穴位不同针刺方式促进缺血性脑卒中手功能恢复的研究

目的:研究穴位不同针刺方式促进缺血性脑卒中手功能障碍的恢复。方法:将120例缺血性脑卒中手功能障碍的患者随机分为手针(AC)组、电针(EA)组、神经肌肉电刺激(NMES)组和假穴位刺激(Sham)组4组,每组各30例,所有的病例均接受常规的康复训练,手针组在此基础上增加手法针刺治疗,电针组则增加电刺激治疗,神经肌肉电刺激组则增加肌电刺激,治疗假穴位刺激组则接受假刺激治疗,穴位统一选择"曲池"和"外关"两穴,1次/d,30min/次,5d/周,共4周。所有的患者均于治疗前后采用简式Fugl-Meyer上肢运动功能评价表(FMU)、改良Barthel指数评定(MBI)对患者患侧上肢运动功能及日常生活活动能力进行评价。结果:治疗前4组患者的FMU评分和MBI评分差异无显著性意义(P0.05),治疗后4组患者FMU和MBI评分均有提高(P0.05)。组间比较,治疗后,手针组、电针组、神经肌肉电刺激组和假穴位刺激组相比,三组疗效指标FMU和MBI的前后变化值明显优于假穴位刺激组(P0.05)。神经肌肉电刺激组比电针组、手针组在改善上肢运动功能疗效指标FMU值更明显(P0.01),而电针组和手针组相比较,电针组比手针组改善上肢运动功能疗效指标FMU值更显著(P0.05)。神经肌肉电刺激、手针和电针三组在改善患者ADL能力疗效指标MBI评分上差异不显著(P0.05)。结论:三种穴位不同针刺方式均可改善缺血性脑卒中手功能障碍的运动功能和促进ADL能力的恢复,神经肌肉电刺激结合了电刺激和患者主动运动模式,比针刺刺激更有利于脑卒中后手功能的恢复。     

穴位不同刺激方式改善缺血性脑卒中患者手功能障碍的临床观察

目的:运用静息态功能核磁(rsf MRI)评估穴位不同刺激方式对缺血性脑卒中患者手功能障碍的脑功能连接差异。方法:将148例缺血性脑卒中手功能障碍患者按照随机数字表法分为经皮电刺激组(n=37)、电针组(n=36)、手法针刺组(n=38)和假针组(n=37),4组均在配合康复训练基础上于曲池、外关穴分别实施经皮电刺激、电针、手法针刺、假针刺,干预时间为4周。4组分别于治疗前后进行Fugl-Meyer评定表中上肢功能评分、改良Barthel指数评估。4组中各选取10例左侧缺血性脑卒中患者于治疗前后分别接受rsf MRI检查。结果:与假针组比较,治疗后经皮电刺激组、电针组和手针组FMU和MBI均升高(P0.05),与电针组和手针组比较,经皮电刺激组FMU升高更明显(P0.01),与手针组比较,电针组FMU值明显升高(P0.05)。4组患者以左侧M1为种子点进行rsf MRI检查发现,治疗后经皮电刺激组左侧M1与左侧中央前后回、右侧小脑、右侧辅助运动区功能连接增加;电针组左侧M1与左侧中央后回、左侧额中回、左侧顶下小叶及左侧辅助运动区功能连接增加;手针组左侧M1与左侧中央前、后回的连接增加,与左侧小脑的功能连接减少;假针组左侧M1与左侧中央后回的连接增加,但其连接强度4组中最小,且与左侧额中回、左侧中央前回的连接减少。结论:曲池、外关穴实施经皮电刺激、电针、手针均能改善脑卒中患者的手功能障碍,其中经皮电刺激效果最好,其机制可能与大脑中央前后回、辅助运动区、额中回与M1的功能连接增强有关。     

基于fMRI任务态与静息态对头针疗法的研究进展

头针疗法是针灸体系的重要组成部分且广泛应用于临床,但是有关其作用原理研究的文献却不足以完全阐明头针机理,并指导其发展方向.功能磁共振成像技术因其独特优势,成为穴位针刺脑部中枢效应机制研究的首选方法.通过阅读分析相关文献及该领域整体研究趋势,发现应用功能磁共振成像技术对头针疗法进行研究主要集中在特异性脑区激活、针刺作用机...     

针刺胃扩张模型大鼠内关、足三里等穴位下丘脑室旁核相关神经元的反应

背景：既往有关针刺对胃功能调节的神经机制研究多以外周神经为主,涉及中枢,尤其是高位中枢的研究较少。目的：探讨针刺“内关”、“足三里”等穴位对下丘脑室旁核胃相关神经元作用的影响。方法：运用微电极细胞外记录技术,在大鼠胃扩张的基础上,找出室旁核胃相关神经元,予以手针刺激“内关”、“足三里”等穴位各30 s,观察其对室旁核胃相关神经元的影响。结果与结论：60只大鼠共记录到109个下丘脑室旁核神经元放电,109个下丘脑室旁核神经元中与胃扩张相关的神经元有56个,56个胃扩张相关神经元中,对针刺足三里、内关、脾俞、胃俞有反应的神经元个数分别是44,47,29,33,有反应的神经元出现的比例分别是78.57%,83.47%,51.79%,58.93%。结果表明下丘脑室旁核中存在同时对胃扩张刺激和针刺刺激起反应的躯体内脏汇聚神经元,且参与针刺对胃功能的调节作用。     

手针、电针及经皮穴位电刺激调节人脑功能的功能性磁共振观察

目的:比较不同的针刺方法对人脑功能的调节作用。方法:16名健康成年被试(男8例),每名被试均参加4次实验,分别接受手针、电针、经皮穴位电刺激及触觉对照刺激,在刺激过程中同时进行功能性磁共振(血氧依赖水平,blood oxygen level dependent,BOLD)数据采集。结果:4种刺激均表现为对躯体运动感觉系统、岛叶和小脑的BOLD信号激活。此外,电针还表现为对边缘系统的BOLD信号的抑制,而经皮穴位电刺激则特异性地激活了基底核(P<0.001,uncorrected,k>22)。结论:电针和经皮穴位电刺激可模拟手针对脑BOLD信号的调节作用,表明3者有其共性,又各具特色。其生理意义有待进一步阐明。     

针刺足三里穴对端粒酶基因敲除小鼠海马P2X受体及其表达的影响

目的观察针刺足三里穴对端粒酶基因敲除小鼠海马P2X受体表达的影响。 方法采用随机数字表法将端粒酶基因敲除的早衰模型纯合子小鼠分为空白组、手针组及电针组，每组各6只小鼠。3组小鼠均正常饲养，期间空白组不给予任何特殊处理，手针组及电针组小鼠分别给予手针或电针刺激足三里穴。于治疗7d后观察各组小鼠海马区P2X受体及cAMP应答元件结合蛋白(CREB)表达间差异。 结果①手针组及电针组海马区P2X4相对表达量［分别为（0.67±0.05）和（0.70±0.13）］均较空白组（0.79±0.03）有下降趋势，但各组间差异均无统计学意义（P>0.05）。②电针组及手针组海马区P2X7表达［分别为（1.00±0.04）和（1.07±0.02）］均较空白组（1.21±0.05）明显下降（P<0.05），但电针组与手针组海马区P2X7表达组间差异无统计学意义（P>0.05）。③电针组小鼠海马区CREB表达（0.67±0.07）较空白组（0.82±0.05）及手针组（0.86±0.03）明显下降（P<0.05）。 结论电针可抑制端粒酶基因敲除小鼠海马区P2X4受体及CREB表达，其相关信号通路在针刺治疗神经退行性疾病的作用机制中可能发挥重要作用。     

电针参数定量化的实验与临床研究进展

通过对电针频率、波型、电流强度、刺激时间等不同参数的实验与临床研究进行综合分析后,产生不同的电针参数具有不同的针效;电针参数量化存在合理性,有待于进一步开展更为全面、细致地研究,以提高电针的临床疗效。     

基于多模态磁共振成像探讨针刺治疗卒中后失语症的研究进展

卒中后失语症（post-stroke aphasia, PSA）是指因脑血管或言语中枢神经功能紊乱引起的后天性语言功能障碍。针刺治疗PSA已取得较好的临床疗效,但其作用机制尚未明确。近年来,多模态MRI飞速发展,此项技术具有无辐射、多参数、多序列成像等优点,已被众多学者应用于PSA中枢效应机制研究。本研究基于功能MRI、弥散张量成像、结构性MRI、磁共振波谱成像等多模态成像技术,从脑功能、脑结构及脑代谢等角度探讨了针刺对PSA患者中枢效应机制,旨在为针刺治疗PSA临床个体化诊疗方案提供新方向,为研究针刺治疗PSA的潜在机制提供新思路。     

电针足三里穴后脑功能磁共振成像显示不同脑区的激活变化

目的:传统医学认为针刺足三里可补气、抗衰老。应用脑功能磁共振成像客观观察电针刺激足三里穴对各认知功能相关脑区活动情况的影响。方法:观察于2004-03/10在首都医科大学宣武医院神经内科完成。纳入标准:年龄在50～60岁之间,性别不限,饮食规律,无精神或神经系统疾病史且自愿参加本研究的健康人。排除标准:MRI确定患有其他疾病者及接受过针刺治疗者。共有3人符合以上标准,男1人,女2人。通过脑功能磁共振成像技术观察电针刺激志愿者右侧下肢足三里穴引起中枢神经系统不同脑区的功能变化,一次脑功能磁共振成像扫描给予间断电针刺激3次,采用静息-刺激交替模式。结果:进入结果分析保持为3人。电针刺激足三里穴主要引起两侧前额叶和颞叶的神经功能变化,左侧脑部激活较右侧表现明显,具体为左侧颞上回、颞中回、颞下回激活,右侧颞中回激活。此外,左侧脑干有少量激活,其他脑区无明显激活。结论:电针刺激足三里穴能激活前额叶和颞叶等与认知功能有关的脑区。     

针刺合谷穴后前额叶脑功能血氧水平依赖信号与神经递质谷氨酸及谷氨酰胺复合物的关系

目的 观察针刺右侧合谷穴时前额叶血氧水平依赖（BOLD）信号、较正后谷氨酸谷氨酰胺复合物（GLx⁺）浓度及其相关性。方法 对76名健康受试者采集静息及刺激[手针及纤毛机械刺激针（纤毛针）]合谷穴时BOLD功能MRI（fMRI）及磁共振波谱（MRS）数据,分析BOLD信号定量值与Glx⁺浓度的相关性。结果 手针较纤毛针针刺激发更多负激活,以前额叶内侧皮层（mPFC）及前扣带回（ACC）为著。2组BOLD信号定量值差异和Glx⁺浓度差异均无统计学意义（P均>0.05）。BOLD定量信号与Glx⁺浓度均无明显相关（P均>0.05）,刺激前后Glx⁺浓度差异均无统计学意义（P均>0.05）。结论 手针针刺合谷穴诱发边缘叶-旁边缘叶-新皮层网络负激活效应,手针和纤毛针刺激前后Glx⁺浓度多无明显变化;BOLD信号定量值与Glx⁺浓度无明显相关。     

A pilot study of functional magnetic resonance imaging of the brain during manual and electroacupuncture stimulation of acupuncture point (LI-4 Hegu) in normal subjects reveals differential brain activation between methods

OBJECTIVES: To characterize the brain activation patterns evoked by manual and electroacupuncture on normal human subjects. DESIGN: We used functional magnetic resonance imaging (fMRI) to investigate the brain regions involved in electroacupuncture and manual acupuncture needle stimulation. A block design was adopted for the study. Each functional run consists of 5 minutes, starting with 1-minute baseline and two 1-minute stimulation, the interval between the two stimuli was 1 minute. Four functional runs were performed on each subject, two runs for electroacupuncture and two runs for manual acupuncture. The order of the two modalities was randomized among subjects. During the experiment, acupuncture needle manipulation was performed at Large Intestine 4 (LI4, Hegu) on the left hand. For each subject, before scanning started, the needle was inserted perpendicular to the skin surface to a depth of approximately 1.0 cm. Electroacupuncture stimulation was delivered using a continuous rectangular wave form (pulse width 30 ms) at a frequency of 3 Hz. For manual acupuncture, the needle was rotated manually clockwise and counterclockwise at a rate of about 180 times per minute (3 Hz). SUBJECTS: Eleven right-handed, normal, healthy volunteer adults, 6 male and 5 female, ages 21-64 participated in the experiment. RESULTS: Results showed that electroacupuncture mainly produced fMRI signal increases in precentral gyrus, postcentral gyrus/inferior parietal lobule, and putamen/insula; in contrast, manual needle manipulation produced prominent decreases of fMRI signals in posterior cingulate, superior temporal gyrus, putamen/insula. CONCLUSION: These results indicate that different brain networks are involved during manual and electroacupuncture stimulation. It suggests that different brain mechanisms may be recruited during manual and electroacupuncture.     

Test-retest study of fMRI signal change evoked by electroacupuncture stimulation

Recent efforts to use fMRI to investigate the effects of acupuncture needle manipulation on the brain have yielded discrepant results. This study was designed to test the reliability of fMRI signal changes evoked by acupuncture stimulation. Six subjects participated in six identical scanning sessions consisting of four functional scans, one for each of the four conditions: electroacupuncture stimulation (2 Hz) at GB 37, UB 60, non-acupoint (NP), and a control task of the finger tapping. In the group analysis across all subjects and sessions, both the average ratings on a Subjective Acupuncture Sensation Scale and the average fMRI signal changes (increases and decreases) were similar for GB37, UB 60, and NP. Visual inspection of the activation maps from individual sessions and ICC analysis revealed that fMRI signal changes evoked by electroacupuncture stimulation were significantly more variable than those from the control finger-tapping task. The relatively large variability across different sessions within the same subject suggests multiple sessions should be used to accurately capture the activation patterns evoked by acupuncture stimulation at a particular point for a specific subject.     

Research on the neurophysiological mechanisms of acupuncture: review of selected studies and methodological issues

This presentation reviews studies that contribute to an understanding of the neurophysiological mechanisms of acupuncture. A 1973 study, using volunteer medical students, looked into acupuncture's analgesic effect on experimentally induced pain and suggests that humoral factors may mediate acupuncture-induced analgesia. In a study of the possible role of the cerebrospinal fluid transmission of pain suppression effects of acupuncture, cerebrospinal fluid from acupuncture-treated rabbits was infused into recipient rabbits. The analgesic effect was observed in the recipient rabbits, suggesting that acupuncture-induced analgesia may be mediated by substances released in the cerebrospinal fluid. Studies of electroacupuncture in rats revealed that both low-frequency and high-frequency stimulation could induce analgesia, but that there are differential effects of low- and high-frequency acupuncture on the types of endorphins released. In another study, low-frequency electroacupuncture, given as median nerve stimulation in cats, was shown to protect the myocardium by inhibiting sympathetic pressor response and increasing myocardial oxygen demand. The development of neuroimaging tools, such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), make noninvasive studies of acupuncture's effects on human brain activity possible. Studies using PET have shown that thalamic asymmetry present among patients suffering from chronic pain was reduced after the patients underwent acupuncture treatment. Other studies, using fMRI, have pointed to relationships between particular acupoints and visual-cortex activation. These powerful new tools open the possibility to new scientific studies of this ancient therapy.     

A Functional Neuroimaging Study of Expectancy Effects on Pain Response in Patients With Knee Osteoarthritis

Placebo treatments and healing rituals share much in common, such as the effects of expectancy, and have been used since the beginning of human history to treat pain. Previous mechanistic neuroimaging studies investigating the effects of expectancy on placebo analgesia have used young, healthy volunteers. Using functional magnetic resonance imaging (fMRI), we aimed to investigate the neural mechanisms by which expectancy evokes analgesia in older adults living with a chronic pain disorder and determine whether there are interactions with active treatment. In this fMRI study, we investigated the brain networks underlying expectancy in participants with chronic pain due to knee osteoarthritis (OA) after verum (genuine) and sham electroacupuncture treatment before and after experiencing calibrated experimental heat pain using a well tested expectancy manipulation model. We found that expectancy significantly and similarly modulates the pain experience in knee OA patients in both verum (n?=?21, 11 female; mean?±?SD age 57?±?7 years) and sham (n?=?22, 15 female; mean?±?SD age 59?±?7 years) acupuncture treatment groups. However, there were different patterns of changes in fMRI indices of brain activity associated with verum and sham treatment modalities specifically in the lateral prefrontal cortex. We also found that continuous electroacupuncture in knee OA patients can evoke significant regional coherence decreases in pain associated brain regions. Our results suggest that expectancy modulates the experience of pain in knee OA patients but may work through different pathways depending on the treatment modality and, we speculate, on pathophysiological states of the participants.

针刺正常老年人"四关穴"的脑功能MRI研究

目的采用脑功能磁共振成像(fMRI)探讨针刺正常老年人“四关穴”(双侧太冲穴和合谷穴)的中枢神经机制。方法针刺13例正常老年人“四关穴”,同时进行全脑fMRI扫描。为避免针刺后效应的影响,实验采用单组块设计。数据采用SPM99进行分析。图像中每个体素的t值形成统计参数图,以P<0.05(经比较修正后)的体素作为激活体素。结果针刺正常老年人“四关穴”激活双侧小脑半球、小脑蚓部、左侧额中回、双侧额下回、双侧中央旁小叶、双侧丘脑、后扣带回和前扣带回。针刺“四关穴”所激活的脑区,并非是单独针刺太冲穴和合谷穴所激活脑区的简单叠加。结论针刺正常老年人“四关穴”激活后扣带回和额叶,这可能是该组合穴治疗精神类疾病的中枢神经机制。fMRI是一种客观显示针刺治疗脑改变的方法。     

Acupuncture modulation of capsaicin-induced inflammation: effect of intraperitoneal and local administration of naloxone in rats. A blinded controlled study

OBJECTIVE: It is believed that acupunctural stimulation induces an analgesic response mainly through a central mechanism: that is, through an increase in the production of opioid peptides and their release at different levels in the nervous system. We sought to establish whether the modulating effect of acupuncture on experimental neurogenic edema can be attributed to a central mechanism only or whether a peripheral mechanism could also exist. Intraperitoneal administration was compared to local administration in the same paw in rats that were injected with capsaicin and in the same dermatome of the acupunctural stimulation. MATERIALS AND METHODS: Experimentation was conducted on 105 male Sprague-Dawley rats weighing 180-220 g, divided into 7 groups as follows: group 1, control; groups 2-4 (15 animals), stimulated with manual acupuncture; group 3 also treated with intraperitoneal naloxone 1 mg/kg; group 4 also treated locally with naloxone (20 microg); groups 5-7 (15 animals), stimulated with 5 Hz and 5 mA electroacupuncture (EAP); group 6 also treated with intraperitoneal naloxone, 1 mg/kg, group 7 also treated locally with naloxone (20 microg). RESULTS: The results indicate that the administration of 1 mg/kg of naloxone intraperitoneally can inhibit the modulating effect of acupunctural stimulation. Equally effective in inhibiting the modulating effect of acupunctural stimulation, although not having a systemic effect, is a 20-microg dose of naloxone administered peripherally on the site of edema induction. CONCLUSION: It is possible to conclude that both systemic and peripheral mechanisms seem to be implicated in the modulating effect of acupuncture on the neurogenic inflammation mechanism.     

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。     

功能磁共振成像观察补法、泻法针刺足三里穴对大脑作用的中枢机制

目的 用功能磁共振成像(fMRI)方法观察补法和泻法针刺足三里穴对大脑作用的中枢机制. 方法 选取32名健康右利手志愿者,对11名受检者用补法电针刺激右侧足三里穴(ST36)、11名用泻法电针刺激ST36、10名电针刺激右侧足三里穴同一水平向外2～3 cm处.同时行全脑fMRI扫描;用SPM2软件进行图像后处理. 结果 电针结束后5 min,泻法组的脑区激活不明显,而补法组平均信号升高的脑区主要有双侧尾状核头部、丘脑、左侧岛叶、扣带回及小脑齿状核.电针结束后20～30 min期间两组脑区的激活最为明显,均激活左侧的丘脑、中央旁小叶、中央前回、颞中回、额中回、岛叶、双侧尾状核头部、小脑半球、前、后扣带回;两组激活区域大致相同,但补法组激活的脑区范围更广、强度更大.针刺假穴组只激活中央旁小叶及小脑半球. 结论 补、泻手法针刺足三里穴均能激活边缘系统、辅助运动区、灰质结构等脑区,而应用补法能更早、更强烈地激活上述脑区.     

Neurobiology of Acupuncture: Toward CAM

It has long been accepted that acupuncture, puncturing and scrapingneedles at certain points on the body, can have analgesic andanesthetic effects, as well as therapeutic effects in the treatmentof various diseases. This therapy, including acupuncture anesthesia,has drawn the attention of many investigators and become a researchsubject of international interest around the world. Numerousstudies have demonstrated that the nervous system, neurotransmitters,endogenous substances and Jingluo (meridians) may respond toneedling stimulation and electrical acupuncture. An abundanceof information has now accumulated concerning the neurobiologicalmechanisms of acupuncture, in relation to both neural pathwaysand neurotransmitters/hormonal factors that mediate autonomicregulation, pain relief and other therapeutics. Early studiesdemonstrated that the analgesic effects of electroacupuncture(EA) are mediated by opioid peptides in the periaqueductal gray.Recent evidence shows that nitric oxide plays an important rolein mediating the cardiovascular responses to EA stimulationthrough the gracile nucleus-thalamic pathway. Other substances,including serotonin, catecholamines, inorganic chemicals andamino acids such as glutamate and -aminobutyric acid (GABA),are proposed to mediate certain cardiovascular and analgesiceffects of acupuncture, but at present their role is poorlyunderstood. The increased interest in acupuncture health carehas led to an ever-growing number of investigators pursuingresearch in the processes of the sense of needling touch, transductionof needling stimulation signals, stimulation parameters andplacebos. In this Review, the evidence and understanding ofthe neurobiological processes of acupuncture research have beensummarized with an emphasis on recent developments of nitricoxide mediating acupuncture signals through the dorsal medulla-thalamicpathways.     

功能性磁共振探查光明、太冲穴与大脑功能的关系

背景随着功能磁共振成像(fMRI)的引入,其无损伤性的研究手段,为古老针刺方法的研究带来了新的前景,人们从大脑的不同功能着手,尝试着用fMRI来解开经络穴位与大脑的相关性.目的通过fMRI观察针刺光明、太冲穴位时,大脑不同区域的相关反应.设计以医学院的健康自愿参加实验的学生为研究对象,随机对照的验证性研究.单位一所中医药大学医院的针灸科,一所中医药大学的基础医学院及德国弗莱堡大学医学院放射医疗中心.对象实验于1997-06在德国弗莱堡大学医学院放射医疗中心进行,健康志愿者19例,皆为医学院学生.男4例,女15例.受试者均自愿参加,无针刺经历,无神经及精神病史.按随机对照原则分为视觉刺激加针刺单侧组7例,男2例,女5例.视觉刺激加针刺双侧组6例,男1例,女5例.单纯针刺双侧组6例,男1例,女5例.方法用fMRI对不同条件的各组学生在针刺光明、太冲穴时,视觉皮质区与相关脑区的反映以及是否诱导其功能进行了观察.针刺用无菌无磁性的不锈钢针(直径为0.25 mm,长约30 mm,华佗牌,苏州医疗器械公司生产),每穴操作完后,询问其得气情况.针刺的所有例数统一由有多年工作经验的针灸医师完成.主要观察指标大脑皮质的血氧饱和水平(BOLD)的变化,幅度,响应延迟,时间波动.大脑视觉皮质功能区是否被激活.结果视觉刺激加针刺单侧组,视觉刺激加针刺双侧组在视觉刺激时以及光明和太冲穴进针时未观察到视区BOLD的相应变化.视觉刺激加针刺单侧组,视觉刺激加针刺双侧组,单纯针刺双侧组在观察其单侧和双侧行针时均观察到视区BOLD的变化.其中6例在岛叶、颞叶顶下小叶、上丘、楔叶、枕中回等出现象数聚集.结论针刺对单侧和双侧穴位的刺激均能改善大脑相关区域的BOLD,但与进行手法和视觉刺激无关.