Zhang Zhuang, Wang Yafeng, Sun Junjun, Hu Nijuan, Wu Guiwen, Hu Shangqing, Wang Pei, Zhao Minyi, Ma Liangxiao, Zhu Jiang
Beijing University of CM, Beijing 100029, China.
Department of Acupuncture and Moxibustion, Changzhou City First People's Hospital.
Zhongguo Zhen Jiu. 2018 Apr 12;38(4):445-50. doi: 10.13703/j.0255-2930.2018.04.029.
The research regarding the central mechanism of acupuncture (arrival of ) based on functional magnetic resonance imaging (fMRI) in recent 10 years was analyzed to summarize existing research achievements and experience.
The literature regarding fMRI-based research published from January of 2007 through December of 2016 in CNKI and PubMed databases was collected. The research content and methods, including research design, inclusion criteria, acupoint selection and evaluation, were analyzed.
Totally 18 articles regarding the central mechanism of acupuncture based on fMRI was included. According to research content, the literature was divided into two categories: research and sensation research. In research, the differences of and not on brain functional activity were compared to summarize the central response pattern of ; in sensation research, the differences of different sensations and intensities of on central response were compared to explore the effects of different sensations and intensities of on brain functional activity. In recent 10 years, the number of research gradually increased, and the type of design was various, mainly RCT and paired design. The majority of participants was healthy people, and single acupoint was the focus of researches, including Zusanli (ST 36), Waiguan (TE 5), Hegu (LI 4), etc. The evaluation of was based on visual analogue scale (VAS). The research contents were mainly the effects of and not and different sensations on brain function activities. The present studies confirmed that and not as well as different sensations had different impacts on brain functional effects, and different acupoints had specific activated brain areas. There was a positive correlation between the degree of and the intensity of the activation of brain regions. Furthermore, tingling sensation was not included to sensations.
The number and quality of fMRI-based research need to be improved; the research content is simple, and research method is in exploratory stage. The results obtained in the literature are the phenomena of in the central level, and it is imperative to summarize the essential link between and the central effect through these phenomena to reveal the mechanism of . The specific impact of for brain function needs more clinical exploration.
分析近10年基于功能磁共振成像（fMRI）对针刺中枢机制的研究，总结现有研究成果与经验。
收集2007年1月至2016年12月在CNKI和PubMed数据库发表的基于fMRI的研究文献。分析研究内容与方法，包括研究设计、纳入标准、穴位选择与评估。
共纳入18篇基于fMRI的针刺中枢机制研究文献。根据研究内容，文献分为两类：针刺效应研究和针感研究。在针刺效应研究中，比较针刺与非针刺对脑功能活动的差异，总结针刺的中枢反应模式；在针感研究中，比较不同针感及强度对中枢反应的差异，探讨不同针感及强度对脑功能活动的影响。近10年，研究数量逐渐增加，设计类型多样，主要为随机对照试验（RCT）和配对设计。多数研究对象为健康人，单穴位是研究重点，包括足三里（ST 36）、外关（TE 5）、合谷（LI 4）等。针刺评估基于视觉模拟评分法（VAS）。研究内容主要为针刺与非针刺及不同针感对脑功能活动的影响。现有研究证实，针刺与非针刺以及不同针感对脑功能效应有不同影响，不同穴位有特定的脑激活区域。针刺程度与脑区激活强度呈正相关。此外，麻感未纳入针感范畴。
基于fMRI的针刺研究数量和质量有待提高；研究内容单一，研究方法尚处于探索阶段。文献所得结果是针刺在中枢层面的现象，需通过这些现象总结针刺与中枢效应的本质联系以揭示针刺机制。针刺对脑功能的具体影响需更多临床探索。
