针刺足三里穴对大脑运动皮层兴奋性和抑制性的影响

发布时间：2018-05-04 23:17

  本文选题：经颅磁刺激(TMS) + 足三里穴(ST36)　； 参考：《上海体育学院》2016年硕士论文

【摘要】：研究目的:针刺的作用机制一直是国内外学者研究的热点。大脑运动皮层兴奋性和抑制性可以作为研究针刺机制的一个有意义的指标,但在这方面的研究还较少。所以本研究使用经颅磁刺激探讨针刺足三里穴对大脑运动皮层兴奋性和抑制性的影响,并与针刺非穴位对比,以此来探讨针刺的作用机制,为针刺的临床应用提供神经学理论依据。研究方法:招募并筛选出40名健康受试者。本研究共包括两个实验,每个实验随机选取20名受试者。实验选取针刺右侧足三里穴,并选其非穴位作为对照。所有受试者在针刺时使用得气量表对得气感进行量化。实验一研究针刺足三里对大脑运动皮层兴奋性的影响,在针刺过程中测试针刺前,针刺后即刻、针刺后4分钟、针刺后8分钟、拔针后即刻、拔针后4分钟和拔针后8分钟的运动诱发电位振幅(MEP)。实验二研究针刺足三里对大脑运动皮层抑制性的影响,在针刺过程中,测试针刺前、针刺后即刻和拔针后即刻的短间隔抑制(SICI)和长间隔抑制(LICI)。所有数据均采用Spike2和SPSS20.0软件分析处理。研究结果:(1)得气量表发现针刺足三里时,所有受试者得气感平均得分比针刺非穴位时高,且具有显著差异性,在酸麻胀重痛每个感觉比较时也具有显著差异性(P0.05)。(2)实验一研究发现针刺足三里后即刻、针刺后4分钟和拔针后即刻相比静息时MEP振幅大,且具有显著差异性(P0.05)。针刺非穴位时,其余时间点的MEP振幅相比静息时MEP振幅没有显著差异性。比较针刺过程中相同时间点足三里和非穴位的MEP振幅,发现其中在针刺后即刻、针刺后4分钟这二个时间点,足三里比非穴位的MEP振幅大,且具有显著差异性(P0.05),实验一说明针刺足三里相比非穴位可以特异性的影响大脑运动皮层兴奋性。(3)实验二研究发现针刺足三里过程中,针刺足三里后即刻的SICI和LICI相比静息时降低,且具有显著差异性(P0.05)。针刺非穴位过程中,针刺非穴位后即刻相比静息时SICI和LICI有所降低,但无显著差异性。实验二说明针刺足三里可以降低大脑运动皮层的抑制性。研究结论:针刺足三里穴相比非穴位能特异性的影响MEP振幅,即增强了大脑运动皮层兴奋性,并且在针刺后具有后续效应。针刺足三里也能影响大脑运动皮层的SICI和LICI,即降低了大脑运动皮层抑制性。得气与否是针刺产生疗效的关键,也是针刺穴位相比非穴位产生特异性的关键。
[Abstract]:Objective: the action mechanism of acupuncture has been a hot topic for scholars at home and abroad. Excitability and inhibition of cerebral motor cortex can be used as a meaningful index to study the mechanism of acupuncture, but there are few researches in this field. So this study used transcranial magnetic stimulation to explore the effect of acupuncture on excitability and inhibition of cerebral motor cortex, and compared with acupuncture at non-acupoints to explore the mechanism of acupuncture. To provide the nerve theory basis for the clinical application of acupuncture. Methods: 40 healthy subjects were recruited and selected. This study consists of two experiments, 20 subjects were randomly selected from each experiment. Acupuncture at Zusanli (right side) was selected and non-acupoints were selected as control. All subjects used the Qi scale to quantify the feeling of Qi. The first experiment was to study the effect of acupuncture on excitability of cerebral motor cortex. In the process of acupuncture, we tested the excitability of acupuncture before, immediately after acupuncture, 4 minutes after acupuncture, 8 minutes after acupuncture, and immediately after acupuncture. The amplitude of motor evoked potential (MEP) was measured 4 minutes after needle extraction and 8 minutes after needle extraction. The second experiment was to study the effect of acupuncture on the inhibitory effect of Zusanli on the inhibition of cerebral motor cortex. In the process of acupuncture, the short interval inhibition (SICI) and long interval inhibition (LICI) before, immediately after and immediately after acupuncture were tested. All data were analyzed and processed by Spike2 and SPSS20.0 software. The results of the study showed that the average score of Qi sensation of all subjects was higher than that of non-acupoint acupuncture when acupuncture was applied to Zusanli, and there was significant difference between them. There was also significant difference in each sensation of acid-flax distention pain (P0.05N. 2) Experimental 1 found that the amplitude of MEP was larger immediately after acupuncture at Zusanli, 4 minutes after acupuncture and 4 minutes after acupuncture than that at rest, and there was significant difference in amplitude of MEP between the two groups (P 0.05). There was no significant difference in the amplitude of MEP between the rest of the time points and the rest of the time when acupuncture was not at acupoint. Comparing the MEP amplitudes of Zusanli and non-acupoints at the same time point during acupuncture, it was found that the amplitude of MEP in Zusanli was larger than that at non-acupoint at two time points: immediately after acupuncture and 4 minutes after acupuncture. The experiment 1 shows that acupuncture at Zusanli can specifically affect the excitability of cerebral motor cortex compared with non-acupoints. Experiment 2 shows that acupuncture in Zusanli can affect the excitability of cerebral motor cortex in the process of acupuncture. The SICI of Zusanli immediately after acupuncture was lower than that of LICI at rest, and the difference was significant (P 0.05). In the process of acupuncture, the SICI and LICI were lower immediately after acupuncture than at rest, but there was no significant difference. Experiment 2 shows that acupuncture in Zusanli can reduce the inhibition of cerebral motor cortex. Conclusion: acupuncture at Zusanli (Zusanli) has a specific effect on the amplitude of MEP, that is, it enhances the excitability of cerebral motor cortex and has a follow-up effect after acupuncture. Acupuncture at Zusanli also affects the SICI and LICI of the motor cortex, which reduces the inhibition of the motor cortex. Qi is the key to the therapeutic effect of acupuncture and the specificity of acupuncture points compared with non-acupoints.
【学位授予单位】：上海体育学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246
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本文编号：1845117