正常人体针灸效应功能性磁共振成像的研究

目的评价针刺体表穴位对脑部相应区域的功能性磁共振成像(fMRI)表现。方法17例健康志愿者，在1，5TMRI仪上进行针刺足三里(S36)、阳陵泉(G34)的实时动态fMRI检查，观察并分析针刺效果明显者的脑部功能变化情况，判断针刺效果及其意义。结果17例志愿者中13例检查成功，可见躯体感觉运动区(SMC)、运动前区(PMC)、副运动区(SMA)激活明显，额叶前部、扣带回、尾状核头部、豆状核及丘脑、岛叶、岛盖皮质大多有大面积明显激活，小脑和桥脑也可见有激活，在左侧丘脑、SMA、SMC、PMC激活区附近有信号减低的现象，但激活的像素数不多；信号减低区包括两侧额叶内侧面皮质，双侧扣带回前部皮质，两侧海马区，右侧眶回、基底节、尾状核头部等。结论针刺对脑部相关穴位的治疗效应显著，可产生广泛而复杂的脑功能变化，fMRI可清楚显示针刺效应引起的脑部功能变化，是针刺机制及效应良好且直观的评价途径。

A study of the effects of acupuncture on normal subjects as detected by fMRI

Objective To evaluate the effects of acupuncture in certain acupoints on fMRI image of corresponding brain areas. Methods Seventeen healthy volunteers were recruited and underwent real time imaging processing of fMRI while acupunctured at two acupoints on the right limb: S36 and G34, the functional changes in brain were observed and analyzed. Results Thirteen of the 17 volunteers were examined successfully. Bilateral activation can be seen clearly in the sensorimotor cortex (SMC), the premotor cortex (PMC) and the supplementary motor area (SMA). In addition, wide activation can be seen in the prefrontal cortex, the cingulate, the gyrus, the head of caudate nucleus, the lentiform nucleus, the thalamus, the insula and the insula operculum. In some cases, activations can be seen in the pons and the cerebellum. In left hemisphere, deactivation can be seen in areas close to the activated areas of thalamus SMC, PMC and SMA, but there were not much pixels. The deactivated areas included the bilateral medial cortex of frontal lobes, anterior cingulates, hippocampus complex, the ipsilateral orbital gyrus, basal gyrus and the contralateral amygdale formation. Conclusion The effects of acupuncture at S36 and G34 could result in wide and complex functional changes of brain. The fMRI can demonstrate clearly the functional changes of brain caused by acupuncture and serve as an valid tool for studying the effects and mechanism of acupuncture.