基于多元功能影像数据MSE复杂度分析的“阳陵泉-胆腑-脑”相关性及机制

“Acupoint-zang-fu association” is the key of the meridian and collateral theory of acupuncture. “Lower-he-point treating for visceral organs” is an important principle for acupoint selection guided by the theory of “meridian-organ relationship”. Investigating the scientific foundation of “Lower-he-point treating for visceral organs” from the inter-connection at three levels from local acupoint to target organ to brain, can help giving a more thorough understanding of the “acupoint-zang-fu association”. With the gallbladder and its lower-he-point, Yanglingquan, considered as the target fu-organ and stimulus point for acupuncture, and gallstones, the most common disease in biliary system, this study will probe the contrast between subjects of two base states: with and without gallbladder, as well as the contrast between subjects with healthy or pathological gallbladders, based on a combination of techniques such as laser-speckle-imaging, CDFI-fNIRS and fMRI.The study will collect multivariate, synchronized and quantitative imaging data from subjects in accordance with “Yanglingquan-gallbladder-brain”, forming information at three different levels, from the meridian’s local acupoint to target organ and to central neural systems, and analyze their correlation as well inter-group contrast utilizing the multiscale entropy(MSE) complexity. The study thus proposes a thorough, multifaceted and deep exploration on the underlying mechanism of “Lower-he-point treating for visceral organs” from three different angle: the physical absence/presence of gallbladder, the physiological states of gallbladder and the absence/presence of specific inter-connection between Yanglingquan and a pathological gallbladder, seeking to provide new insights and techniques in further understanding the theoretical foundation of “acupoint-zang-fu association”.

“经穴-脏腑相关”是针灸经络学说的核心，“合治内府”是“经穴-脏腑相关”理论指导下针灸治疗腑病的重要选穴原则。从“穴位局部-靶器官-脑”三个层次的相关性入手探讨“合治内府”的科学内涵对深入阐释“经穴-脏腑相关”理论具有重要意义。本研究拟以胆囊这一人体非不可或缺的器官为脏腑研究对象，以胆腑的下合穴阳陵泉为经穴刺激点，以胆道系统常见病、多发病——胆石症为疾病载体，联合同步激光散斑-CDFI-fNIRS与fMRI技术，从有/无胆囊两种不同机体状态的受试者、胆囊处于生理/病理状态的受试者两方面切入，通过对受试者穴位局部、靶器官、中枢三个层面上进行“阳陵泉-胆囊-脑”多元功能影像数据同步、定量、可视化采集，并进行基于MSE复杂度的三个层面相关性分析与组间比较，从胆囊结构物理性存在与否、胆囊功能是否异常、阳陵泉与功能异常胆囊是否特异性相关三个角度，全面、多层次、深入阐释传统针灸“合治内府”的实现机制，

“经穴-脏腑相关”是针灸经络学说的核心，“合治内府”是其临床运用的典型体现。本研究拟从有/无胆囊的受试者、胆囊处于生理/病理状态的受试者两个方面入手，从受试者穴位局部、靶器官、中枢三个层面对“阳陵泉-胆囊-脑”进行多元数据比较、关联分析，以全面、多层次、深入阐释传统针灸“合治内府”理论的科学内涵，为“经穴-脏腑相关”理论提供研究的思路和证据。研究结果发现，与健康受试者（胆囊处于生理状态下）和胆囊切除术后受试者（病理性胆囊切除后）相比，胆石症患者（胆囊处于病理状态下）呈现背外侧前额叶、体感运动皮层血氧水平异常降低，针刺阳陵泉穴过程中，该异常改变显著升高，且针刺后阳陵泉穴局部压痛阈值与患者体感运动皮层HbO2水平呈显著相关。且与针刺他经他穴组和非经非穴组相比，针刺阳陵泉穴干预后，胆石症患者背外侧前额叶与体感运动区功能连接度增强。该结果提示，阳陵泉穴作为“胆府”下合穴，针刺阳陵泉穴对病理性“胆府”具有局部-中枢调节效应，一定程度上说明了阳陵泉穴与“胆府”具有相关性。该研究发现为阐释中医经典理论“经穴-脏腑相关”提供了部分客观依据，为包括阳陵泉穴在内的下合穴临床应用的推广起到促进作用，以指导临床合理用穴。

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