本文選題：經(jīng)顱磁刺激(TMS) + 足三里穴(ST36)　； 參考：《上海體育學(xué)院》2016年碩士論文

【摘要】：研究目的:針刺的作用機(jī)制一直是國內(nèi)外學(xué)者研究的熱點。大腦運(yùn)動皮層興奮性和抑制性可以作為研究針刺機(jī)制的一個有意義的指標(biāo),但在這方面的研究還較少。所以本研究使用經(jīng)顱磁刺激探討針刺足三里穴對大腦運(yùn)動皮層興奮性和抑制性的影響,并與針刺非穴位對比,以此來探討針刺的作用機(jī)制,為針刺的臨床應(yīng)用提供神經(jīng)學(xué)理論依據(jù)。研究方法:招募并篩選出40名健康受試者。本研究共包括兩個實驗,每個實驗隨機(jī)選取20名受試者。實驗選取針刺右側(cè)足三里穴,并選其非穴位作為對照。所有受試者在針刺時使用得氣量表對得氣感進(jìn)行量化。實驗一研究針刺足三里對大腦運(yùn)動皮層興奮性的影響,在針刺過程中測試針刺前,針刺后即刻、針刺后4分鐘、針刺后8分鐘、拔針后即刻、拔針后4分鐘和拔針后8分鐘的運(yùn)動誘發(fā)電位振幅(MEP)。實驗二研究針刺足三里對大腦運(yùn)動皮層抑制性的影響,在針刺過程中,測試針刺前、針刺后即刻和拔針后即刻的短間隔抑制(SICI)和長間隔抑制(LICI)。所有數(shù)據(jù)均采用Spike2和SPSS20.0軟件分析處理。研究結(jié)果:(1)得氣量表發(fā)現(xiàn)針刺足三里時,所有受試者得氣感平均得分比針刺非穴位時高,且具有顯著差異性,在酸麻脹重痛每個感覺比較時也具有顯著差異性(P0.05)。(2)實驗一研究發(fā)現(xiàn)針刺足三里后即刻、針刺后4分鐘和拔針后即刻相比靜息時MEP振幅大,且具有顯著差異性(P0.05)。針刺非穴位時,其余時間點的MEP振幅相比靜息時MEP振幅沒有顯著差異性。比較針刺過程中相同時間點足三里和非穴位的MEP振幅,發(fā)現(xiàn)其中在針刺后即刻、針刺后4分鐘這二個時間點,足三里比非穴位的MEP振幅大,且具有顯著差異性(P0.05),實驗一說明針刺足三里相比非穴位可以特異性的影響大腦運(yùn)動皮層興奮性。(3)實驗二研究發(fā)現(xiàn)針刺足三里過程中,針刺足三里后即刻的SICI和LICI相比靜息時降低,且具有顯著差異性(P0.05)。針刺非穴位過程中,針刺非穴位后即刻相比靜息時SICI和LICI有所降低,但無顯著差異性。實驗二說明針刺足三里可以降低大腦運(yùn)動皮層的抑制性。研究結(jié)論:針刺足三里穴相比非穴位能特異性的影響MEP振幅,即增強(qiáng)了大腦運(yùn)動皮層興奮性,并且在針刺后具有后續(xù)效應(yīng)。針刺足三里也能影響大腦運(yùn)動皮層的SICI和LICI,即降低了大腦運(yùn)動皮層抑制性。得氣與否是針刺產(chǎn)生療效的關(guān)鍵,也是針刺穴位相比非穴位產(chǎn)生特異性的關(guān)鍵。
[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.
【學(xué)位授予單位】：上海體育學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246
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本文編號：1845117