基于fMRI的合谷穴功能特异性研究

目的：研究合谷穴功能的特异性为临床应用提供依据。方法：将健康志愿受试者扫描序列分为对照序列和针刺序列。对照序列采用合谷穴与非经穴贴皮电刺激,针刺序列采用针刺合谷穴与非经穴贴皮形成电刺激。针刺受试者左合谷穴或右合谷穴,通过Bold-fMRI观察针刺合谷穴在大脑皮层的激活区域。采集fMRI大脑扫描数据进行分析得出脑功能图像。结果：针刺左侧合谷可激活右侧额内侧回、右侧颞上回、右侧颞中回、右侧岛叶、左侧尾状核,双侧额下回;针刺右侧合谷可激活：左侧额内侧回、左侧颞中回、左侧额下回、右侧辅助运动区。结论：针刺合谷穴可激活大脑皮层语言运用中枢、面部反应区、听觉皮区,与合谷穴功能基本吻合。     

合谷穴针刺周围性面瘫患者脑功能成像初步分析

目的:通过周围性面瘫病人与正常健康志愿者的针刺前、针刺中以及针刺后fMRI的对照研究,探讨针刺合谷穴治疗周围性面瘫的神经生理机制.方法:研究对象分为2组,面瘫组35例,正常对照组24例.2组采用相同的磁共振扫描序列采集针刺前、中、后3个静息态和1个针刺任务态的功能数据.利用AFNI程序分析任务态的针刺脑激活区,以及静息态的PCC、SI(左侧和右侧)、MI(左侧和右侧)以及SⅡ(左侧和右侧)的功能联系区.对所有fMRI数据进行组内分析和组间分析,并用Monte Carlo方法对分析结果进行校正.结果:任务态组内分析显示2组均可见多个脑区激活;静息态组内分析显示针刺前、中、后2组的PCC、SI、MI和SⅡ都与其他脑区存在着广泛的功能联系;组间分析显示面瘫组针刺前左侧SI和右侧MI与运动前区的功能联系增强;针刺中2组之间的功能联系没有显著性差异;面瘫组针刺后双侧的SⅡ与视觉及听觉皮层的功能联系减弱.结论:1)面瘫病人感觉运动皮层之间的功能联系增强;2)2组之间的针刺即时效应存在少许差别,针刺后的差别更加明显;3)针刺合谷穴治疗周围性面瘫的可能机制是针刺作用通过强化感觉运动皮层之间的相互功能联系,促进脑功能重组,实现针刺治疗周围性面瘫的临床疗效.     

合谷穴与合谷配太冲针刺即时效应和后遗效应的脑功能网络连接差异

目的:利用功能磁共振成像(Functional Magnetic Resonance Imaging,fMRI)技术观察电针针刺正常人的合谷、合谷配太冲时的即时效应和取针后的后遗效应的脑功能网络响应差异.方法:将20例健康受试者随机分为合谷组和合谷配太冲组,每组10例.合谷组仅针刺合谷穴,合谷配太冲组则需在合谷、太冲穴同时针刺,皆得气后连上电针.采用fMRI收集针灸前、针灸中和针灸后的图像数据.脑功能连接分析的感兴趣区为面口运动区(Face Motor Area,faceMOT)、默认网络前部(Anterior Default Mode Network,aDMN)和后部(Posterior Default Mode Network,pDMN).结果:合谷组与合谷配太冲组比较,在faceMOT针刺时双侧颞上回、中央沟盖和右侧颞上极功能连接加强,右侧中央前、后回、左侧脑岛则降低(P<0.05);而取针后右侧岛盖部/三角部额下回、双侧楔前叶功能连接增强(P<0.05).在aDMN针刺时双侧楔前叶功能连接减弱(P<0.05);而取针后右侧颞下回、枕下回脑功能连接增强,右侧额下回则下降(P<0.05).在pDMN针刺时右侧舌回、楔前叶、距状回脑功能连接加强,双侧距状回、楔叶则降低(P<0.05);而取针后右侧舌回、距状回增强,双侧距状回、楔叶减弱(P<0.05).结论:合谷单穴和合谷配太冲穴在针刺时和取针后的脑功能网络响应具有差异,针刺时合谷比合谷配太冲更突出表现在听觉语言、视觉的脑区响应,而合谷配太冲更突出在面口区、运动、内脏功能和情感的脑区功能响应;取针后合谷的针刺后遗效应更多表现在情感、思维、运动语言、内脏相关脑区的响应,而合谷配太冲则表现在视觉的脑区的响应.     

"面口合谷收"研究进展

合谷穴是临床上最常用的穴位之一,对面口部疾病的治疗更有特效,古人总结为＂面口合谷收＂。科研工作者已对针刺合谷穴的作用机制进行了研究,兹从临床效应、解剖学基础、生物全息理论、红外热像、面神经诱发电位波幅、脑功能成像技术6个方面综述如下。     

针刺即时效应对急性脑梗死患者脑功能成像的影响

【目的】探讨针刺治疗急性脑梗死的作用机理。【方法】应用fMRI脑功能成像评价针刺内关穴的即时效应,对急性脑梗死患者及健康人相关脑功能区兴奋性的影响,对15例急性脑基底节区梗死患者和15例健康志愿者,针刺双侧内关穴,分别于针刺前、后行静息态fMRI脑功能成像扫描,获取两组被试静息态的fMRI数据,通过后处理软件得到脑梗死患者和健康对照组不同脑区的脑功能激活图像。【结果】患者针刺后,在右侧枕叶和左侧顶叶存在正激活,而左侧运动区有负激活。健康人针刺后,在双侧顶叶和枕叶出现正激活,在双侧额叶出现负激活。【结论】针刺内关穴对脑梗死患者和正常人的脑功能活动激活区域表现存在差异,提示针刺内关穴对机体病理与生理状态下fMRI脑功能成像影响不同。     

针刺对脑功能影响的影像学研究回顾

正笔者整理1996年以来国内发表的基于脑功能性磁共振的针刺效应文献,分析并探讨针刺效应在脑功能研究领域的进展。1针刺脑功能效应研究的现状国内最早的针刺功能磁共振成像(fMRI)文献是李定忠等[1]2000年发表于《中国针灸》杂志的经穴皮部挑治与深刺的对比研究     

经皮神经电刺激合谷穴与功能性磁共振成像的相关性研究

目的:观察经皮神经电刺激合谷穴的功能性磁共振成像(fMRI)表现,为揭示针灸效应中枢机制提供可视性数据.方法:对8名健康右利手年轻被试者进行左手合谷穴经皮神经电刺激,同时进行全脑fMRI,对脑内活动区域进行定位.结果:经皮神经电刺激合谷穴激活的脑功能区主要以对侧为主的双侧枕叶视觉皮层(BA19),前扣带回、海马回、对侧...     

用fMRI技术探讨针刺百会穴对脑功能的影响

[目的]观察针刺百会穴对人脑不同区域BOLD信号的影响;探讨针刺百会穴脑功能成像的实验方法。[方法]选取6例正常人,针刺百会穴的同时用1·5T磁共振仪扫描脑部,所得图像数据经AFNI软件相关系数法分析处理。[结果](1)6例正常人左右侧颞上回,右侧中央前回、中央后回、缘上回、颞中回、背侧丘脑、尾状核激活(r>0·8)。(2)信号升高区域r值范围为(0·7,0·98),其各体素信号-时间曲线大多呈“”样改变。[结论]针刺百会穴调节脑功能的作用可能与针刺百会穴时不同脑区的信号改变有关;fMRI是一种可行的研究针刺作用机理的方法。     

针刺得气对健康受试者脑功能反应影响的研究

[目的] 探索针刺得气对受试者脑功能的影响，为客观表征针刺得气提供实验依据。[方法] 对30例健康受试者的手三里穴分别施行得气与不得气针刺操作，以视觉模拟评分（VAS）量表评价受试者主观得气感，并运用功能性近红外光谱（fNIRS）技术全程采集受试者脑功能信号，比较针刺得气与不得气时受试者的脑激活和脑连接情况；分析主观得气感与脑功能激活的相关性。[结果] 针刺得气激活了双侧额叶岛盖部、背外侧前额叶皮质区、左侧三角部及右侧额极区，使同侧顶叶和颞叶、左侧颞叶与右侧顶叶之间的脑功能连接增强；受试者得气感与脑功能反应具有相关性。[结论] 针刺得气可激活受试者双侧额叶，增强不同脑区间的功能连接性，受试者脑功能反应可能有助于客观表征针刺得气。     

基于功能磁共振的针刺机制初步研究——从问题到方法

当前基于功能磁共振(functional MRI,fMRI)的针刺机制研究面临诸多基本问题,例如由于针刺持续性效应所带来的对研究方法的重新审视、围绕针刺特异性问题探讨控制组的选取原则,以及针刺作用过程中存在着大量混淆的因素,已成为其主要问题。针对这些问题,本文创新性地提出基于静息态种子点相关的脑网络分析方法和Reblocking方法,通过对控制组更严格的实验设计,较好地验证了针刺穴位的特异性以及针刺持续性效应对静息态脑网络的调节作用。     

Differences in thermal effects of moxibustion at Zusanli(ST 36) and Hegu(LI 4) on various facial areas in healthy people

OBJECTIVE:To study the effects of temperature on different facial areas by suspended moxibustion at two points,Zusanli(ST 36) and Hegu(LI 4),and probe the phenomena underlying self-regulation in the human body after thermal stimulation.METHODS:Thirty healthy volunteers accepted moxibustion over Zusanli(ST 36) and Hegu(LI 4),and the order of moxibustion points was randomly determined.Moxibustion method:suspension of moxibustion over Zusanli(ST 36) and Hegu(LI 4) on both sides was performed using an ignited moxa stick stuck in a support for 20 min.Observation method:An infrared thermal image of the face was taken before and after suspended moxibustion using a CK350 medical infrared thermal imaging instrument.Data analysis:A thermal microscopic section view system(TMTSys) was used to analyze the change in temperature in special facial areas.Statistical analysis was carried out using SPSS 14.0 software.RESULTS:Before moxibustion was suspended,the facial thermal image showed a T-shaped thermal area related to the vascular distribution with even temperature and good symmetry on both sides.Suspended moxibustion over Zusanli(ST 36) have a very significant increase in temperature at the forehead,around the nose,at the corners of the mouth,and at the cheeks and lips(P<0.01).Suspended moxibustion over Hegu(LI 4) also have a significant(P<0.05) increase in temperature around the nose,the corners of the mouth,the cheeks,and lips,where has a new high temperature area was formed(P<0.01).Suspended moxibustion over Hegu(LI 4) raised the temperature at the middle point of the lips more obviously than did Zusanli(ST 36) in the same person,(P<0.05).After 10 min of moxibustion over Zusanli(ST 36) and Hegu(LI 4),the change in temperature in the facial area reached its peak value.CONCLUSIONS:Facial infrared thermography of healthy people revealed a T-shaped thermal area reflecting a physiological thermal area.Moxibustion over Zusanli(ST 36) or Hegu(LI 4) raised the temperature in this facial T-shaped thermal area.Hegu(LI 4) led to the formation of a new thermal area in the lips.The time required for moxibustion to regulate human body temperature was 10 min.     

The Safety of Electroacupuncture at Hegu （LI 4） plus Oxytocin for Hastening Uterine Contraction of Puerperants --A Randomized Controlled Clinical Observation

Objective:To investigate the safety of electroacupuncture plus oxytocin for uterine contraction of puerperants.Methods:276 puerperants with difficult labor were randomly divided into a medication group.treated with intravenous dripping of oxytocin,and an acupuncture plus medication group,in the medication group,intravenous dripping of oxytocin was given,and in the other group,acupuncture at bilateral Hegu(LI 4)was added.Heart rate,respiratory frequency,blood pressure of puerperants,fetal heart rate and birth process were observed.Results:During laboring,the indices observed,including heart rate,respiratory frequency,blood pressure,fetal heart rate and birth process.were allin normal range in all of the 276 cases,with better effects in acupuncture plus medication Group M.Conelusions:Electroacupuncture at bilateral Hegu(LI 4)plus intravenous dripping of oxytocin can intensify the uterine contraction,shorten the birth process to avoid probable systemic exhaustion due to excessive consumption,and with no side effects on life signs of the pueroerants and newborns.Conclusions:Electroacupuncture at bilateral Hegu(LI 4) plus intravenous dripping of oxytocin can intensify the uterine contraction, shorten the birth process to avoid probable systemic exhaustion due to excessive consumption, and with no side effects on life signs of the puerperants and newborns.     

针刺督脉治疗缺血性中风的理论研究

督脉具有统率、督促的作用,能总督诸阳。督脉在针灸临床治疗缺血性中风中发挥着重要的作用,其研究经历了漫长的发展历程。针刺督脉治疗缺血性中风具有深厚的理论基础和良好的效果,值得进一步研究应用。     

针刺刺激可达到前气功状态

目的：研究在短时间之内使普通人进入前气功状态的方法。方法：健康的试验参与者以不随机的方式纳入本次研究。使用多通道生理记录仪检测试验参与者是否有进入前气功状态。参与者在针刺合谷穴的时候获得酸（得气）的感觉,同时暗示参与者丹田处有热及放松的感觉,由此让参与者进入一个松、静、自然的前气功状态。结果：本研究中,72.2%没有习练气功经历的参与者成功进入前气功状态。参与者进入气功状态后,大部分生理指标与基线指标相比有显著差异。结论：使用针刺引起酸的感觉可以让试验参与者快速进入前气功状态。因此气功的研究不再限制在特定的人才可以实行,本研究方法可以应用到每个人身上。     

针刺鼻三针加枕骨下项线痛点治疗过敏性鼻炎

目的 观察针刺鼻三针加枕骨下项线痛点治疗过敏性鼻炎急性发作期的治疗效果.方法 收集我院针灸科门诊42例过敏性鼻炎急性发作期患者作为观察组,采用针刺鼻三针加枕骨下项线痛点治疗;选取同样例数作为对照组,只针刺鼻三针穴.观察、比较2组治疗的总体有效率.结果 观察组总有效率92.9%,对照组69.0%,2组比较差异有统计学意义(P<0.05).结论 针刺鼻三针加枕骨下项线痛点治疗过敏性鼻炎急性发作期,疗效比单纯针刺鼻三针更有效.     

针刺督脉对脑缺血再灌注大鼠脑组织核转录因子κB表达的影响

目的研究针刺督脉经穴对局灶性脑缺血大鼠脑组织核转录因子κB（NF-κB）蛋白表达的影响。方法将雄性SD大鼠随机分为假手术组、模型组、针刺对照组和针刺督脉组共四组,线栓法制作大脑中动脉栓塞（MCAO）模型。利用免疫组化法检测针刺后NF-κB蛋白表达的变化;以激光共聚焦扫描显微镜检测NF-κB转录活性。结果大鼠MCAO后NF-κB转录和蛋白表达增加,针刺督脉组MCAO 24 h和72 h NF-κB蛋白表达减少,在MCAO 24 hNF-κB转录活性减弱。结论针刺督脉经穴可能通过抑制MCAO急性期NF-κB蛋白的过度表达,减少细胞凋亡,减轻炎症反应,改善脑缺血再灌注损伤。     

Effects of Electroacupuncture at Different Acupoints on Changes of Uterine Myoelectricity Induced by Oxytocin and Progesterone in Pregnant Rats

Objective: To observe the effects of electroacupuncture (EA) at different acupoints on abnormal changes of uterine myoelectric activities in pregnant rats so as to analyze the specificity of regulative effects of the acupoint. Methods: Forty-eight pregnant (18-20 days) Wistar rats were randomly divided into control group (n=10), "Sanyinjiao" (SP 6) group (n=9), "Neiguan" (PC 6) group (n=10), "Hegu" (LI 4) group (n=8), and "Sanyinjiao plus Hegu" group (n=11). These rats were anesthetized by intraperitoneal injection of a mixture solution of 1.5% chloralose (50mg/kg) and 25% urethane (420mg/kg). Electrohysterogram (EHG) was recorded by using a pair of stainless steel electrodes inserted into the subserous layer of the left mid part of the uterus. The reference electrode was placed in the adjoining subcutaneous tissue of the incision. Oxytocin and progesterone were given to the local uterus nearby the recording electrode to induce excitement and suppression of myoelectric activities of the uterus respectively. EA (2mA, 5/15Hz) was carried out at the above-mentioned acupoints separately for 20min, and the influence of EA on changes (amplitude and frequency) of fast waves and slow waves of the uterine myoelectric activity was analyzed. Results: As compared with control group, EA at SP6 plus LI4 and at SP6 alone had a significantly inhibitory effect on oxytocin-induced increase in the frequency and amplitude of both fast and slow waves (P<0.05); and EA at LI4 had a markedly inhibitory effect on the amplitude of fast waves (P<0.05). EA at PC6 had no any marked effect on both frequency and amplitude of fast and slow waves of EHG (P>0.05). Compared with control group, EA at SP6 plus LI4 and at SP6 alone could relieve or significantly relieve progesterone-induced suppression of the frequency and amplitude of both fast and slow waves (P<0.05); and the effects of EA at SP6 plus LI4 appeared earlier and lasted longer than those of EA at SP6; while EA at LI4 and PC6 had no obvious effect on progesterone-induced changes of the frequency and amplitude of both fast and slow waves (P>0.05). Conclusion: EA at SP6 plus LI4 and at SP6 alone has a dual-directional regulative effect on abnormal EHG, the effect of EA at SP6 plus LI4 is the strongest, EA at SP6 the secondary, EA at LI4 the weakest, and EA at PC6 shows no effect. In short, EA at different acupoints have their own relative specificity in regulating abnormal uterine myoelectric activities.     

影响针刺治疗腰椎间盘突出症疗效的相关因素

目的 :观察针刺治疗腰椎间盘突出症的疗效及年龄、病程、病理分型、辨证分型、经络分型与疗效的关系。方法 :采用针刺郄穴为主治疗腰椎间盘突出症 ,与常规针刺法相对照 ,同时两组都配合穴位注射当归注射液。电针用疏密波 ,每天 1次 ,10次为 1疗程 ,连续观察 2个疗程。结果 :治疗组的总有效率明显高于对照组 (P <0 .0 1) ;中医辨证分型、经络分型对疗效没有明显影响 ,而年龄、病程、病理分型则对疗效有明显影响。年龄较大、病程较长、髓核脱出者治疗效果较差。结论 :影响针刺治疗腰椎间盘突出症疗效的因素有年龄、病程、病理分型。应根据年龄、病程、病理分型不同采用相宜的治疗以提高疗效     

五脏俞透刺治疗慢性疲劳综合征的临床观察

目的观察五脏俞透刺治疗慢性疲劳综合征的疗效。方法将120例临床确诊慢性疲劳综合征的患者,随机分为五脏俞透刺组（60例）和常规针刺对照组（60例）,用相应方法针刺治疗30 d。结果采用五脏俞透刺组治疗后,患者疲劳症状积分明显减少,总有效率达95.00%,对照组总有效率为86.67%,明显好于常规针刺对照组,（P〈0.05）。结论五脏俞透刺是治疗慢性疲劳综合征的有效方法,有较好的临床疗效。