The Effect On Cerebral Functional Areas By Acupuncture At Zushanli In Hemorrhagic Stroke Patients :an FMRI Study

Objective: Based on the“treat flaccidity alone to take YangMing”theory,using functional magnetic resonance imaging to observe the change of brain function in the process of acupuncture effect when the brain function is in different states.Objective to investigate the effect of acupuncture at Zusanli(ST 36)on brain function in patients with hemorrhagic stroke,to explore the effect of brain center on the mechanism of acupuncture and to provide the reference for the correlation between meridian and brain.Methods:Grouping:According to different states of brain function,including the central nervous fiber optic nerve conduction disorder group(experimental group)and the central nerve fiber conduction normal group(normal group).There were 12 patients with basal ganglia hemorrhage and right hemiplegia in the experimental group,there were 12 healthy volunteers in the normal group.Set point:Two groups of subjects on the right side of Zusanli(the experimental side of the right side),Their 2-5 refers to the proximal interphalangeal joint at the middle of the horizontal width of the horizontal width of the external knee at present 3inches and their width of the middle finger is taken from the front edge of the tibia.Needle:Sterling Silver needle(0.40mm×40mm).Data acquisition:using of SIEMENS Aera1.5T superconducting magnetic resonance imaging system,20 channel head coil and a combination of anti noise earplugs,goggles.Based on the classical block design model,after the start of the scan4120 s acupuncture needle into the “de qi”,rest for 30 s,twirling and reinforcing and reducing manipulation for 30 s,Such operation need repeat 3 times.Data processing:The BOLD-fMRI image information is transferred to a computer with Matlab and SPM8 software for post-processing,the results of the experiment on the data of the experiment data that do not exceed the standard of motion correction.The results of the normal group and experimental group using paired T test,the results of the experimental group were compared with the two sample T test,next statistical threshold probability is set to P<0.001,more than 5regions of continuous activation pixels are considered as meaningful activation regions.At the end of acupuncture,the score of "de qi" was recorded and evaluated,as shown in Table 3.Results:(1)In the normal group,12 patients had mild pain in 1 cases,there were 8 cases of acid expansion,and in the other 3 cases of expansion.score of "de qi" Contain acid4.75±1.836,expansion6.82±1.537.fMRI showed that the active brain area was:Right cingulate cortex(BA30),Left superior frontal gyrus(BA10)and Posterior central parietal lobe.(2)There were 12 patients in the experimental group,who were not fit for the experiment in 2 cases,none of the 6 patients had any feeling in the remaining 10 patients.There were 4 cases of conscious foreign body stimulation of the lower limb,but no pain or other sensations.score of "de qi" is 0.fMRI didn’t showed active brain areas.(3)The normal group was compared with the experimental group,fMRI showed that the active brain area was:Left putamen,Left anterior occipital lobe,Left medial frontal gyrus,Left brain white matter and left middle frontal gyrus(BA46).Conclusion:(1)In the normal state of the central nerve fibers,acupuncture on the right side of the normal healthy subjects had a better sense of "de qi",the effective activation area is related to the limbic system,somatosensory center and cognitive function.(2)In the disorder state of the central nerve fibers,no effective activation of thebrain function area when acupuncture at Zusanli point had a poor sense of "de qi" on patients with hemorrhagic stroke on the right side.(3)Comparison between healthy subjects and patients with hemorrhagic stroke(right hemiparesis and sensory loss),acupuncture may be related to the cognitive function of the brain and the activation area on the left side may be related to the function of the nerve fibers to control the movement of the ipsilateral limb.(4)The above results suggest:The Qi of acupoints may be related to the integrity of central nerve fiber conduction;Acupuncture points on the left limb of patients with hemorrhagic stroke can treat right hemiplegia.