静息态低频振幅对针刺足三里穴中枢作用机制初探

Central Modulating Mechanism of ST36(Zusanli)Acupuncturing on Amplitude of Low-frequency Fluctuation in Resting-state

目的观察分析针刺足三里穴引起静息态下脑区低频振幅(ALFF)的改变,以探讨其中枢作用机制。方法 15名健康青年志愿者,分别针刺双侧足三里经穴和非经穴,留针20min后拔针,并采集静息态功能磁共振数据,利用REST软件计算脑区的ALFF,然后用SPM5进行组内单样本t检验,分别得到针刺足三里经穴、非经穴脑区ALFF的变化图,最后比较经穴组与非经穴组ALFF变化脑区的差异。结果针刺足三里穴可引起较广泛大脑皮层(包括额、颞、顶、枕叶)及脑干、小脑等脑区ALFF增高,针刺足三里穴,ALFF增高的脑区范围及ALFF增高的幅度均较非经穴组明显。经穴组与非经穴组比较,右侧小脑后叶、梭状回、中央后回、中央前回、缘上回、顶下小叶、额中回的ALFF均增高,差异有统计学意义(P<0.05),左侧颞下极、颞上回、颞中回、钩回及双侧扣带回前部、右侧杏仁体、右侧眶下回ALFF减低,差异有统计学意义(P<0.05)。结论针刺足三里穴可引起多个功能脑区ALFF增高,其机制可能是通过相应的作用中枢及复杂的脑功能网络调节,对靶器官产生作用效应。

Objective To observe and analyze the changes in brain amplitude of low-frequency fluctuation（ALFF）in resting-state induced by ST36（Zusanli）point acupuncturing（Ac）,and to discuss its central modulating mechanism.Methods Fifteen healthy young volunteers received ST36 Ac and non-acupoints Ac respectively,the resting-state fMRI data were acquired before and 20 min after the withdrawal of AC.ALFF of encephalic regions were calculated using REST software,and one-sample t-test analysis was performed on the intragroup data acquired after Ac by statistical parametric mapping 5（SPM5）,to get the maps of ALFF changes induced by ST36 Ac and non-acupoints Ac respectively for analyzing the difference between them finally.Results ST36 Ac increased ALFF in widespread brain areas,including cerebral cortex（frontal,temporal,parietal and occipital lobe）,brainstem,cerebellum,etc.,with the amplitude and extent higher than those increased by non-acupoint Ac,showing statistical significance in ALEF of right cerebellar posterior lobe,fusiform gyrus,central posterior gyrus,central anterior gyrus,supramarginal gyrus,inferior parietal lobule,middle frontal gyrus（P0.05）.Meanwhile,ALFF in brain areas of left temporal pole,superior temporal gyrus,mid-temporal gyrus,uncus,bilateral forepart of callosal gyrus,right amygdala,right inferior gyri orbitales were decreased by Ac,also showeing significant difference between ST36 Ac and non-acupoint Ac（P0.05）.Conclusion ST36 Ac could induce ALFF changes in multiple functional regions of brain,and its mechanism is probably produced by modulating the respective functional center and complex network in brain to infuence the target organs.