrogastrogram in the Weishu(BL21) and Zhongwan(CV12) group, compared with the Weishu(BL21) group and the Zhongwan(CV12) group(P<0.05). The three groups' ALFF of spontaneous neural activity in the brian had different changes after acupuncture than that of before acupuncture. Acupuncturing Weishu(BL21) and Zhongwan(CV12) caused more extensive changes in the brain region than that of single acupoint acupuncture. Compared with acupuncturing the single acupoint, the ALFF value of the posterior cingulate cortex, thalamus, precuneus and lingual gyrus changed significantly than acupuncturing Weishu(BL21) and Zhongwan(CV12). Correlation analysis showed that, the ALFF changes of insula, fusiform gyrus, parahippocampal gyrus were positively correlated with the change of gastric movement amplitude, while the ALFF change in the medial frontal gyrus was negative correlated with the change of gastric movement amplitude. Conclusion: Acupuncturing Weishu(CV12) and Zhongwan(BL21) could affect more ALFF change in extensive brain regions compared with acupuncturing single Weishu(CV12) or Zhongwan(BL21), and posterior cingulate gyrus, thalamus, precuneus, and lingual gyrus may be the key brain regions for intracerebral integration mechanism by acupuncturing Weishu(CV12) and Zhongwan(BL21). The insula, fusiform gyrus, parahippocampal gyrus and medial frontal gyrus are closely related to regulating the gastric movement by acupuncturing Weishu(CV12) and Zhongwan(BL21).
引文
[1]Scheffold B E,Hsieh C L,Litscher G.Neuroimaging and Neuromonitoring Effects of Electro and Manual Acupuncture on the Central Nervous System:A Literature Review and Analysis.Evidence-Based Complementary and Alternative Medicine,2015,2015(2):641742
[2]Han J S.Acupuncture analgesia:areas of consensus and controversy.Pain,2011,152(3):S41-S48
[3]Napadow V,Kettner N,Liu J,et al.Hypothalamus and amygdala response to acupuncture stimuli in carpal tunnel syndrome.Pain,2007,130(3):254-266
[4]Ying Li,Hui Zheng,Fang Zeng,et al.Use acupuncture to treat functional constipation:study protocol for a randomized controlled trial.Trials,2012,13(3):104
[5]Wang H,Shen G M,Liu W J,et al.The neural mechanism by which the dorsal vagal complex mediates the regulation of the gastric motility by Weishu(RN12)and Zhongwan(BL21)Stimulation.Evid Based Complement Alternat Med,2013,2013(5):291764
[6]Wang H,Liu W J,Shen G M,et al.Neural mechanism of gastric motility regulation by electroacupuncture at RN12 and BL21:A paraventricular hypothalamic nucleus-dorsal vagal complexvagus nerve-gastric channel pathway.World J Gastroenterol,2015,21(48):13480-13489
[7]万坚,朱莉,周慧,等.功能性消化不良患者水负荷试验时大脑感知作用的f MRI研究.胃肠病学,2011,16(12):721-725
[8]蔡荣林,申国明,王浩.俞募配穴的理论基础及协同效应机制探讨与思考.中华中医药杂志,2016,31(5):1555-1558
[9]Zang Y F,He Y,Zhu C Z,et al.Altered baseline brain activity in children with ADHD revealed by resting state funtional MRI.Brain Dev,2007,29(2):83-91
[10]陈媛.胃俞募配穴治疗功能性消化不良的边缘系统整合机制研究.成都:成都中医药大学,2012:45-58
[11]Fang J L,Wang X L,Liu H S,et al.The Limbic-Prefrontal Network Modulated by Electroacupuncture at CV4 and CV12.Evid Based Complement Alternat Med,2012:515893
[12]李政杰,曾芳,杨洁,等.不同机体状态对针刺效应影响相关研究的评述.针刺研究,2013,38(5):428-431
[13]杨聃琳,李晓陵,王丰,等.不同功能状态下针刺脑功能成像的研究进展.中医药信息,2015,32(1):122-125
[14]高立明,姚树坤,张瑞星,等.健康青年近端胃功能与胃电活动检测.解放军医学杂志,2008,33(2):146-148
[15]Crone J S,Schurz M,H?ller Y,et al.Impaired consciousness is linked to changes in effective connectivity of the posterior cingulate cortex within the default mode network.Neuro Image,2015,110:101-109
[16]Nierhaus T,Pach D,Huang W,et al.Differential cerebral response to somatosensory stimulation of an acupuncture point vs.two nonacupuncture points measured with EEG and f MRI.Front Hum Neurosci,2015,9:74
[17]张岳,霍梦娟,刘波,等.基于局部一致性方法探讨电针针刺单、组穴对健康志愿者默认网络的影响.中国中西医结合影像学杂志,2017,15(1):1-4
[18]Morgan V L,Rogers B P,Abou-Khalil B.Segmentation of the thalamus based on BOLD frequencies affected in temporal lobe epilepsy.Epilepsia,2015,56(11):1819-1827
[19]Feng Y,Bai L,Ren Y,et al.Investigation of the large-scale functional brain networks modulated by acupuncture.Magnetic Resonance Imaging,2011,29(7):958-965
[20]李政杰,曾芳,杨玥,等.功能性消化不良患者针刺治疗后对针刺足三里脑的响应.世界华人消化杂志,2013,21(19):1882-1887
[21]周思远.针刺天枢穴双向调节肠道功能的中枢响应机制研究.成都:成都中医药大学,2014
[2]Han J S.Acupuncture analgesia:areas of consensus and controversy.Pain,2011,152(3):S41-S48
[3]Napadow V,Kettner N,Liu J,et al.Hypothalamus and amygdala response to acupuncture stimuli in carpal tunnel syndrome.Pain,2007,130(3):254-266
[4]Ying Li,Hui Zheng,Fang Zeng,et al.Use acupuncture to treat functional constipation:study protocol for a randomized controlled trial.Trials,2012,13(3):104
[5]Wang H,Shen G M,Liu W J,et al.The neural mechanism by which the dorsal vagal complex mediates the regulation of the gastric motility by Weishu(RN12)and Zhongwan(BL21)Stimulation.Evid Based Complement Alternat Med,2013,2013(5):291764
[6]Wang H,Liu W J,Shen G M,et al.Neural mechanism of gastric motility regulation by electroacupuncture at RN12 and BL21:A paraventricular hypothalamic nucleus-dorsal vagal complexvagus nerve-gastric channel pathway.World J Gastroenterol,2015,21(48):13480-13489
[7]万坚,朱莉,周慧,等.功能性消化不良患者水负荷试验时大脑感知作用的f MRI研究.胃肠病学,2011,16(12):721-725
[8]蔡荣林,申国明,王浩.俞募配穴的理论基础及协同效应机制探讨与思考.中华中医药杂志,2016,31(5):1555-1558
[9]Zang Y F,He Y,Zhu C Z,et al.Altered baseline brain activity in children with ADHD revealed by resting state funtional MRI.Brain Dev,2007,29(2):83-91
[10]陈媛.胃俞募配穴治疗功能性消化不良的边缘系统整合机制研究.成都:成都中医药大学,2012:45-58
[11]Fang J L,Wang X L,Liu H S,et al.The Limbic-Prefrontal Network Modulated by Electroacupuncture at CV4 and CV12.Evid Based Complement Alternat Med,2012:515893
[12]李政杰,曾芳,杨洁,等.不同机体状态对针刺效应影响相关研究的评述.针刺研究,2013,38(5):428-431
[13]杨聃琳,李晓陵,王丰,等.不同功能状态下针刺脑功能成像的研究进展.中医药信息,2015,32(1):122-125
[14]高立明,姚树坤,张瑞星,等.健康青年近端胃功能与胃电活动检测.解放军医学杂志,2008,33(2):146-148
[15]Crone J S,Schurz M,H?ller Y,et al.Impaired consciousness is linked to changes in effective connectivity of the posterior cingulate cortex within the default mode network.Neuro Image,2015,110:101-109
[16]Nierhaus T,Pach D,Huang W,et al.Differential cerebral response to somatosensory stimulation of an acupuncture point vs.two nonacupuncture points measured with EEG and f MRI.Front Hum Neurosci,2015,9:74
[17]张岳,霍梦娟,刘波,等.基于局部一致性方法探讨电针针刺单、组穴对健康志愿者默认网络的影响.中国中西医结合影像学杂志,2017,15(1):1-4
[18]Morgan V L,Rogers B P,Abou-Khalil B.Segmentation of the thalamus based on BOLD frequencies affected in temporal lobe epilepsy.Epilepsia,2015,56(11):1819-1827
[19]Feng Y,Bai L,Ren Y,et al.Investigation of the large-scale functional brain networks modulated by acupuncture.Magnetic Resonance Imaging,2011,29(7):958-965
[20]李政杰,曾芳,杨玥,等.功能性消化不良患者针刺治疗后对针刺足三里脑的响应.世界华人消化杂志,2013,21(19):1882-1887
[21]周思远.针刺天枢穴双向调节肠道功能的中枢响应机制研究.成都:成都中医药大学,2014