“足缓难行刺冲阳”脑效应机制功能磁共振成像研究
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摘要
目的通过针刺正常健康志愿者右侧冲阳穴,观察脑内的激活区和抑制区,从而探讨"足缓难行刺冲阳"的脑效应机制。材料与方法应用3.0 T磁共振扫描采集16名健康志愿者针刺右侧冲阳穴数据,并进行数据处理与统计分析。结果针刺冲阳穴引起的正激活脑区为:左侧小脑前叶、小脑后叶、额叶中央前回、颞上回(BA42)、颞横回(BA41)、颞中回、顶叶中央后回、外核、豆状核、外侧苍白球;右侧小脑后叶、额叶中央前回(BA6)、额中回(BA10)、额下回、颞横回、颞中回、顶叶中央后回(BA3)、顶下小叶、扣带回(BA24)、脑岛、丘脑;负激活脑区:左侧枕上回、后扣带回(BA30)、楔前叶、颞中回;右侧海马、外核。结论针刺冲阳穴产生的针刺效应与大脑中枢关系密切,针刺信息可以直接影响"疼痛矩阵"而减轻疼痛,可能与正激活丘脑影响疼痛信息的传导,和负激活边缘系统抑制主观感受的情绪反应有关。
Objective: To observe the activation and inhibitory areas in the brain by acupuncture normal healthy volunteers, and to explore the brain effect mechanism of "acupuncture at Chongyang point for the treatment of walking slowly and difficulty". Materials and Methods: Using the 3.0 T MR scan, 16 healthy volunteers were collected and the data were processed and statistically analyzed. Materials and Methods: Using the 3.0 T MR scan, 16 healthy volunteers were collected and the data were processed and statistically analyzed. Results: Acupuncture at Chongyang point positive activation area: the left cerebellum anterior lobe, cerebellum posterior lobe, center prefrontal gyrus of frontal lobes, superior temporal gyrus(BA42), temporal transverse back(BA41), middle temporal gyrus, parietal lobe, outer core, lentiform nucleus, the lateral pallidum, the right cerebellum posterior lobe, forehead prefrontal(BA6), middle frontal gyrus(BA10), inferior frontal gyrus, gyri temporales transversi, gyri temporalis mediium, posterior central gyrus of parietal lobe(BA3), inferior parietal lobule, cingulate gyrus(BA24), insula, thalamus. Negative activation area: the left occipital, posterior cingulate(BA30), precuneus, temporal gyrus, the right hippocampus, outer core. Conclusions: Acupuncture Chongyang closely associated with brain center of acupuncture effect, acupuncture information can directly affect the "pain matrix" reduce analgesic effect, pass though the effect of positive activation of thalamus on the conduction of pain information, and negative activated limbic system restrain subjective feelings of emotional response to alleviate the pain.
Objective: To observe the activation and inhibitory areas in the brain by acupuncture normal healthy volunteers, and to explore the brain effect mechanism of "acupuncture at Chongyang point for the treatment of walking slowly and difficulty". Materials and Methods: Using the 3.0 T MR scan, 16 healthy volunteers were collected and the data were processed and statistically analyzed. Materials and Methods: Using the 3.0 T MR scan, 16 healthy volunteers were collected and the data were processed and statistically analyzed. Results: Acupuncture at Chongyang point positive activation area: the left cerebellum anterior lobe, cerebellum posterior lobe, center prefrontal gyrus of frontal lobes, superior temporal gyrus(BA42), temporal transverse back(BA41), middle temporal gyrus, parietal lobe, outer core, lentiform nucleus, the lateral pallidum, the right cerebellum posterior lobe, forehead prefrontal(BA6), middle frontal gyrus(BA10), inferior frontal gyrus, gyri temporales transversi, gyri temporalis mediium, posterior central gyrus of parietal lobe(BA3), inferior parietal lobule, cingulate gyrus(BA24), insula, thalamus. Negative activation area: the left occipital, posterior cingulate(BA30), precuneus, temporal gyrus, the right hippocampus, outer core. Conclusions: Acupuncture Chongyang closely associated with brain center of acupuncture effect, acupuncture information can directly affect the "pain matrix" reduce analgesic effect, pass though the effect of positive activation of thalamus on the conduction of pain information, and negative activated limbic system restrain subjective feelings of emotional response to alleviate the pain.
引文
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[15]Liu J,Qin W,Guo Q,et al.Divergent neural processes specific to the acute and sustaines phases of verum and sham acupuncture.J Magn Reson Imaging,2011,33(1):33-40.
[16]Vaina LM,Solomon J,Chowdhury S,et al.Functional neuroanatomy of biological motion perception in humans.Proc Natl Acad Sci U S A,2001,98(20):11656-11661.
[17]Xu ZY,Li A,Li XL,et al.A fMRI study of cerebral regions activiated by acupuncture of Dazhong acupoint.Chin J Magn Reson Imaging,2014,5(5):332-335徐佐宇,李昂,李晓陵,等.针刺大钟穴激活脑区的功能MRI研究.磁共振成像,2014,5(5):332-335.
[18]Hui KK,Liu J,Marina O,et al.The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI.Neuroimage,2005,27(3):479-496.
[2]Ma TT,Pei P,Yu YC,et al.A new interpretation of the theory of acupoint compatibility.Beijing traditional Chin Med,2016,35(3):244-246.马婷婷,裴培,遆逸辰,等.腧穴配伍理论新解.北京中医药,2016,35(3):244-246.
[3]Duan G,Liu H,Pang Y,et al.Hippocampal fractional amplitude of low-frequency fluctuation and functional connectivity changes in premenstrual syndrome.J Magn Reson Imaging,2018,47(2):545-553.
[4]Liu L,Li XL,Wang F,et al.Research prospect of acupuncture mechanism based on fMRI technique.Information Traditional Chin Med,2014,31(1):80-83.刘力,李晓陵,王丰,等.基于fMRI技术对针刺作用机制的研究展望.中医药信息,2014,31(1):80-83.
[5]Zhang F,Li XL,Wu D,et al.MRI study of acupuncture in Dazhong and Taixi in brain activation area.Chin J Magn Reson Imaging,2016,7(7):481-485.张帆,李晓陵,吴迪,等.针刺大钟、太溪组穴脑激活区功能MRI研究.磁共振成像,2016,7(7):481-485.
[6]Yu GQ,Qiao LD,Sun ST.Professor Sun Shentian's Clinical record of Acupuncture in the treatment of pain Syndrome.Jilin Traditional Chin Med,2010,30(7):563-564.于国强,乔立达,孙申田.孙申田教授针灸治疗痛证临床纪实.吉林中医药,2010,30(7):563-564.
[7]Yu GQ,Dai R,Yang JQ,et al.Professor Sun Shentian's treatment of nape dorsal fasciopathy with transmeridian needling.Jilin Traditional Chin Med,2017,37(6):621-623.于国强,代蕊,杨静秋,等.孙申田教授循经透刺法治疗项背筋膜病.吉林中医药,2017,37(6):621-623.
[8]Liu JP,Xu CS,Zhang W,et al.Research status of magnetic resonance brain functional imaging in acupuncture analgesia mechanism.Chin JIntegrated Traditional Chin Westn Med Imageol,2014,12(2):201-204.刘军平,徐春生,张威,等.针刺镇痛机制的磁共振脑功能成像研究现状.中国中西医结合影像学杂志,2014,12(2):201-204.
[9]Chen J,Ge M,Liu B,et al.A resting brain functional imaging study of gender differences in chronic pain.Chin J Pain Med,2013,19(12):714-718.陈俊,葛缅,刘波,等.慢性疼痛性别差异的静息态脑功能成像研究.中国疼痛医学杂志,2013,19(12):714-718.
[10]Tracey I,Johns E.The pain matrix:reloaded or reborn as we image tonic pain using arterial spin labelling.Pain,2010,148(3):359-360.
[11]Li G,Huang L,Cheung RT,et al.Cortical activations upon stimulation of the sensorimotor-implicated acupoints.Magn Reson Imaging,2004,22(5):639-644.
[12]Huo MJ,Zhang Y,Liu B,et al.FMRI study on Acupuncture of single Acupoint and Group Acupoint.Radiol Pract,2016,31(3):219-223.霍梦娟,张岳,刘波,等.针刺单穴和组穴的fMRI研究.放射学实践,2016,31(3):219-223.
[13]Jiang CC,Li YG.Advances in brain functional MRI studies of pain.Chin J Magn Reson Imaging,2015,11(6):876-880.蒋诚诚,李勇刚.疼痛的脑功能MRI研究进展.磁共振成像,2015,11(6):876-880.
[14]Hui KK,Marina O,Claunch JD,et al.Acupuncture mobilizes the brain's default modeand its anti-correlated network in healthy subjects.Brain Res,2009,1287:84-103.
[15]Liu J,Qin W,Guo Q,et al.Divergent neural processes specific to the acute and sustaines phases of verum and sham acupuncture.J Magn Reson Imaging,2011,33(1):33-40.
[16]Vaina LM,Solomon J,Chowdhury S,et al.Functional neuroanatomy of biological motion perception in humans.Proc Natl Acad Sci U S A,2001,98(20):11656-11661.
[17]Xu ZY,Li A,Li XL,et al.A fMRI study of cerebral regions activiated by acupuncture of Dazhong acupoint.Chin J Magn Reson Imaging,2014,5(5):332-335徐佐宇,李昂,李晓陵,等.针刺大钟穴激活脑区的功能MRI研究.磁共振成像,2014,5(5):332-335.
[18]Hui KK,Liu J,Marina O,et al.The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI.Neuroimage,2005,27(3):479-496.