Specific effects of needling different acupoints of patients with vascular dementia

摘要

目的

运用脑功能成像技术, 研究不同穴位针刺前后, 血맜性痴呆 (VD) 患者大脑皮层葡萄糖代谢的变化。

方法

25 例VD病人, 随机分为5 组。 A组治以针对偏瘫的常规穴位 (手足三阳经为主), B组加用百会, C组加用水沟, D组加用神门, E组加用百会、 水沟和神门。 治疗前后, 所有病人均接受正电子发射型计算机断层显像 (PET) 检测。 划定VD患者双侧额叶 (眶回)、 双侧顶叶、 双侧颞叶 (海马及海马旁回) 、 双侧枕叶、 双侧丘脑、 双侧豆状核、 双侧尾核、 双侧扣带回、 双侧小脑为感兴趣区。

结果

针刺偏瘫的常规穴位, 豆状核和颞叶葡萄糖代谢升高; 针刺百会穴额叶、 颞叶和豆状核葡萄糖代谢升高, 针刺水沟穴则额叶、 丘脑和豆状核升高, 针刺神门穴顶叶和豆状核升高, 同时针刺三穴, 额叶、 颞叶、 丘脑和豆状核等不同脑区葡萄糖代谢升高。

结论

百会、 水沟、 神门对不同脑功能区的葡萄糖代谢产生不同的影响, 在脑区有着不同的作用侧重。

Abstract

Objective

To observe the effects of needling Baihui (GV 20), Shuigou (GV 26) and Shenmen (HT 7) on cerebral glucose metabolism in patients with vascular dementia (VD) by cerebral functional imaging technique.

Methods

Twenty-five patients with VD were divided into 5 groups (Group A, B, C, D and E) randomly. Patients in the Group A were treated by needling routine acupoints for hemiplegia (Acupoints of the three yang meridians of hand and foot), and besides the routine acupoints, patients in the Group B were treated by needling Baihui(GV 20), the Group C by Shuigou(GV 26), the Group D by Shenmen(HT 7), and the Group E by Baihui(GV 20), Shuigou(GV 26), and Shenmen(HT 7). All the patients were examined by Positron Emission Tomography (PET) to detect the cerebral glucose metabolism in the bilateral frontal lobes(orbital gyri), parietal lobes, temporal lobes(hippocampus and hippocampal gyrus), occipital lobes, thalamus, lentiform nucleus, caudate nuclei, cingulate gyrus and cerebellum before treatments and after treatments.

Results

After needling the routine acupoints for hemiplegia, glucose metabolism increased in lentiform nucleus and temporal lobe; needling Baihui(GV 20), increased in frontal lobe, temporal lobe and lentiform nucleus; needling Shuigou(GV 26), increased in frontal lobe, thalamus and lentiform nucleus; needling Shenmen(HT 7), increased in parietal lobe and lentiform nucleus; and needling these three acupoints, increased in frontal lobe, temporal lobe, thalamus and lentiform nucleus.

Conclusion

Needling Baihui(GV 20), Shuigou(GV 26) and Shenmen(HT 7) affect glucose metabolism in different functional regions of the brain, and Baihui(GV 20), Shuigou(GV26) and Shenmen(HT 7) relate to different functional regions of the brain.