针刺烦躁焦虑患者太冲穴即刻脑功能变化的fMRI研究

A fMRI study on brain function of acupuncture at Taichong acupoint on anxiety patients

目的:观察针刺太冲穴对烦躁焦虑患者脑功能的调节,为针刺太冲穴治疗中医“郁证”提供临床依据。方法:招募中医烦躁焦虑状态受试者24例,随机平均分成针刺组和对照组各12例,对照组接受一次静息态fMRI扫描,针刺组在针刺太冲穴后即刻行一次静息态fMRI扫描。结果:针刺太冲穴即刻针刺组双侧梭状回低频振荡振幅(ALFF)信号较对照组增高;左侧额中回、左侧额上回、右侧额中回ALFF信号较对照组减低。以ALFF信号增高的右侧梭状回为种子点行功能连接分析,发现左侧角回,后扣带回、楔前叶功能连接增强。以ALFF信号增高的左侧梭状回为种子点行功能连接分析,发现右侧颞上回、右侧颞中回、右侧额下回、后扣带回、右侧中央后回功能连接增强。以ALFF信号减低的左侧额中回、额上回为种子点,发现双侧海马、双侧海马旁回、双侧中央前回、双侧中央后回、后扣带回功能连接增强;右侧小脑半球功能连接减弱。以ALFF信号减低的右侧额中回为种子点,发现右侧岛叶功能连接增强;左侧小脑半球、双侧丘脑、右侧尾状核体部、左侧角回功能连接减弱。结论:针刺太冲穴对负责情绪的脑区产生了调制效应,为针刺太冲穴治疗烦躁焦虑的脑机制研究提供了一定依据。

Objective:To observe the regulation of acupuncture at Taichong acupoint on the brain function of irritability and anxiety,and to provide clinical evidence for acupuncture at Taichong acupoint to treat TCM‘stagnation syndrome’.Methods:24 TCM irritability and anxiety subjects were recruited.They were randomly divided into the acupuncture group and the control group,with 12 cases in each group.The control group received brain resting-state fMRI scan only once,the acupuncture group performed resting-state fMRI scan after acupuncture at Taichong acupoint immediately.Results:The amplitude of low-frequency fluctuation(ALFF)signal of both fusiform gyrus in the acupuncture group was higher than that in the control group,while the ALFF signal of left middle frontal gyrus,left superior frontal gyrus and right middle frontal gyrus in the acupuncture group was lower than that in the control group.Using the right fusiform gyrus as the seed point for the functional connectivity(FC)analysis,the enhanced FC was found in left angular gyrus,posterior cingulate gyrus and precuneus.Using the left fusiform gyrus as the seed point,the enhanced FC was found in right middle temporal gyrus,right inferior temporal gyrus,right inferior frontal gyrus,posterior cingulate gyrus,and right central posterior gyrus.Using the left middle frontal gyrus and superior gyrus as the seed point,the enhanced FC was found in bilateral hippocampus and parahippocampal gyrus,bilateral anterior and posterior central gyrus,posterior cingulate gyrus,while the weakened FC was found in right cerebellar hemisphere.Using the right middle frontal gyrus as the seed point,the enhanced FC was found in the right insula,while the weakened FC was found in left cerebellar hemisphere,bilateral thalamus,right caudate nucleus and left angular gyrus.Conclusions:Acupuncture at Taichong acupoint can activate the brain area responsible for emotions and achieve the purpose of improving irritability and anxiety.This may be the mechanism of acupuncture at Taichong acupoint to improve irritability and anxiety,and it also proves that acupuncture at Taichong acupoint is effective in improving the irritability and anxiety state.