针刺列缺穴治疗颈椎病患者的脑功能成像研究
发布时间：2018-08-13 08:16
【摘要】：目的 通过功能性磁共振成像技术（fMRI），观察针刺列缺穴对正常人和颈椎病患者的脑功能成像影响的异同，探索针刺列缺穴治疗颈椎病与脑功能激活区之间的内在联系，以揭示针刺列缺穴治疗颈椎病的可能机制。 方法 正常组20例（均为湖北中医药大学在校学生及社会中征集的志愿者，2012年5月--2012年12月），男性12例，女性8例。年龄22～55岁，平均年龄30±1.4岁；颈椎病患者组20例（均为武汉市第一医院针灸科门诊病人，2012年5月--2012年12月），男性11例，女性9例。年龄22～55岁，平均年龄32±1.5岁。 全部受试者均为右利手，选取右侧的列缺穴进行针刺刺激。所有受试者均由同一位具有丰富针刺经验的针灸医师施行针刺。针灸医师采用无菌不锈钢针进行针刺，进针深度为0.5～0.8寸，得气后采用平补平泻手法行针。 应用美国通用电气公司3.0T GE signa HDXT MRI系统的血氧水平依赖性磁共振成像技术，观察针刺前及针刺过程中所有受试者的脑功能区的变化。采用EPI序列扫描，参数为：TR=3000ms,TE=40ms,FA=90°,扫描矩阵96×96，层厚5mm，层距0mm，每3秒获得覆盖全脑的29层图像，共扫描6分24秒，获得静息态的脑功能成像和针刺后的脑功能激活区。并将实验获得的数据进行统计分析。利用SPM8软件对数据进行后处理、统计、分析，对单个被试数据进行组内分析，设定统计阈值为p㩳0.05，设定未经校正的激活范围阈值为10个像素，即考虑为有意义的激活区是连续激活像素到达10个以上的区域。然后对对照组和试验组数据分别的进行单样本t检验，其统计阈值设定为p0.05，，多重比较使用Alphasim校正。 结果 1.正常组和颈椎病患者组分别有2例和1例实验对象，由于实验过程中头部晃动过大而被剔除。 2.正常组针刺列缺穴后主要激活了双侧的顶下小叶、中央前回、中央后回、颞上回、颞中回和额下回，以及左侧岛叶和左侧缘上回（按照被激活脑区的体素值大小依次排序）。 3.颈椎病患者组针刺列缺穴后主要激活了双侧的小脑、顶下小叶、中央前回、颞上回、枕叶。以及左侧大脑的颞中回和中央后回（按照被激活脑区的体素值大小依次排序）。 结论 针刺列缺穴对正常人脑部功能区域的激活不是特定的某一个区域，而是可以激活多个脑功能区，并且其激活的脑功能区与其主治的病症有着一定的相关性。颈椎病患者与正常者的脑功能激活区有着诸多的相同，但颈椎病患者的脑功能激活区有其特异性，推测可能是针刺列缺穴对颈椎病患者起到的治疗效果的特定脑功能区。
[Abstract]:Objective to observe the effects of acupuncture on brain function imaging of normal subjects and patients with cervical spondylopathy by functional magnetic resonance imaging (fMRI), and to explore the relationship between acupuncture treatment of cervical spondylosis and the activation of brain function. To reveal the possible mechanism of acupuncture for treatment of cervical spondylosis. Methods A total of 20 normal subjects (including 12 males and 8 females) were enrolled in Hubei University of traditional Chinese Medicine from May 2012 to December 2012. There were 20 patients with cervical spondylosis (all outpatients in Department of Acupuncture and moxibustion, first Hospital of Wuhan, from May 2012 to December 2012), 11 males and 9 females. The average age was 32 卤1.5 years. All subjects were right-handedness, select the right side of the lack of points for acupuncture stimulation. All subjects were treated by the same acupuncture practitioner with rich experience in acupuncture. Acupuncture physician used sterile stainless steel needle for acupuncture, the depth of needle was 0.5 ~ 0.8 inch. The changes of brain functional areas of all subjects before and during acupuncture were observed by using the 3.0T GE signa HDXT MRI system of General Electric Company of the United States of America. EPI sequence was used to scan. The parameters were 90 掳, 96 脳 96, 5 mm thick and 0 mm apart. 29 images covering the whole brain were obtained every 3 seconds, and the rest brain function imaging and the brain function activation area after acupuncture were obtained. The data obtained from the experiment were statistically analyzed. The data were processed, analyzed and analyzed by SPM8 software. The statistical threshold was set as p0.05, and the threshold of uncorrected activation range was 10 pixels. That is to say, the meaningful activation region is continuously activated to more than 10 pixels. Then the data of the control group and the test group were tested with a single sample t-test, the statistical threshold was set to p0.05, and the Alphasim correction was used for the multiple comparisons. Result 1. There were 2 cases in normal group and 1 case in cervical spondylopathy group. 2. 2. In the normal group, bilateral inferior parietal lobules, precentral gyrus, posterior central gyrus, superior temporal gyrus, middle temporal gyrus and inferior frontal gyrus were mainly activated after acupuncture. And left insular lobe and left superior marginal gyrus (in order of voxel value of activated brain region). 3. In the group of patients with cervical spondylopathy, bilateral cerebellum, inferior parietal lobule, precentral gyrus, superior temporal gyrus and occipital lobe were mainly activated after acupuncture. And left middle temporal gyrus and postcentral gyrus (in order of voxel value of activated brain region). Conclusion Acupuncture can activate several brain functional areas rather than a specific one, and the activation of brain functional areas has a certain correlation with the disease. The activation regions of brain function in patients with cervical spondylopathy are similar to those in normal subjects, but the activation areas of brain function in patients with cervical spondylosis have their own specificity.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R246.9;R445.2
本文编号：2180404
[Abstract]:Objective to observe the effects of acupuncture on brain function imaging of normal subjects and patients with cervical spondylopathy by functional magnetic resonance imaging (fMRI), and to explore the relationship between acupuncture treatment of cervical spondylosis and the activation of brain function. To reveal the possible mechanism of acupuncture for treatment of cervical spondylosis. Methods A total of 20 normal subjects (including 12 males and 8 females) were enrolled in Hubei University of traditional Chinese Medicine from May 2012 to December 2012. There were 20 patients with cervical spondylosis (all outpatients in Department of Acupuncture and moxibustion, first Hospital of Wuhan, from May 2012 to December 2012), 11 males and 9 females. The average age was 32 卤1.5 years. All subjects were right-handedness, select the right side of the lack of points for acupuncture stimulation. All subjects were treated by the same acupuncture practitioner with rich experience in acupuncture. Acupuncture physician used sterile stainless steel needle for acupuncture, the depth of needle was 0.5 ~ 0.8 inch. The changes of brain functional areas of all subjects before and during acupuncture were observed by using the 3.0T GE signa HDXT MRI system of General Electric Company of the United States of America. EPI sequence was used to scan. The parameters were 90 掳, 96 脳 96, 5 mm thick and 0 mm apart. 29 images covering the whole brain were obtained every 3 seconds, and the rest brain function imaging and the brain function activation area after acupuncture were obtained. The data obtained from the experiment were statistically analyzed. The data were processed, analyzed and analyzed by SPM8 software. The statistical threshold was set as p0.05, and the threshold of uncorrected activation range was 10 pixels. That is to say, the meaningful activation region is continuously activated to more than 10 pixels. Then the data of the control group and the test group were tested with a single sample t-test, the statistical threshold was set to p0.05, and the Alphasim correction was used for the multiple comparisons. Result 1. There were 2 cases in normal group and 1 case in cervical spondylopathy group. 2. 2. In the normal group, bilateral inferior parietal lobules, precentral gyrus, posterior central gyrus, superior temporal gyrus, middle temporal gyrus and inferior frontal gyrus were mainly activated after acupuncture. And left insular lobe and left superior marginal gyrus (in order of voxel value of activated brain region). 3. In the group of patients with cervical spondylopathy, bilateral cerebellum, inferior parietal lobule, precentral gyrus, superior temporal gyrus and occipital lobe were mainly activated after acupuncture. And left middle temporal gyrus and postcentral gyrus (in order of voxel value of activated brain region). Conclusion Acupuncture can activate several brain functional areas rather than a specific one, and the activation of brain functional areas has a certain correlation with the disease. The activation regions of brain function in patients with cervical spondylopathy are similar to those in normal subjects, but the activation areas of brain function in patients with cervical spondylosis have their own specificity.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R246.9;R445.2
【参考文献】
相关期刊论文 前10条
1 常时新,孔祥泉,李刚,刘定西,熊茵;多穴位联合电针刺激对卒中恢复期皮层功能变化的fMRI监测[J];中国中西医结合影像学杂志;2003年01期
2 邓振生;丘茂林;Fitch-SohnC.;Lai S.;;针灸刺激与视觉相关的穴位引起大脑功能区响应的fMRI研究[J];实用放射学杂志;2005年12期
3 姜玲珍,张莲瑛;电针加耳压治疗神经根型颈椎病47例[J];上海针灸杂志;2001年03期
4 付平,贾建平,徐敏,王敏;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[J];中国临床康复;2005年16期
5 胡军武,王苇,漆剑频,夏黎明,王承缘,肖旭轩;正常人体针灸效应功能性磁共振成像的研究[J];中华物理医学与康复杂志;2005年03期
6 李洁巍;张云亭;;刺激穴位激活语言皮质的fMRI研究[J];临床放射学杂志;2005年12期
7 付平,贾建平,王敏;针刺神门穴对阿尔茨海默病患者脑功能磁共振成像的影响[J];中国临床康复;2005年01期
8 梁繁荣,刘雨星,罗荣,赵纪岚,余曙光,夏晓红,陈瑾;不同针法对急性佐剂性关节炎大鼠下丘脑β-内啡肽的后效应观察[J];中国针灸;2004年11期
9 付平,贾建平,朱江,黄建军;针刺内关穴对机体不同功能状态下fMRI脑功能成像的影响[J];中国针灸;2005年11期
10 王苇,朱芳,漆剑频,夏业玲,夏黎明,王承缘;人脑对针刺与对指反应的实时动态功能MRI的对比研究[J];中华放射学杂志;2002年03期
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