【摘要】：目的 通過功能性磁共振成像技術(shù)（fMRI），觀察針刺列缺穴對正常人和頸椎病患者的腦功能成像影響的異同，探索針刺列缺穴治療頸椎病與腦功能激活區(qū)之間的內(nèi)在聯(lián)系，以揭示針刺列缺穴治療頸椎病的可能機制。 方法 正常組20例（均為湖北中醫(yī)藥大學在校學生及社會中征集的志愿者，2012年5月--2012年12月），男性12例，女性8例。年齡22～55歲，平均年齡30±1.4歲；頸椎病患者組20例（均為武漢市第一醫(yī)院針灸科門診病人，2012年5月--2012年12月），男性11例，女性9例。年齡22～55歲，平均年齡32±1.5歲。 全部受試者均為右利手，選取右側(cè)的列缺穴進行針刺刺激。所有受試者均由同一位具有豐富針刺經(jīng)驗的針灸醫(yī)師施行針刺。針灸醫(yī)師采用無菌不銹鋼針進行針刺，進針深度為0.5～0.8寸，得氣后采用平補平瀉手法行針。 應(yīng)用美國通用電氣公司3.0T GE signa HDXT MRI系統(tǒng)的血氧水平依賴性磁共振成像技術(shù)，觀察針刺前及針刺過程中所有受試者的腦功能區(qū)的變化。采用EPI序列掃描，參數(shù)為：TR=3000ms,TE=40ms,FA=90°,掃描矩陣96×96，層厚5mm，層距0mm，每3秒獲得覆蓋全腦的29層圖像，共掃描6分24秒，獲得靜息態(tài)的腦功能成像和針刺后的腦功能激活區(qū)。并將實驗獲得的數(shù)據(jù)進行統(tǒng)計分析。利用SPM8軟件對數(shù)據(jù)進行后處理、統(tǒng)計、分析，對單個被試數(shù)據(jù)進行組內(nèi)分析，設(shè)定統(tǒng)計閾值為p㩳0.05，設(shè)定未經(jīng)校正的激活范圍閾值為10個像素，即考慮為有意義的激活區(qū)是連續(xù)激活像素到達10個以上的區(qū)域。然后對對照組和試驗組數(shù)據(jù)分別的進行單樣本t檢驗，其統(tǒng)計閾值設(shè)定為p0.05，，多重比較使用Alphasim校正。 結(jié)果 1.正常組和頸椎病患者組分別有2例和1例實驗對象，由于實驗過程中頭部晃動過大而被剔除。 2.正常組針刺列缺穴后主要激活了雙側(cè)的頂下小葉、中央前回、中央后回、顳上回、顳中回和額下回，以及左側(cè)島葉和左側(cè)緣上回（按照被激活腦區(qū)的體素值大小依次排序）。 3.頸椎病患者組針刺列缺穴后主要激活了雙側(cè)的小腦、頂下小葉、中央前回、顳上回、枕葉。以及左側(cè)大腦的顳中回和中央后回（按照被激活腦區(qū)的體素值大小依次排序）。 結(jié)論 針刺列缺穴對正常人腦部功能區(qū)域的激活不是特定的某一個區(qū)域，而是可以激活多個腦功能區(qū)，并且其激活的腦功能區(qū)與其主治的病癥有著一定的相關(guān)性。頸椎病患者與正常者的腦功能激活區(qū)有著諸多的相同，但頸椎病患者的腦功能激活區(qū)有其特異性，推測可能是針刺列缺穴對頸椎病患者起到的治療效果的特定腦功能區(qū)。
[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 鹵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 擄, 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.
【學位授予單位】：湖北中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R246.9;R445.2

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