中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (12): 1997-2003.doi: 10.4103/1673-5374.172318

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

针刺干预缺血性脑卒中：小脑被激活可能是得气后发挥作用的的中枢机制之一？

  

  • 收稿日期:2015-09-20 出版日期:2015-12-30 发布日期:2015-12-30
  • 基金资助:

    国家重点基础研究发展计划(973计划)资助课题(No.2006CB504505，2012CB518504)；广东省“大学生创新实验计划”立项课题(No.1212112038)

Acupuncture for ischemic stroke: cerebellar activation may be a central mechanism following Deqi

Miao-keng Li1, #, Yu-jie Li2, #, Gui-feng Zhang3, Jun-qi Chen4, *, Ji-ping Zhang1, Ji Qi1, Yong Huang1, *, Xin-sheng Lai5, Chun-zhi Tang5   

  1. 1 School of Chinese Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
    2 First Clinical Medical School, Southern Medical University, Guangzhou, Guangdong Province, China
    3 Zhaoqing Medical College, Zhaoqing, Guangdong Province, China
    4 Department of Rehabilitation Medicine, the Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong Province, China
    5 College of Acupuncture and Massage, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
  • Received:2015-09-20 Online:2015-12-30 Published:2015-12-30
  • Contact: Yong Huang, M.D. or Jun-qi Chen, M.D., nfhy@fimmu.com or meixibao@126.com.
  • Supported by:

    This research was supported by the National Key Basic Research and Development Plan of China (973 Program), No. 2006CB504505, 2012CB518504; the “University Students Innovation Experiment Project” in Guangdong Province of China, No. 1212112038.

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摘要：

针刺后“得气”与否是影响针刺干预效果的重要因素。目前能够查阅到的针刺得气研究，绝大部分是探讨生理状态“得气”对脑功能的影响，针刺外关穴(SJ5)对机体病理与生理状态下fMRI脑功能成像影响的结论尚不统一。我们将缺血性脑卒中患者12例进行外关穴(SJ5)针刺，在针刺的同时运用fMRI扫描脑部，获取脑激活区的图像数据。扫描完毕随即运用得气量表量化受试者的感觉，依据感觉量化结果将所得图像数据分为外关穴得气组及不得气组进行比较。结果显示，外关穴得气组激活的脑区是左侧颞叶颞上回(BA39)，负激活的脑区是右小脑前叶及左侧丘脑；外关穴不得气组激活的脑区是右额叶内侧额回(BA11)、右边缘叶(BA30，35)、左额叶(BA47)，负激活的脑区只有右顶叶(BA40)；与不得气组比较，得气组能显著的激活右侧小脑前叶和右侧边缘叶(BA30)。结果说明针刺“得气”产生临床作用具有脑功能学变化依据，小脑的激活可能是针刺治疗缺血性脑卒中的中枢机制之一。

关键词: 神经再生, 中医药, 针刺, 缺血性脑卒中, 脑功能成像技术, Brodmann area, 针刺, 外关, 得气, 不得气, 973计划

Abstract:

The needling sensation of Deqi during acupuncture is a key factor of influencing acupuncture outcome. Recent studies have mainly focused on the brain function effects of Deqi in a physiological state. Functional magnetic resonance imaging (fMRI) on the effects of acupuncture at Waiguan (SJ5) in pathological and physiological states is controversial. In this study, 12 patients with ischemic stroke received acupuncture at Waiguan (SJ5) and simultaneously underwent fMRI scanning of the brain, with imaging data of the activated areas obtained. Based on the patient’s sensation, imaging data were allocated to either the Deqi group or non-Deqi group. In the Deqi group, the activated/deactivated areas were the left superior temporal gyrus (BA39)/right anterior lobe of the cerebellum and left thalamus. In the non-Deqi group, the activated areas included the medial frontal gyrus of the right frontal lobe (BA11), right limbic lobe (BA30, 35), and left frontal lobe (BA47), while the only deactivated area was the right parietal lobe (BA40). Compared with the non-Deqi group, the Deqi group exhibited marked activation of the right anterior lobe of the cerebellum and right limbic lobe (BA30). These findings confirm that the clinical effect of Deqi during acupuncture is based on brain functional changes. Cerebellar activation may be one of the central mechanisms of acupuncture in the treatment of ischemic stroke.

Key words:  nerve regeneration, traditional Chinese medicine, acupuncture, functional magnetic resonance imaging, ischemic stroke, Brodmann area, Waiguan (SJ5) acupoint, Deqi, non-Deqi, 973 Program, neural regeneration