推拿特定穴不同操作时间对脾虚腹泻患儿脑功能网络调控机制研究

The project,after the previous substantial research, is based on the core problem that the best time-effect relationship of the pediatric massage special acupoints, Infants with diarrhea due to Spleen deficiency will be used as objects in this topic, the incision of which is Pitu and Dachang specific points by Tuina, Advanced brain imaging fusion technology ,such as fMRI, DTI and DTT will be made as to study the law of development about white matter myelinization of healthy infants and infants with diarrhea of Spleen deficiency in the development stage, explain systemly at a certain frequency contact pressure and different operating time to stimulate massage’s special acupoints on infant activate brain areas site and Connection space-time characteristics，establish three-dimensional imaging map of white matter fiber bundle, at the same time analysis different operation time curative effect with the brain structure and the function network diagram, In order to analysis the role law and mechanism of the central nervous network reorganization on Infants with diarrhea due to Spleen deficiency with Pitu and Dachang specific points by Tuina under different ageing relationship comprehensively.the project will provide scientific basis in view of the special acupoint time-effect relationship.In order to guide scientific compatibility of clinical specific acupoints and improve the clinical effect, lay a solid foundation for the basic theory of modern children massage, offer a new view and research means for the mechanism research of massage at the same time.

本课题组在前期研究基础上，基于小儿推拿特定穴的最佳时效关系这一关键科学问题，立足于触觉神经生理和儿童脑发育理论，以脾虚腹泻患儿为研究对象，运用fMRI、DTI 和DTT 等脑功能成像融合技术，研究推补脾土穴和大肠穴不同操作时间对正常儿童和脾虚腹泻患儿激活脑区的特征、白质纤维的结构和各向异性特点，以及建立纤维束三维时空成像，同时将不同操作时间的疗效与脑结构与功能网络图进行相关性分析，揭示正常儿童和脾虚腹泻患儿推脾土、推大肠穴不同操作时间存在以触觉介导的多个脑功能区重组的特异感觉通路，最终阐明推拿特定穴治疗小儿脾虚腹泻的最适宜时效特性的脑网络可塑性机制。本项目从特定穴时效关系角度为推拿治疗小儿腹泻提供神经影像学依据，对于把握推拿特定穴最佳时效规律和提高临床疗效，构建规范科学的小儿推拿临床指导模式均具有非常重要的指导意义。

课题组在前期研究基础上，立足于触觉神经生理和儿童脑发育理论，以正常儿童与脾虚腹泻患儿为研究对象，运用fMRI等脑功能成像融合技术，研究推补脾土穴和大肠穴不同操作时间对正常儿童和脾虚腹泻患儿激活脑区的特征并建立纤维束三维时空成像，同时将不同操作时间的疗效与脑结构与功能网络图进行比较。.研究结果显示，正常儿童与脾虚腹泻患儿推脾土、推大肠穴不同操作时间存在以额、顶、枕叶多个脑区为触觉介导的脑功能区重组特异感觉通路，并存在具有可塑性的脑中枢-胃肠神经环路。研究同时表明20分钟是推拿特定穴的最佳时效，且脾土与大肠穴穴位组合能够产生最佳疗效。与其他组相比，脾虚腹泻患儿推脾土与大肠穴20分钟能够激活更多内脏感运脑区（右侧海马、右侧海马旁回、右侧前中扣带、左侧岛叶），并在“丘脑、小脑、基底节-边缘叶、岛叶”脑中枢-胃肠调控神经通路、额顶枕叶多脑区触觉特异通路的基础上，形成以躯体感觉、内脏感运为主的多中枢脑神经网络调控整合机制。另外，本研究揭示了正常和脾虚腹泻患儿推拿后激活脑区之间纤维束神经传导成像图。.本项目从特定穴时效关系角度为推拿治疗小儿腹泻提供神经影像学依据，对于把握推拿特定穴最佳时效规律和提高临床疗效，构建规范科学的小儿推拿临床指导模式均具有非常重要的指导意义。发表论文6篇，培养研究生5名。