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1、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李腊梅1，李学智1，吕发金2，郭仲杰2，宋云娥1，谢洪武1，唐曦1（400016重庆，重庆医科大学：中医药学院1，附属第一医院影像科2）[摘要]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BOLD扫描，计算并比较各组低频振幅（a
2、mplitudeoflowfrequencyfluctuation，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
3、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。[关键词]体质；针刺效应；磁共振成像；低频振幅[中图法分类号][文献标志码]AInfluenceofdifferentsensitiveconstitutiononacupunctureanalgesiaeffectanditsCNSmodulatingmechanism:Aresting-statefMRIstudyLiLamei,LiXuezhi,LvFajin,GuoZhongjie,SongYune,XieHon
4、gwu,TangXi(CollegeofChineseMedicine,ChongqingMedicalUniversity,Chongqing,40016,China)[Abstract]ObjectiveToobservetheanalgesiaeffectindifferentsensitiveconstitutionandstudyitscentralnervemodulatingmechanism.MethodsaccordingtoTCMtheoryonconstitution,45healthyvolun
5、teerswereselectedanddividedintothreetypicalgroups,theyareinsensitivegroup,normalgroupandsensitivegroup,15caseseachgroup.Measuredthepressurepainthreshold(PPT)beforeandafteracupunctureatZusanlipoint,Thenpairedttestwasusedtocomparetheeffectofanalgesiaineachgroup.Tw
6、oweekslater,resting-stateBOLDfMRIscanswereobtainedbyusingagradient-echoecho-planarimagingsequencebeforeandafteracupunctureatST36.AllthefMRIdatawereanalyzedbythemethodofamplitudeoflowfrequencyfluctuation(ALFF).Pairedt-testwasusedtoanalyzethedataacquiredbeforeanda
7、fteracupuncture.Results1.ComparedthePPTbeforeandafteracupuncture,normalgroupandsensitivegrouphadobviousstatisticalsignificanceexceptinsensitivegroup.2.Comparedwiththeimagebeforeacupuncture,theinsensitivegroupshowedsignificantdecreasedALFFvaluesintheleftfusiformg
8、yrusandtheleftinferiortemporalgyrus.ThenormalgrouphadsignificantlyincreasedALFFvaluesinthebilateralcerebellumposteriorlobe,brainstem,limbiclobe,leftinferiortemporalgy
