【作者】 方继良；

【导师】 刘保延； 朱兵；

【作者基本信息】 中国中医科学院 ， 中西医结合基础， 2010， 硕士

【摘要】 实验目的：利用fMRI技术,观察比较电针躯干部不同神经节段支配穴位的脑激活功能区、及功能区之间的功能连接的异同。分析针刺不同穴位产生的特征性脑功能网络,同时探讨电针能否改变脑静息态默认功能模式,是否存在针刺即时后效应。材料和方法：共纳入21名健康志愿者,男10名,女11名,年龄22-28岁,实验通过广安门医院伦理委员会批准,实验前每位受试者均填写知情同意书。每位受试者在同日接受两个穴位的fMRI试验,选择位于躯干、由不同神经节段支配的、同经络、同为结缔组织的关元穴和中脘穴(CV4、CV12),fMRI扫描分别在针刺前静息状态、针刺单个穴位留针状态、电针刺激状态、针刺后静息态采集脑功能数据；并对电针针感进行了记录。采用SPM2、短程和长程“中心度”脑功能网络分析方法,分析电针不同穴位时脑激活功能区、及功能区之间的功能网络连接。结果：两穴位的各针感频率和强度分别比较,发现只存在胀满感强度有显著性差异(p<0.05),关元穴显示更为强烈的胀满感觉,其余针感频率和强度无显著性差异。通过分析发现,电针关元、中脘穴均诱导产生了额叶内侧部的明显负激活现象,留针及电针能改变脑静息默认功能模式,额叶内侧回、扣带前回前下部及海马区(脑边缘叶-旁边缘叶-新皮层系统,LPNN)脑功能网络出现了明显的即时针刺后效应。两穴位脑效应比较显示只存在较小的差异。结论：针刺关元、中脘穴均具有对脑边缘叶-旁边缘叶-新皮层网络的调制作用,能改变脑静息默认功能模式,产生即时针刺后脑效应,但也存在较小的差异,显示了穴位脑效应的相对特异性。本实验中针刺诱导产生的脑功能网络模式与以往研究的情绪认知功能调节环路有相似的特点。我们推论,针灸镇静、抗焦虑、抗抑郁症的治疗效应可能需要通过这-边缘叶-旁边缘叶-新皮层网络所介导。更多还原

【Abstract】 The specific brain effects of acupoint are an important scientific concern in the research of acupuncture neuromechanism. However, most fMRI acupuncture studies focused on acupoints on the limb, employed simple design and data analyzing method, and some interpreted the results without convincible evidence. Therefore, researches on acupoints of different properties, using new experiment designs and new data analyzing methods are warranted. In this study, brain effects of acupuncture on trunk at acupoints Guanyuan (CV4) and Zhongwan (CV12) were tested using fMRI scan on 21 healthy volunteers at resting state, during needle retention, electroacupuncture (EA), and post-EA resting state. According anatomic knowledge, Guanyuan (CV4) and Zhongwan (CV12) have different nerve innervations, but share the same meridian category and same tissue type (connective tissue). Brain areas activated by EA at these two acupoints were analyzed with SPM2. The local and remote connectivity maps were calculated with whole brain correlation analysis. We thus compared brain functional activity and connectivity between CV4 and CV12. It revealed that EA at CV4 and CV12 induced apparent deactivation effects in the limbic-paralimbic-neocortical network (LPNN); default mode of the brain at rest was modified by needle retention and EA, respectively; functional brain network changed significantly after EA, and instant post-acupuncture effects were found mainly in the ventral medial prefrontal cortex and anteroinferior portion of the anterior cingulate cortex. The results showed that relatively small differences of brain activity and functional connectivity were found between these two acupoints. It indicates that relative specificity of acupoint effect in the brain exists. The results demonstrated similarity between functional brain network mode of acupuncture effects and functional circuits of emotional and cognitive regulation. Therefore, we hypothesize that therapeutic effects of acupuncture analgesia、acupuncture on anxiety. depression may be mediated by the limbic-paralimbic-neocortical network (LPNN)更多还原