臺灣博碩士論文加值系統

中文摘要
針灸刺激對人體的影響可分為短時間的即時效應與長時間的持續性效應，過去的針灸相關研究因實驗方法的限制都以即時效應為主。然而，隨著靜息態磁振造影(resting-state functional magnetic resonance image)的發展，利用其不需執行作業的特性，傳統針灸的持續性研究已有進展。但是雷射針灸的持續性效應仍無直接證據，故本研究以探討雷射針灸的持續性效應為主要目的。
本研究所選定的雷射針灸刺激穴位是左腳湧泉穴。19個慣用右手且無中樞神經系統疾病的健康受試者參與本研究。靜息態的大腦預設模式網路是使用後扣帶皮層(posterior cingulate cortex)為種子點，進而獲得種子點與其他腦區的時間相關性。
研究結果發現，血氧濃度相依對比與大腦預設模式在左側前腦島(Anterior insula)都有顯著增加。此外，在記憶功能上扮演重要角色的海馬迴也是雷射針灸刺激所活化的腦區。本研究的成果首次展示雷射針灸刺激的持續性效應，在刺激停止後仍然產生大腦預設模式網路的改變。

ABSTRACT
The instant effect and sustained effect are all induced by acupuncture stimulating. The former denotes the effect is occurred immediately while the acupuncture is stimulating, the latter denotes the effect is still functioning after the acupuncture stimulate is accomplished. The instant effect was the major research topic in the past two decades; however, the development of resting state fMRI study brings up the opportunity to investigate the task-free brain activities, such as sustained effect. Although the sustained effect of traditional acupuncture stimulating was reported in some studies, there are no direct evidence to reveal the sustain effect of the laser acupuncture. Therefore, I am aiming to investigate the sustain effect of laser acupuncture stimulating in this study.
The acupoint Yongquan, locate at the sole of left foot, was stimulated in this study. All of 19 healthy subjects participate in this study. The default mode network (DMN) was obtain by calculating the temporal correlation between the seed point posterior cingulate cortex and the other brain regions.
In the results, both of the BOLD contrast of laser acupuncture stimulating and the functional connectivity of DMN after laser acupuncture stimulated showed the greater activation in anterior insula. Moreover, BOLD contrast of laser acupuncture stimulating showed the greater activation in hippocampus, which plays an important role in the memory. In summary, this study demonstrates the sustain effect of laser acupuncture stimulating, which showed the increase functional connectivity of DMN after acupuncture stimulating.

目錄
誌謝 i
中文摘要 ii
ABSTRACT iii
目錄 v
第一章 緒論 1
1.1研究動機與目的 1
1.2論文架構 2
第二章 研究背景與文獻回顧 3
2.1中醫針灸理論 3
2.2半導體雷射與雷射針灸 5
2.3靜息態功能性磁振造影 7
第三章 研究素材與研究方法 12
3.1受測者 12
3.2實驗設備與MRI影像取得 12
3.3實驗設計 13
3.4資料前處理 14
3.5 雷射針灸刺激血氧濃度相依對比分析 15
3.6 雷射針灸刺激功能性相關分析 15
3.7 群組統計檢定 16
第四章 結果 17
4.1 雷射針灸刺激的血氧濃度對比 17
4.2雷射針灸刺激對大腦功能性連結的改變 17
第五章 討論 19
5.1雷射針灸刺激的血氧濃度對比 19
5.2雷射針灸刺激對大腦功能性連結的影響 19
5.4傳統針灸與雷射針灸刺激的差異 20
5.5實驗的限制 21
第六章 結論與未來工作 22
6.1 結論 22
6.2 未來工作 22
參考文獻 24

參考文獻
[1].林昭庚(2001)。新針灸大成。台中:中國醫校學院針灸研究中心
[2].黃維三(2004) 。針灸科學。台北:國立編譯館 (第三版)
[3].吳季華(2011)。慢性病治療的新曙光-雷射針灸。台北:書泉
[4].謝長倭(2010)。調變低功率紅外線雷射照射特定穴位造成不同的大
腦區域反應之研究 (NSC 100-2221-E-468-006-)。台北：中華民國
行政院國家科學委員會。
[5]. Dhond, R.P., Yeh C., Park, K., Kettner, N., Napadow, V.(2008).
“Acupuncture modulates resting state connectivity in default and
sensorimotor brain networks,” Pain. June. 136 (3), 407–418.
[6].林昭庚(2009)。新編彩圖針灸學。台北:知音
[7]. NIH, “Acupuncture,” NIH Consensus Statement, vol. 15, no. 5,
pp. 1–34, 1997.
[8]. Han, J.S., (2011) “Acupuncture analgesia: areas of consensus and controversy,” Pain, 152(3 Suppl):S41-8.
[9].Whittaker, P. , (2004) “Laser acupuncture：past, present, and
Future,” Lasers in Medical Science, vol. 19,no.2,pp. 69-80-2004.
[10]. Harrls, D.M., (1998). “ Laser Biostimulation: Review and
Hypothesis,” Laser Topics, pp. 9-14.
[11]. Hsieh, C.W., Wu, J.H., Hsieh, C.H., Wang, Q.F., Chen, J.H., (2011) “Different brain network activations induced by modulation and nonmodulation laser acupuncture,” Evidence-Based Complementary and Alternative Medicine, vol.2011, pii: 951258.
[12]. Baxter. G.D., Bleakley. C., McDonough. S.,(2008) “Clinical effectiveness of laser acupuncture: a systematic review,” J
Acupunct Meridian Stud 1(2):65−82.
[13]. Ogawa, S., Tank, D.W., Menon, R., Ellermann, J.M.,Kim, S.G. ,
Merkle, H., Ugurbil, K. (1992), “Intrinsic signal changes
accompanying sensory stimulation: functional brain mapping with
magnetic resonance imaging,” Proc Natl Acad Sci U S A. July 1; 89(13): 5951–5955.
[14]. Huettel, S. A.,(2009) “Functional Magnetic Resonance Imaging ,” Second Edition ed.
[15]. Ogawa, S., Lee, T.M. (1990), “Magnetic resonance imaging of blood vessels at high fields: in vivo and in vitro measurements and image simulation”, Magn Reson Med.,. 16(1):p.9-18.
[16]. Kwong,K.K., Belliveau J.W., Chesler, D.A., Goldberg,
I.E., Weisskoff, R.M., Poncelet, B.P., Kennedy, D.N. , Hoppel,
B.E. , Cohen, M.S. , Turner, R. (1992), “Dynamic magnetic resonance imaging of human brain activity during primary sensory stimulation,”Proc Natl Acad Sci U S A, 89(12):p.5675-9.
[17]. Thulborn, K.R., Waterton, J.C., Matthews, P.M., Radda G.K. (1982),“Oxygenation dependence of the transverse relaxation time of water protons in whole blood at high field,” Biochim Biophys Acta, 714(2):p.265-70.
[18]. Fox, M.D., Greicius, M.,(2010) “Clinical applications of resting
state functional connectivity,” Frontiers in systems neuroscience ,
17;4:19.
[19]. Biswal, B., Yetkin, F., Haughton, V., & Hyde, J.,(1995).
“Functional connectivity in the motor cortex of resting human
brain using echo-planar MRI,” Magn Reson Med,. 34(4):p.537-41.
[20]. Raichle, M.E., MacLeod, A.M., Snyder, A.Z., Powers, W.J. (2001), Gusnard D.A., Shulman G.L., “A default mode of brain function, ” Proc Natl Acad Sci USA, 98:676–682.
[21]. Greicius, M.D., Supekar, K., Menon, V., Dougherty, R.F., (2009)
“Resting-state functional connectivity reflects structural
connectivity in the default mode network,” Cerebral Cortex, January;19:72-78.
[22]. Fransson, P. (2005), “ Spontaneous low-frequency BOLD signal fluctuations: an fMRI investigation of the resting-state default mode of brain function hypothesis,” Hum Brain Mapp ; 26:15–29.
[23]. Raichle, M.E., (2010), “Two views of brain function,” Trends in Cognitive Sciences, Apr;14(4):180-90.
[24]. WHO, “WHO Standard Acupuncture Point Locations in the Western Pacific Region,” World Health Organization Western Pacific Region, 2008.
[25].Siedentopf, C.M., Golaszewski, S.M., Mottaghy, F.M., Ruff C.C.,
Felber S., Schlager A. (2002). “Functional magnetic resonance
imaging detects activation of the visual association cortex during
laser acupuncture of the foot in humans,” Neuroscience Letters,
vol. 327, no. 1, pp. 53–56.
[26].Siedentopf, C.M., Koppelstaetter, F., Haala I.A., Haid V., Rhomberg, P., Ischebeck A., Buchberger W., Felber S., Schlager A., Golaszewski S.M. (2005). “Laser acupuncture induced specific cerebral cortical and subcortical activations in humans,” Lasers in medical science, vol.20, no.2, pp. 68–73.
[27]. Bai, L., Qin, W., Tian, J., Dong, M., Pan, X., Chen, P., Dai, J., Yang, W., Liu, Y., (2009),“Acupuncture modulates spontaneous activities in the anticorrelated resting brain networks,” Brain Research; 1279:37-49.
[28].Liu, J., Qin, W., Guo, Q., et al.,(2010) “Distinct brain networks for time-varied characteristics of acupuncture,” Neurosci Lett 468: 353–358.