针刺太冲及其临近穴脑反应区功能磁共振成像比较

Comparison of central effects of acupuncturing Taichong and nearby two acupoints by functional MRI

目的利用功能磁共振(fMRI)观察针刺相邻穴位的大脑中枢反应,探讨穴位的相对特异性。方法用盲法随机分别针刺10例正常人左侧太冲、行间、内庭和邻近非经络假穴点,手针采用捻针和不捻针两种状态对比,利用1.9TMRI行全脑功能成像,用SPM99处理图像。结果发现在4穴上针刺时均产生了脑灰质结构的不同激活和抑制效应,太冲和行间激活和抑制区更相似,但太冲穴信号强度更强,内庭穴也可见较多的激活和抑制区,但与太冲穴相差较大,对照非经络假穴偶见激活灶,与太冲穴差异最大;各穴大脑抑制区也各有特点,但对照穴抑制区最为分散,并见双侧中央前回等皮层的抑制,各穴均见大脑边缘叶系统部分抑制。结论不同穴位针刺时可能对脑皮层神经活动有较相对特异的作用。同经络相似神经支配的不同穴位脑中枢效应最相似,不同经络相邻近神经节段支配区的经穴有明显差异,而相邻近神经节段的对照穴大脑反应区与各穴位差异最大。

Objective To compare the cerebral activation patterns following acupuncture between different acupoints using fMRI. Methods Ten healthy subjects were investigated the cortical activation patterns during stimulation of three real （LIV2, LIV3 and ST44） and one sham acupoints, they were punctured in a randomized and for the subjects blinded order employing rotating and non rotating methods using a blocked paradigm on a 1.9 T scanner. The functional data were analyzed by using SPM 99. Results Both of fMRI signal increasing and signal decreasing areas were found in all four acupoints. However, they were in differential patterns, namely on LIV2 and LIV3 they were similar, but the density of signal increasing on LIV3 was the highest; following by LIV2, and then ST44; on ST44 were more different patterns from LIV3; on the sham point the increasing areas were sparsely and the areas of signal decreasing were the more dispersed, including motor area, SⅡ. On all four acupoints, the decreasing signal can be found in the limbic system. Conclusion Acupuncture seems to result in relative specific cerebral activation patterns according to the neural innervations of acupoints and different meridians.