面口合谷收的大脑皮层交叉代表区可塑性机制研究

Relationship between orafacial areas and Hegu acupoints, which contains the principle of selection of acupoints according the transmission route of meridian and is the spirit of meridian theory, still remain unknown and puzzle many acupuncturists. In recent 20 years, a competitive.activity-dependent interaction between the face and hand representations of motor cortex has been demonstrated, in which sensory afferents play an important role. In the present study, some novel electrophysiological and imaging techniques, including transcranial magnetic stimulation, functional magnetic resonance, mutichannel recording in vivo, etc, are applied to explore the plasticity mechanism of relationship between orafacial areas and Hegu acupoints, which will provide detailed scientific evidence to reveal the scientific connotation of meridian theory and selection of acupoints according the transmission route of meridian.

"面口合谷收"所蕴涵的循经远道取穴原则是经络学说的精髓，但其内在机制不明，始终困扰着广大针灸工作者。近20年来脑可塑性这一生命科学前沿研究表明，大脑皮层手区和面区存在交叉代表区之间的竞争性活动依赖性的相互作用，躯体感觉传入对此有重要的调节作用。本研究以此为出发点，利用经颅磁刺激、功能性磁共振、多通道在体电生理记录等神经电生理和神经影像学的前沿技术，深入探寻"面口合谷收"的大脑皮层交叉代表区可塑性机制，将为揭示经络学说及循经远道取穴的科学内涵提供翔实的科学依据。

“面口合谷收”所蕴涵的循经远道取穴原则是经络学说的精髓。本研究以此为出发点，利用经颅磁刺激、在体多通道电生理记录等当前神经科学的前沿技术，灵长类动物和临床研究相结合，结果表明：①合谷穴区和面口部的感觉传入在大脑皮层发生会聚可能是“面口合谷收”重要的生理学基础。②病理状况下，合谷穴区或面口部的感觉传入或运动传出发生障碍时，大脑皮层合谷穴区和面区发生功能重组，可能是“面口合谷收”的生物学机制。③无论是生理还是病理状况（面瘫或面肌痉挛），针刺手部的合谷穴兴奋运动皮层手区，针刺面部穴位均兴奋运动皮层的面区。因此，面瘫宜选用面部穴位治疗，面肌痉挛宜选用手部的合谷穴治疗。本研究深刻揭示了“面口合谷收”的科学内涵，在继承经典理论的基础上，取得了突破，尤其对针灸临床治疗面瘫和面肌痉挛具有重要的指导意义。