Huang Haoming, Yue Xiaomei, Huang Xi, Long Wenjie, Kang Shangyu, Rao Yawen, Zeng Jingchun, Zuo Junling, Wang Lin, Li Hongjuan, Wang Yeqing, Qiu Shijun, Zhao Weixuan
The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Neurol. 2022 Jul 22;13:930753. doi: 10.3389/fneur.2022.930753. eCollection 2022.
Stomach 36 (ST36, ) is one of the important acupoints in acupuncture. Despite clinical functional magnetic resonance imaging (fMRI) studies of ST36 acupuncture, the brain activities and the neural mechanism following acupuncture at ST36 remain unclear.
Literature searches were conducted on online databases, including MEDLINE, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang database, WeiPu database, and China Biology Medicine, for task-based fMRI studies of acupuncture at ST36 in healthy subjects. Brain regions activated by ST36 acupuncture were systematically evaluated and subjected to seed-based mapping meta-analysis. Subgroup analysis was conducted on control procedures, manual acupuncture, electrical acupuncture (EA), and acupuncture-specific activations. Meta-regression analysis was performed to explore the effects of needle retention time on brain activities following ST36 acupuncture stimulation. The activated brain regions were further decoded and mapped on large-scale functional networks to further decipher the clinical relevance of acupuncturing at ST36.
A total of sixteen studies, involving a total of 401 right-handed healthy participants, that satisfied the inclusion criteria were included in the present meta-analysis. Meta-analysis showed that acupuncturing on ST36 positively activates the opercular part of the right inferior frontal gyrus (IFG.R), left superior temporal gyrus (STG.L), and right median cingulate/paracingulate gyri (MCG.R) regions. Needle retention time in an acupuncture session positively correlates with the activation of the left olfactory cortex, as shown in meta-regression analysis. Subgroup analysis revealed that EA stimulation may be a source of heterogeneity in the pooled results. Functional network mappings showed that the activated areas were mapped to the auditory network and salience network. Further functional decoding analysis showed that acupuncture on ST36 was associated with pain, secondary somatosensory, sound and language processing, and mood regulation.
Acupuncture at ST36 in healthy individuals positively activates the opercular part of IFG.R, STG.L, and MCG.R. The left olfactory cortex may exhibit positive needle retention time-dependent activities. Our findings may have clinical implications for acupuncture in analgesia, language processing, and mood disorders.
足三里（ST36）是针灸中的重要穴位之一。尽管已有关于ST36针刺的临床功能磁共振成像（fMRI）研究，但针刺ST36后的脑活动及神经机制仍不清楚。
在包括MEDLINE、Embase、Cochrane图书馆、科学网、中国知网、万方数据库、维普数据库和中国生物医学数据库在内的在线数据库中进行文献检索，以查找健康受试者中基于任务的ST36针刺fMRI研究。系统评估ST36针刺激活的脑区，并进行基于种子点的映射元分析。对对照程序、手针、电针（EA）和针刺特异性激活进行亚组分析。进行元回归分析以探讨留针时间对ST36针刺刺激后脑活动的影响。进一步对激活的脑区进行解码并映射到大规模功能网络上，以进一步解读针刺ST36的临床相关性。
本元分析共纳入16项研究，涉及401名右利手健康参与者，均符合纳入标准。元分析表明，针刺ST36可正向激活右侧额下回岛盖部（IFG.R）、左侧颞上回（STG.L）和右侧中央旁扣带回（MCG.R）区域。元回归分析显示，针刺过程中的留针时间与左侧嗅觉皮质的激活呈正相关。亚组分析表明，电针刺激可能是汇总结果中异质性的来源。功能网络映射显示，激活区域映射到听觉网络和突显网络。进一步的功能解码分析表明，针刺ST36与疼痛、二级体感、声音和语言处理以及情绪调节有关。
健康个体针刺ST36可正向激活IFG.R、STG.L和MCG.R的岛盖部。左侧嗅觉皮质可能呈现出与留针时间相关的正向活动。我们的研究结果可能对针刺在镇痛、语言处理和情绪障碍方面的临床应用具有启示意义。
