梁丘穴联合足三里穴电针刺激时的fMRI研究

Functional MRI study of electro-acupuncture Liangqiu(ST34) combined with Zusanli(ST36)

目的:利用f MRI观察足阳明胃经上的梁丘穴联合足三里穴电针刺激时大脑的活动规律。方法:选取25例体型中等、右利手的健康成年人,其中男13例,女12例;年龄22～50岁,选取受试者右侧梁丘穴联合右侧足三里穴进行电针刺激,同时行f MRI。结果:梁丘穴联合足三里穴电针刺激时,所有受试者均产生酸、麻、胀、钝痛、重和热的复杂针感,且强度不一。f MRI表现为以激活或负激活峰值为中心的不规则簇状区,且多个相近的激活或负激活脑功能区相连成片。其中脑功能激活区的峰值位于:(1)左侧尾状核体部和右侧豆状核;(2)左侧颞下回(BA20)、左侧海马旁回及左侧尾状核尾;(3)右侧海马旁回、右侧海马、右侧海马旁回(杏仁核包含在其中);(4)左侧海马旁回(BA30)、左侧后扣带回(BA29、30);(5)右侧中央前回(BA6)、右侧角回(BA39)。而脑功能负激活区的峰值位于:(1)小脑右半球前叶、小脑左半球前叶蚓部;(2)左侧颞上回(BA22)、左侧屏状核、左丘脑;(3)右侧中央后回(BA2)、右侧顶下小叶(BA40)、右侧中央前回(BA44);(4)左侧顶下小叶(BA40);(5)左侧中央前回(BA5、BA6);(6)右侧颞下回(BA37)。结论:梁丘穴联合足三里穴进行电针刺激时,激活脑区和负激活脑区较单独针刺足三里穴时明显集中、激活或负激活程度明显增高;大部分活动脑区与足三里穴单独针刺时相同;部分活动脑区与足三里穴单独针刺时不同。

Objective:Using functional MRI(fMRI)technology to observe the activity of the brain during Liangqiu(ST34)and Zusanli(ST36)on the stomach meridian of Foot Yangming stimulated by electro-acupuncture(EA).Methods:25 healthy adults were selected(ages 22~50 years old)with moderate body size and right-handedness,including 13 males and 12 females.To select the right ST34 and ST36 with EA,fMRI was scanned at the same time as acupuncture.Results:When ST34 combined with ST36 were EA,all subjects produced a complex feel of acid,flax,distention,heavy and dull pain,with varying intensity.FMRI showed irregular clusters centered on the peak of positive or negative activation areas,and the adjacent areas were connected to each other.The positive activated clusters were observed in:①body of the left caudate nucleus and the right lentiform nucleus,②the left inferior temporal gyrus(BA20),the left parahippocampal gyrus and tail of the left caudate nucleus,③the right parahippocampal gyrus and the right hippocampus,④the left posterior cingulate gyrus(BA29,30),the left parahippocampal gyrus(BA30),⑤the right precentral gyrus(BA6)and the right angular gyrus(BA39).The negative activated clusters were observed in:①the right cerebellar anterior lobe,the vermis of left cerebellar anterior lobe,②the left superior temporal lobe(BA22),the left claustrum and the left thalamus,③the right postcentral gyrus(BA2),the right parietal lobe inferior parietal lobule(BA40),the right precentral gyrus(BA44),④the left lobe inferior parietal lobule(BA40),⑤the left precentral gyrus(BA5,BA6),⑥the right inferior temporal gyrus(BA37).Conclusions:ST34 combined with ST36 to stimulate the EA,the excitatory brain regions and inhibitory brain regions were significantly more concentrated than those of ST34 or ST36 alone,and the degree of activation or deactivation increased significantly.Most active brain regions are the same as ST36 alone,some active brain regions are different from ST36 alone.