功能性磁共振探查光明、太冲穴与大脑功能的关系(英文)

Relationship between cerebral function and Kuangming and Taichong acupoints detected with functional MRI

摘要背景:随着功能磁共振成像(fMRI)的引入,其无损伤性的研究手段,为古老针刺方法的研究带来了新的前景,人们从大脑的不同功能着手,尝试着用fMRI来解开经络穴位与大脑的相关性。目的:通过fMRI观察针刺光明、太冲穴位时,大脑不同区域的相关反应。设计:以医学院的健康自愿参加实验的学生为研究对象,随机对照的验证性研究。单位:一所中医药大学医院的针灸科,一所中医药大学的基础医学院及德国弗莱堡大学医学院放射医疗中心。对象:实验于1997-06在德国弗莱堡大学医学院放射医疗中心进行,健康志愿者19例,皆为医学院学生。男4例,女15例。受试者均自愿参加,无针刺经历,无神经及精神病史。按随机对照原则分为视觉刺激加针刺单侧组7例,男2例,女5例。视觉刺激加针刺双侧组6例,男1例,女5例。单纯针刺双侧组6例,男1例,女5例。方法:用fMRI对不同条件的各组学生在针刺光明、太冲穴时,视觉皮质区与相关脑区的反映以及是否诱导其功能进行了观察。针刺用无菌无磁性的不锈钢针(直径为0.25mm,长约30mm,华佗牌,苏州医疗器械公司生产),每穴操作完后,询问其得气情况。针刺的所有例数统一由有多年工作经验的针灸医师完成。主要观察指标:大脑皮质的血氧饱和水平(BOLD)的变化,幅度,响应延迟,时间波动。

BACKGROUND:The functional MRI(fMRI),a harmless research method,has brought new perspective to the understanding of ancient needling methods.The correlation between meridian points and cerebrum has been studied with fMRI in different cerebral regions.OBJECTIVE:To observe the correlation between Kuangming(Luo- Connection Point,GB37) and Taichong(Shu- Stream and Yuan- Source point,Liv3) with fMRI in different cerebral regions.DESIGN:Randomized controlled experimental study based on healthy volunteers of medical college.SETTING:Department of acupuncture in a medical university of traditional Chinese medicine,basic medical college in a medical university of traditional Chinese medicine,medical radiology center of medical college of University Freiburg in Germany.PARTICIPANTS:This study was conducted in Medical Radiology Center of Medical College of University Freiburg in Germany in June 1997.In this study,altogether 19 healthy volunteers,4 males and 15 females with normal vision,were selected.All of them were medical students without any previous acupuncture experience and history of neurology and psychosis.All healthy volunteers were randomly divided into three groups,including visual stimulation+ one- sided needling group(n=7,2 males and 5 females),visual stimulation+ double- sided needling group(n=6,1 male and 5 females) and only double- sided needling group(n=6,1 male and 5 females).METHODS:The response of visual cortex and the relative areas, and whether there comes inducing function were observed by fMRI during puncturing at kuangming and taichong.All subjects were informed about the range of possible acupuncture sensation they might experience during needle manipulation before entering the magnet field. For acupuncture,a stainless immagnet acupuncture needle(with a diameter of 0.25 mm and a length of 30 mm.Huatuo Brand. Made in Suzhou Medical Inc.) was used.All subjects were performed by one experienced acupuncturist. MAIN OUTCOME MEASURES:The changes, extent, delayed response, and time fluctuation of the cerebral cortex hemoglobin saturation level(BOLD). Whether the cerebral visual cortex domain was activated or not.RESULTS:There were no change of BOLD in visual cortex during visual stimulation and inserting needle at Kuangming and Taichong in visual stimulation+ single sided needling group and visual stimulation+ double- sided needling group.There were changes of BOLD of visual cortex in all subjects of the three groups during the period of manipulating needle.Among them six cases were found to have in the insular lobe,temporo- inferior parietal lobule, superior colliculus lobe,cuneate lobe and occipital mid- gyri.CONCLUSION:Single- sided or double- sided continuous needle stimulation can change the BOLD of the related regions of the cerebrum,but the change is unrelated with the insertion method and visual stimulation.