磁刺激穴位干预的临床应用新进展

New progress in clinical application of magnetic stimulation acupoint intervention

在传统中医经穴理论治疗体系中,以针刺、灸法等作用于穴位的中医治疗疾病的方式,已被广为熟知和应用。磁刺激是一种新型刺激疗法,具有无痛、无创、操作简便、易重复、能进行深部刺激等优点,以前大多用于脑功能区或刺激外周的神经、肌肉,取得了较好的效果,是四大脑技术之一。近年来磁刺激技术也在逐步应用于穴位干预中,取得了一定的成效,为此,本文对近十年的国内外文献进行了综述。在睡眠障碍、脑疲劳状态、抑郁症、脑卒中后偏瘫、腰椎手术失败综合征、肌肉疲劳等疾病的临床治疗中,磁刺激穴位有一定的作用,能代替或部分代替常规治疗。但目前大多数研究的样本量偏小,多中心前瞻性的随机对照研究缺少,循证医学证据还不足,需要以后的更高质量的临床研究。在机制方面,大多数研究主要围绕在不同穴位、不同参数、不同状态下的磁刺激干预的大脑皮层变化来进行探讨,目前的主要手段大多聚焦于脑电诱发电位、脑网络,并探讨了如何优化磁刺激系统来达到更好地效果。研究者除了中医针灸专业之外,还有不少的工科研究人员,存在多学科的交叉。综述表明将现代磁刺激技术和传统经穴理论相结合,是磁刺激技术在医学领域的新开拓,对传统中医针灸学的临床应用起到了推动作用,也利于经穴治疗在全科医疗中的推广。

In the treatment system of traditional Chinese medicine meridian theory,acupuncture,moxibustion and other methods for acupoints have been widely known and applied.Magnetic stimulation is a new type of stimulation therapy,which owns various advantages,including painlessness,non-invasiveness,simple operation,easy repeatability and deep stimulation.It is mostly used and played a great role in the brain functional area or in stimulating peripheral nerves and muscles,considered as one of the four brain technologies.In recent years,magnetic stimulation technology has also been gradually applied and received certain achievement in acupoint intervention.To this end,we have done a literature review on domestic and foreign literatures during the past ten years.In the clinical treatment of sleep disorders,cerebral fatigue,depression,post-stroke hemiplegia,lumbar spinal surgery failure syndrome,muscle fatigue and some other diseases,magnetic stimulation acupoints have a certain role and can partially replace or even replace the conventional treatment.However,most of the current studies display a small sample size.Multi-center prospective randomized controlled studies and medical evidence are also insufficient.In this way,clinical studies with higher quality are greatly needed in the fu-ture.In terms of mechanism,most researches mainly focus on the changes of cerebral cortex of magnetic stimulation in-tervention in different acupoints,different parameters,and different states.At present,most of the main methods focus on EEG evoked potentials and brain networks,and then explores how to optimize the magnetic stimulation system to a-chieve better results.In addition to researchers from traditional Chinese medicine and acupuncture,researchers from en-gineering promote the multidisciplinary interdisciplinary in this area.This review shows that the combination of modern magnetic stimulation technology and traditional acupuncture theory is a new development of magnetic stimulation technolo-gy in the medical field,which has promoted the clinical application of traditional Chinese medicine and acupuncture and is also beneficial to the promotion of acupoints in general medical treatment.