用功能磁共振成像探讨经穴和大脑皮层的关系

目的:利用功能磁共振成像研究针刺人体穴位时引起大脑皮层神经兴奋的现象,探讨经穴、经络和大脑皮层的联系。方法:分别针刺足少阳胆经的穴位光明6例、阳陵泉6例和足阳明胃经穴位伏兔6例、足三里6例,均为健康人。用功能磁共振技术观察针刺时大脑的功能状态。结果:针刺足少阳胆经光明穴和阳陵泉穴,对侧枕叶视皮层均有明显兴奋,其中5例受试者(光明穴3例、阳陵泉穴2例)双侧枕叶视皮层都有明显的兴奋区;针刺后枕叶视皮层的平均BOLD信号强度增加的水平为(3.31±1.2)%。针刺足阳明胃经的足三里穴和伏兔穴可以引起下丘脑、海马回、额回的神经兴奋,平均BOLD信号强度增加(4.28±1.5)%。结论:功能磁共振成像显示针刺特定的穴位可以引起大脑相应区域的神经兴奋,同一条经脉上的穴位引起大脑兴奋的区域相同。提示经穴、经络和大脑皮层之间存在某种特定的联系。

Using Functional Magnetic Resonance Imaging to Study the Correlation Between the Acupoint and Cerebral Region

Objective: To study the correlation among acupoints,meridians and cerebral structures with BOLD-based fMRI technique.Methods: Twenty-four healthy volunteer subjects(20 men,4 women;age range 21-48 years) participated in this study and were divided into Guangming(GB 37),Yanglingquan(GB 34),Zusanli(ST 36) and Futu(ST 32) groups with 6 cases in each group.These acupoints(left side) were punctured with filiform needles(0.3 mm×40 mm) and manipulated with hand at a frequency of 200 revolutions/min for 15 sec.The signal data [blood oxygen level depended(BOLD) signals] of the brain were collected by using GE1.5 T Signa/Horizon LX Superconductor Nuclear Magnetic Resonance Imaging System.The signal intensities with the needle at rest before,during and after the needle manipulation periods were processed by using a "functional neuroimage software".Results: After acupuncture stimulation of the left GB-34 and GB-37,the signal intensity was increased(by 3.31±1.2%) in contralateral occipital lobe(visual cortex,7 cases),frontal lobe(8 cases),temporal lobe(5 cases),basal nerve ganglion(5 cases),pons(3 cases);ipsilateral frontal lobe(2 cases) and temporal(1 case);and bilateral occipital lobe(5 cases),frontal lobe(2 cases),temporal lobe(2 cases) and basal nerve ganglion(1 case).Acupuncture of ST-36 and ST-32 resulted in signal increase(4.28±1.5%) in the contralateral hypothalamus(6 cases),hippocampus(8 cases) and frontal lobe(7 cases);ipsilateral hypothalamus(2 cases),hippocampus(2 cases) and frontal lobe(3 cases);and bilateral hypothalamus(3 cases),hippocampus(2 cases) and frontal lobe(1 case).Conclusion: Manual acupuncture at acupoints of the same one meridian results in activation of BOLD signals in the same cerebral regions,suggesting a certain specific correlation between the acupoints of a certain meridian and the cerebral structure.