fMRI探讨针刺足三里穴和下巨虚穴的大脑功能区分布

目的采用磁共振脑功能成像(fMRI)技术与针刺经络穴位相结合的方法来观察足阳明胃经上的足三里穴、下巨虚穴在大脑皮层功能区的分布位置。方法 64名健康志愿者,分为实验组和对照组,均按先后顺序针刺右侧足三里穴、上巨虚穴。使实验组处于得气状态,对照组处于不得气状态。针刺同时进行fMRI扫描。t检验分析得出刺激状态与静息状态信号对比的脑功能图像。结果 得气状态下fMRI图像显示两穴位的脑功能活动区定位无明显差别(P>0.05),主要位于双侧扣带回、岛叶、大脑外侧沟上壁及中央后回等部位。不得气状态下,fMRI图像显示两穴位的脑功能活动区定位亦无明显差别(P>0.05),主要位于左侧中央后回。同一穴位在得气和不得气两种状态下,脑功能活动区定位差别明显(P<0.01)。结论 针刺足三里、下巨虚两穴位治疗胃肠疾病有其科学基础;经络与中枢神经系统密切相关,针刺效应可能通过经络-大脑皮层-内脏这一途径完成。

Investigation of cerebral cortical functional areas of the acupoints in zu-san-li and xia-ju-xu by fMRI

Objective To study the functional areas of Zusanli(ST36) and Xiajuxu(ST39) in the cerebral cortex with fMRI and acupuncture stimulation. Material and Methods 64 healthy Volunteers were divided into two groups. Acupuncture stimulation was induced to both of them by manipulating acupuncture needle at the acupuncture point at right ST36 and then ST39 respectively. FMRI was performed in the experimental group during state of the reaction to the acupuncture ("De-Qi") and in the control group during state of no reaction. Func-tional responses were investigated by students group t-test analysis. Results Chi - square test showed that there was no significant difference (P> 0. 05) in ROI in state of "De-Qi" and in state of no reaction. In state of "De-Qi" , acupuncture mainly resulted in activating bilateral cingulate cortex, insula, upper wall of lateral sulcus and bilateral postcentral gyrus. However, in state of no reaction, acupuncture mainly resulted in activating left postcentral gyrus. Significant difference of between ROI in state of "De-Qi" and no reaction (P<0. 01) at each acupoint was shown. Conclusion Treatment of gastroenteric disease by acupuncturing ST36 and ST39 has its scientific basis. There are close relations between the central nerural system (CNS) and the acupoints. It may be that the acupuncture stimulates the corresponding functional areas in cerebral cortex via the CNS at first, thereby treating disorders of organs.