针刺外关及外关配伍阳陵泉穴脑部功能性磁共振成像.doc

针刺外关及外关配伍阳陵泉穴脑部功能性磁共振成像 　 作者：黄泳, 李天乐, 赖新生, 邹燕齐, 吴俊贤, 唐纯志, 杨君军 【摘要】 目的：基于穴位配伍效应脑相关假说，观察针刺青年健康志愿者右侧外关穴和外关配伍阳陵泉穴对不同脑区激活效应的功能性磁共振成像(functional magnetic resonance imaging, fMRI)。方法：16名健康志愿者，随机分为外关穴组和外关配伍阳陵泉穴组，每组8名，分别针刺右侧外关和外关配伍阳陵泉穴。运用GE 1.5T超导核磁共振系统完成脑部fMRI扫描，所得数据采用感兴趣区（region of interest, ROI）法进行处理和分析。结果：ROI激活几率表明，针刺外关和外关配伍阳陵泉穴均可相对集中（激活几率gt;4）激活双侧额叶和双侧顶叶等脑部功能区，但针刺外关和外关配伍阳陵泉穴对左右各脑区激活几率比较，差异无统计学意义。ROI激活点数表明，针刺外关穴能相对集中（激活点点数gt;10）激活双侧额叶和双侧顶叶等脑部功能区，且针刺外关穴能相对特异地激活右侧小脑（Plt;0.05），而针刺外关配伍阳陵泉穴则相对特异地激活左侧顶叶、左侧枕叶和双侧基底节区（Plt;0.05）。ROI激活强度表明，针刺外关配伍阳陵泉穴对于右侧小脑的激活强度较单纯针刺外关穴高，差异有统计学意义（Plt;0.05）。结论：fMRI脑功能成像研究表明，手足少阳经同名经穴配伍能够加强对运动障碍、感觉障碍、平衡障碍的治疗作用，穴位配伍的作用机制与脑功能区活动有关。 【关键词】 外关; 阳陵泉; 磁共振成像; 随机对照试验 Objective: To observe the cerebral activating effects of needling at Waiguan (SJ5) versus SJ5 plus Yanglingquan (GB34) points in young healthy volunteers based on the hypothesis of “needling effect of combined acupuncture points relates to the brain activation”. Methods: Sixteen healthy volunteers were randomly divided into SJ5 group and SJ5 plus GB34 group, and there were 8 volunteers in each group. The volunteers in the two groups received needling at corresponding points on the right hand or foot respectively. Nuclear magnetic resonance (1.5T, GE Corporation) was used for functional magnetic resonance imaging (fMRI) of the brain before and during the needling, and the obtained experimental data in the regional brain were processed and analyzed by the method of region of interest (ROI). Results: The ROI activation induced by needling of SJ5 or SJ5 plus GB34 was all relatively concentrated (activation rate more than 4 or activation point more than 10) on bilateral frontal and parietal lobes. There were no significant differences in ROI activation rates of brain regions between the two groups. ROI activation points showed that needling at SJ5 could activate the right cerebellum specifically (Plt;0.05, vs SJ5 plus GB34), while needling at SJ5 plus GB34 could activate the left parietal and occi