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重庆医科大学:中医药学院,附属第一医院放射科
纸质出版日期:2013,
网络出版日期:2013-03-30,
移动端阅览
李腊梅, 李学智, 吕发金, 等. 静息态脑功能MRI观察不同敏感度体质人群的针刺镇痛效应[J]. 陆军军医大学学报, 2013,35(6):547-552.
LI LAMEI, LI XUEZHI, LU FAJIN, et al. Acupuncture analgesia effect in different sensitive constitution: a resting-state fMRI study. [J]. Journal of army medical university, 2013, 35(6): 547-552.
目的 研究针刺腧穴引起的中枢效应,探讨不同敏感度体质因素对针刺镇痛的影响。 方法 筛选3组典型体质的健康志愿者,分为不敏感组、正常组和敏感组,每组15例。测定各组针刺左足三里穴前后的试验压痛阈值,应用配对
t
检验比较镇痛效应。2周后,应用功能磁共振成像(fMRI)技术对受试者针刺前后进行静息态血氧水平依赖(blood oxygen level dependent
BOLD)扫描,计算并比较各组低频振幅(amplitude of low frequency fluctuation,ALFF)值。 结果 ①正常组和敏感组针刺前后压痛阈值差异均有统计学意义(
P
<
0.05)。②与针刺前比较,针刺后不敏感组在左颞下回、左梭状回ALFF值降低,未见ALFF值增高脑区;正常组在双侧小脑后叶、脑干、边缘叶、颞下回、右尾状核ALFF值增高;在左中央后回、左中央前回、双侧枕叶ALFF值减低;敏感组在双侧小脑后叶、颞下回、梭状回、额叶、基底节、前扣带回、右缘上回、右补充运动区、左岛叶ALFF值增高;在左颞中回、左中央后回、后扣带回、双侧枕叶ALFF值减低。 结论 不同敏感度体质因素影响针刺镇痛效应,其中枢神经调控机制可能与针刺引起不同的脑区响应网络相关。
Objective To determine the analgesia effect in different sensitive constitution and investigate its underlying central nerve modulating mechanism. Methods Forty-five healthy volunteers were recruited and divided into 3 typical groups according to Traditional Chinese Medicine theory on constitution
that is
insensitive group
normal group and sensitive group
with 15 cases in each group. Pressure pain threshold (PPT) was measured in every group before and after a
cupuncture at Zusanli point (ST36). Then paired t test was used to compare the effect of analgesia among the 3 groups. Two weeks later
resting-state BOLD fMRI scanning was carried out by using a gradient-echo echo-planar imaging sequence before and after acupuncture at ST36. All the fMRI data were analyzed by the method of amplitude of low frequency fluctuation (ALFF). Paired t-test was used to analyze the data acquired before and after acupuncture. Results Compared the PPT before and after acupuncture
normal group and sensitive group had obvious statistical significance (
P
<
0.05). Compared with the image before acupuncture
the insensitive group showed significant decreased ALFF values in the left fusiform gyrus and left inferior temporal gyrus. No increased ALFF was found in this group. The normal group had significantly increased ALFF values in the bilateral cerebellum posterior lobe
brainstem
limbic lobe
left inferior temporal gyrus
and right caudate
and significantly decreased ALFF values in the left postcentralgyrus
left precentral gyrus
and bilateral occipital lobes. The ALFF values in the sensitive group were increased mainly in the bilateral cerebellum posterior lobe
fusiform gyrus
inferior temporal gyrus
basal ganglia
frontal lobe
anterior cingutate
right supramarginal gyrus
right supplementary motor area
and left insular lobe
while the regions with decreased ALFF values were the left middle temporal gyrus
left postcentral gyrus
posterior cingutate
and bilateral occipital lobes. Conclusion Person with different sensitive constitution has different acupuncture analgesia effect. The underlying central nervous modulating mechanism may be due to acupuncture causing response of different brain areas.
体质针刺效应磁共振成像低频振幅
constitutionacupuncture effectmagnetic resonance imagingamplitude of low frequency fluctuation
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