The Study Of Central Mechanism Of Electric-Acupuncture At Zusanli(ST36) For Gastric Mucous Membrane Protection With FMRI And Biochemistry

The therapy value of acupuncture is being increasingly accepted all over the world.However,the development and application of acupuncture is limited in the modern medicine for its mechanism remaining unclear.Recently,some researchers suggested that acupuncture firstly activate certain areas and multiple systems,and then above activated regions stimulate neurotransmitters release to control the target organ.Also the hypothesis was not clearly elucidated.Therefore,our experiment selected Zusanli,a widely used meridian point in gastrointestinal disease treatment, and investigated central mechanism and neural pathways of stomach and Zusanli using fMRI and Biochemistry simultaneously.Purpose1.To observe the change regulation of ET,CGRP,GAS,PGE₂.of normal adult after Electric-acupuncture(EA)at ST36,and analyze the network relations among them and the relations between them and gastric membrane function.2.To acquire brain activation maps induced by EA at ST36 with BOLD -fMRI. The relationship between the change of brain function and the protection of gastric mucous membrane was analyzed,the possible central mechanisms was investigated.3.To explore the underlying central mechanisms of gastric mucous membrane protection induced by EA at ST36,by jointly analyzing the fMRI data and change of gastrointestinal hormone in peripheral blood.In addition,to provide the proof for the further study of acupuncture therapeutic mechanismsMethods 1.Young volunteer(n=31)were divided in two group,one group(n=16) accepted real Electric-acupuncture(EA)at ST36,the others(n=15)accepted EA at sham acupuncture.Nighteen of them(n=16 of real EA group,n=3 of Sham EA group) underwent fMRI scan and were sampled peripheral blood.2.fMRI data were collected while real EA at ST36 or sham EA in right leg with single Block Design.Sham acupuncture point is in medial side of ST36.The subjects were required to complete Acupuncture Sense Questionnaire which described they filling while manipulating needle and estimated the extent of the acupuncture sense3.Examinations of factors involved in gastric mucous membrane function: peripheral blood sample were collected at certain timepoint before and after the EA, then ET,CGRP,GAS and PGE₂ were detected by suing radioimmunoassay(RIA)4.Data analyze software:SPSS13.0 was introduced to anayse the biochemic data of peripheral blood,STAI and Acupunture Sense Questionnaire.fMRI data were analyzed with statistical parametric mapping(SPM2).5.Jointly analyzing the fMRI data and change regulation of gastrointestinal hormone in peripheral blood to explore the underlying central mechanism.Result1.Acupuncture Sense Questionnaire showed real EA group has significantly higher acupuncture sense score than sham EA group(p＜0.01).2.The change regulations of gastric mucous membrane function related factors: in real EA group CGRP,PGE₂ in post-EA period are remarkable higher than pre-EA (p＜0.01),reaching the peak at 25min;ET,GAS in post-EA period are much lower than pre-EA(p＜0.01),reaching the lowest point at 25min,3.Relationship of gastric mucous membrane function related factors:in real EA group,ET is negatively correlated with CGRP during the post-EA period;PGE₂ is negatively correlated with GAS during the post-EA period.4.fMRI data demonstrates significantly activation in the contralateral precentral and postcentral gyri,hypothalamus,hippocampus,superior and middle temporal gyri,medial and superior frontal gyri,paracentral lobule,inferior parietal lobule;and ipsiolateral post cingulate gyrus,lentiform nucleus,Bibateral insula,cerebellum.The regions concerned with gastric mucous membrane function are hypothalamus,thalamus,lentiform nucleus,amygdale,hippoeampus,insularConclusion1.Stimulation at ST36 can enhance the gastric mucous membrane protective factors(CGRP and PGE2)relase,and decrease destructive factors(ET and GAS)in peripheral blood.The considerable protection on gastric mucosa induced by EA at ST 36 is achieved partly by regulating CGRP,PGE2,ET and GAS,which act upon each other to exert the protection function.2.Acupuncture at ST36 resulted in certain brain regions blood flow change, which can be displayed as activation map with BOLD-fMRI.Stimulation of acupoint ST36 by EA activated different parts of the autonomic nerve system:hypothalamus, hippocampus,paracentral lobule,post cingulate gyrus,insula,lentiform nucleus,et al. The above regions are correlated with gastric function.3.Jointly analyzing the fMRI data and change of gastrointestinal hormone in peripheral blood,the underlying central mechanisms of gastric mucous membrane protection induced by EA at ST36 is that acupuncture activates certain areas and multiple systems,which can stimulate neurotransmitters release,then regulate the peripheral humoral factors to achive the protection on the gastric mucous membrane.