针刺外关穴和假穴小脑激活的PET脑功能成像研究

目的观察针刺右侧外关穴后小脑局部葡萄糖代谢变化,研究针刺外关穴小脑的激活区域,探讨针刺穴位小脑的作用机制。方法将18例健康志愿者分为外关穴针刺组、外关穴假针刺组和假穴针刺组3组,每组6例,分别接受右侧外关穴针刺、右侧外关穴假针刺及外关穴旁开假穴点针刺干预,行正电子发射体层显像脑功能成像检查,所得图像采用SPM8软件包进行处理和分析。结果外关穴针刺组及假针刺组各1例因明显刺痛感或头部移动明显,其数据不作进一步统计。与外关穴假针刺组比较,针刺右侧外关穴激活的小脑脑区为左侧小脑前叶山顶及右侧小脑后叶下半月小叶。与假穴针刺组比较,针刺右侧外关穴激活的小脑脑区为右侧小脑后叶山坡、左侧小脑扁桃体、左侧小脑后叶下半月小叶、双侧小脑前叶山顶及双侧小脑后叶。结论针刺穴位特异激活了小脑部分区域。针刺外关穴的治疗作用可能是激活小脑前叶及后叶的结果。

Effects of acupuncture at Waiguan(SJ5) and sham acupoint on cerebellum activation: a positron-emission tomography study

Objective To investigate Waiguan(SJ5) acupuncture-induced cerebellum activation using positron-emission tomography(PET).Methods Eighteen healthy volunteers were divided into three groups(n=6),receiving verum acupuncture at Waiguan(Group A),non-penetrating(placebo) sham acupuncture at Waiguan(Group B) and verum acupuncture at the sham acupoint near the Waiguan acupoint(Group C),respectively.Results Compared with Group B,glucose metabolism was increased in the culmen of the left anterior lobe and the inferior semi-lunar lobule of the right posterior lobe of cerebellum.Compared with Group C,increased glycometabolism was observed in the declive of the right posterior lobe,the cerebellar tonsil of the left cerebellum,the inferior semi-lunar lobule of the left posterior lobe,the bilateral culmen of the anterior lobe,and bilateral posterior lobe of the cerebellum.Conclusion Stimulation of acupoints activates the specific region of the cerebellum.Acupuncture at SJ5 activates the anterior and posterior lobes of the cerebellum,which is helpful to demonstrate the mechanism of acupuncture.