李晓陵 蔡丽娜 王丰

[摘要] 针刺三阴交穴在临床应用广泛，但其治疗机制缺乏客观依据。功能磁共振成像技术的发展，有助于揭示针刺的中枢效应，已成为近年来热点研究领域。本文搜集并阅读分析针刺三阴交穴脑功能磁共振成像的文献，分析比较机体在不同功能状态下针刺三阴交穴脑激活区，发现其研究内容主要集中在生理状态和病理状态下针刺单穴和组穴激活脑区的差异及作用机制。生理状态下針刺三阴交穴激活了特定脑区，证实了针刺腧穴具有相对特异性，针刺组穴的脑激活区不是针刺单穴脑激活区的简单叠加，虽有重叠，但亦存在差异。病理状态下针刺三阴交穴治疗疾病是通过多个脑区协同调节及中枢网络而发挥治疗作用。

[关键词] 针刺；三阴交穴；脑；功能磁共振成像

[中图分类号] R246 [文献标识码] A [文章编号] 1673-7210（2018）09（a）-0029-04

[Abstract] Acupuncture at sanyinjiao point is widely used in clinical practice， but its mechanism lacks objective basis. With the development of functional magnetic resonance imaging technology， the central mechanism of acupuncture is going to be revealed， which has become a hot research field in recent years. After collecting and analyzing the literature of the brain functional magnetic resonance imaging of acupuncture at the point of sanyinjiao， and comparing the brain functional imaging study of the body in different functional states， it is found that the main content of the study is mainly focused on the differences of the brain regions activated by acupuncture the single point and group points in the physiological and pathological conditions. Under physiological conditions， acupuncture at sanyinjiao point activates specific brain regions， confirming that acupuncture points have relative specificity. The brain activation area of acupuncture group points is not a simple superposition of acupuncture points. Although there is overlap， it also exists difference. Under pathological conditions， acupuncture at sanyinjiao point is used to treat diseases through multiple brain regions synergistic regulation and central network.

[Key words] Acupuncture； Sanyinjiao point； Brain； Functional magnetic resonance imaging

针刺指依据中医基础理论，按照一定针刺角度将毫针刺入患者腧穴，使患者产生得气感，以此治疗疾病，临床应用甚广[1]。功能磁共振成像（functional magnetic resonance imaging，fMRI）技术的发展，有助于我们全面多方位揭示针刺中枢机制[2]。fMRI技术探讨针刺腧穴效应机制是近几年的热点研究领域[3-4]，其将针刺和磁共振成像技术相结合[5]，广泛应用于穴位针刺的中枢神经系统研究[6-7]。血氧水平依赖功能磁共振成像技术（blood oxygenation level dependent fMRI，BOLD-fMRI）[8]可无损伤地监测神经元活动时引起周围组织血流动力学的改变而成像，具有非侵入性、时空分辨率高、结构和功能同时成像等优点[9-10]，是目前进行脑功能网络研究最常用最有效的技术手段之一。……