| Background:The traditional acupuncture theory regards meridians as the pathways of the body where blood and qi running.Each organ of the human body has its own channel,through which there is a certain pathway and a certain number of acupoints are distributed,that is called meridian.Acupoints are the location where meridians and organ qi originated and transported.The original meaning of acupoints are "cavitations","issued by the gas pulse," thousands of years' clinical use powerfully confirmed of the efficiency of acupoints.Acupuncture or moxibustion can be used to play the role of the corresponding meridians so as to regulate blood and viscera,the body exert resistance inherent capability to meet the purpose of disease prevention and treatment.Acupoints have relative specificity when compared with non-acupoints in morphology,biophysical properties,pathological response, stimulating effect and its surrounding areas.Specilific is the differences in function between different acupoints,acupoints and non-acupuncture points.That is certain acupoint has obvious curative effect to a certain disease or systematic diseases. Scholars of our country made a lot of clinical and basic research in the specilific of acpoints by using modern science and technology and methods on the structure and function of acupoints,meridian-organ theory,and put forward new ideas for research and technological supporting on the main factors affecting acupoints' effects. 1.Research of the structure of acupoints is based on acupoints' specilific.Zhenguo Yan proposed that the distribution of nerves,vessels and lymphs are not the same in acupoints by researching the micro-structure of Zusanli(ST36),Hegu(LI4), Neiguan(PC6),Shenmen(HT7),etc.These structures in different points have different special emphases in fuction.2.In recent years,Chinese scholars did a lot of work in researching biophysical characteristics of acupoits by using modern science and technology.Some researcher discussed the specific of acupoints in the view of physics by using voltammetric techniques and researched different ancupoints of the voltage response to current changes.3.Researchers started from the relative special connections between acupoints and organs and they finally confirmed the specific of certain acupoint in treating disease of zang-fu organs by researching the comparison between electric acupuncture and acupuncture in treating urethral syndromes as well as the function of Jueyin meridian on heart.Waiguan(SJ5) is one of the eight-extrameridian points,belonging to Sanjiao Meridian of Hand-Shaoyang and connects Yangwei meridian.It lies 2 cun beyond Yangchi(SJ4) in the middle of the wrist transcantion of the forearm between radial and ulnar.Wai means external,guan means barrier.Waiguan means the place the blood and qi of Sanjiao meridian extents and the external blood was not allowed into the barriers,lts therapeutic effects can be summarized as 1.the treatment of diseases of upper limbs,such as upper limb paralysis,shoulder and arm pain,adverse brachiumflexion and extension etc;2.the treatment of diseases along the meridian such as headache,deafness,tinnitus,conjunctival congestion,pain flank;3.the treatment of Exogenous Febrile Disease,triple burner,such as air-adverse.FMRI(Functional Magnetic Resonance Imaging,fMRI) technology is a non-invasive detection methods,with non-invasive nature of individual research subjects and patients repeatability,near sub-millimeter spatial resolution,1s around effective temporal resolution,flexible programming,such as cognitive advantages. The technology used in the study of brain function is a measure of brain activation associated with metabolite concentrations,blood oxygen concentration and hemodynamic changes in the MR signal intensity changes,Hoxygen-dependent-Brain Imaging(Blood Oxygenation Level Dependent-fMRl,BOLD-fMRI). Technology reflccts the effects of the external stimulation to the brain by means of imaging technology that researched external stimulus to change the oxygen concentration in the brain,different magnetic rate of combined hemoglobin and deoxy-hemoglobin oxygen,fMRI technology has been used in acupuncture research. In research of the relationship of Zusanli(ST36),Taichong(LR3),Quchi(LI11) to brain,results were obtained in the research of diseases such as depression,vascular dementia,senile dementia,ischemic stroke.Based on the above,the group first proposed "Meridian specific-brain related theory".The hypothesis thinks there is activated directivity of brain areas in acupoints as well as effects gained after achieved qi.And the "Meridian-specific model of brain function to define" is proposed.Through the acupunct of Waiguan and non-acupoint(group formulate acupoints,positioning in the middle of Sanjiao and small intestine,bilateral to Waiguan(SJ5),the same below) for fMRI brain imaging study to the subject set up "by points to define model-specific brain function, "later to lay a foundation,which can distinguish the acupoints and non-acupoints with objective,form and regulate.Objective To use fMRI brain imaging technology to study the real acupuncture or sham acupuncture Waiguan(SJ5) or non-points that activate different brain regions of healthy young volunteers.We obtained objective evidence of "specific meridians-the brain-related hypothesis",which lay a solid foundation of the latter issue-oriented "Meridian-specific brain function defined model". Meanwhile,other points for further research to provide the specific experience.The ultimate goal isto optimize the acupuncture prescription to guide clinical practice and improve clinical efficacy,such as to provide more scientific and objective technical support.Methods Time:the experiment begins in October 2007 and ends in December 2008,for a total of 14 months to complete.Location:Imaging Center-GE 3.0T magnetic resonance Detect room in South hospital.Volunteer Screening:First, selected volunteers from colleges and universities in Guangzhou,and then selected volunteers apply to the experiment strictly from the primary volunteers according to inclusion and exclusion conditions for the second time.Finally,24 cases best suits the requirements of this task were selected as healthy volunteers,12 male and 12 female, aged 21-27 years old,weighted at 45-70 kg,heighted at 155-183cm.Experimental process:the 24 cases were randomly divided into four groups,6 cases in each group. That is Waiguan acupuncture group,Waiguan(SJ5) sham-acupuncture group, non-point acupuncture group and non-point sham acupuncture group,and each group is stimulated separately.During acupuncture,3.0T superconducting MRI systems produced by General Electric Company(General Electric Company,GE)of the United States is used to scan the 24 volunteers on brain.Acupuncture and magnetic resonance is operated by acupuncturist and MRI technicians.During the acupuncture process,BOLD functional MRI technology of brain imaging is done in order to obtain dynamic activity in different brain regions.Needle:silver needle which will not be influenced by the magnetic resonance machine.Acupoint Location:Choose Waiguan on the right side of the body which lies 2 cun beyond Yangchi(SJ4) in the middle of the wrist transcantion of the forearm between radial and ulnar. Non-acupoint on the right side as above.Disinfection:disinfect the local parts of each acupoint for 3 times within a 3cm diameter.All the needles we used are tube needles. Acupuncture methods:insert 15±2mm deep.Using even tonification and reduction,twist the needle in accordance with the Block Designed,twist the needle 30s after cessation of stimulation 30s,after twisting the needle 30s,such a stimulus and resting alternating,repeated 6 times,sham acupuncture:Point positioning, disinfection method,needles used were as above.Needles exposed casing 1mm, touch the skin softly and light the needle shank 30s later,so that needles left the skin surface,pin down the handle again 30s later with needles 1mm exposed,touch the skin softly.Repeated 6 times and same model was used to stimulate the Block.fMRI detection methods:volunteers were required to have a rest for 10 minutes in a closed case of audio-visual before they were inspected.Using GE 3.0T superconducting magnetic resonance imaging system,set up a set of parameters required by the experiment,and each volunteer had a fMRI brain scan according to the parameters. Finally use SPM2 software to analysis and handled the image datas obtained by the expert.In the standard objective brain on brain activation point,and finally to brain regions,Brodmann district,three-dimensional coordinates and reaction at the activation point on the standard brain images be expressed in the form of experimental results.Before the test,the volunteers had signed informed consent form,and the pilot program was approved by ethics committees.Result:After handling and analysing the data,We find:1.Acupuncture in Waiguan(SJ5) can significantly activate Brodmann area(BA) 45,37,44,40,22,13,37,47,the hippocampus,amygdala,substantia nigra and other regions,the left cerebellum more clear and activation points on the left temporal cortex are more than those on the right side.The activated points of the left side are more than the right side in deeper brain.2.Sham needling in SJ5 can significantly activated the BA46,44,41,13,40,37 and 19.The activated points are mainly concentrated in the cerebral cortex,temporal lobe.We didn't find activated points in cerebellum and deeper brain.3.Acupuncture of sham point can significantly activated BA2,6,8,13,21,37,40,44,45,47,putamen and other areas.Both the left and right side of the brain have activated points,but points on the right side are more than those on the left.Both sides of middle temporal gyms,parietal lobule,supramarginal gyms and the lentiform nucleus have obvious activated points.The activated points mainly concentrated in the cerebral cortex,the deep-activated are mainly in the putamen.4. Sham needling in sham point can significantly activate BA6, 8,9,10,18,21,37,40,43,44.The activated points are mainly distributed in the right side of the brain.The left side also has some activated points;5.In the comparasion of Acupunture and sham-needling in S J5,we find that BA8 and cerebellum have distinct regional activated points;6.In the comparasion of acupuncture in SJ5 and sham point,we find BA2 and left cerebellar regions have activated points;7.Sham needling in S J5 compared with sham point,we find BA7,8,9,18 and other areas have activated points,the main activated points are at the left brain.It is not difficult to find that the distribution of activated points are mainly in the middle brain,no obvious activated points at the temporal lobe.Conclusion:Compared with sham point,Wai guan(SJ5) mainly activate BA2 of the,BA8 and Cerebellar,it must have a specific point,stated SJ5 VS sham point has its specific,to acertain extent confirmed by Professor Xin-Sheng Lai,"Meridian specificity-the brain related to the doctrine."...
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