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1. 广州中医药大学第二附属医院
2. 北京军区总医院全军平衡针灸中心
3. 广州中医药大学第二临床医学院
纸质出版日期:2019
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覃小兰, 王文远, 王进忠, 等. 平衡针镇痛效应观察及脑功能局部一致性分析[J]. 针刺研究, 2019,44(6):446-450.
QIN Xiao-lan, WANG Wen-yuan, WANG Jin-zhong, et al. Analysis on regional homogeneity of resting brain during balance acupuncture-induced analgesic effect in migraine patients without aura[J]. Acupuncture research, 2019, 44(6): 446-450.
覃小兰, 王文远, 王进忠, 等. 平衡针镇痛效应观察及脑功能局部一致性分析[J]. 针刺研究, 2019,44(6):446-450. DOI: 10.13702/j.1000-0607.180667.
QIN Xiao-lan, WANG Wen-yuan, WANG Jin-zhong, et al. Analysis on regional homogeneity of resting brain during balance acupuncture-induced analgesic effect in migraine patients without aura[J]. Acupuncture research, 2019, 44(6): 446-450. DOI: 10.13702/j.1000-0607.180667.
目的:观察平衡针针刺头痛穴对无先兆偏头痛患者的镇痛效应
探讨其与脑区功能改变的关系。方法:将40例无先兆偏头痛患者随机分为头痛穴组和非穴组
每组20例。头痛穴组针刺头痛穴
患者有放电感、麻胀感时立即出针
非穴组针刺非穴
均每天1次
治疗4周。采用视觉模拟量尺(VAS)评分评估针刺镇痛效应
采用静息态功能磁共振成像(fMRI)的局部一致性(ReHo)分析脑区功能改变。结果:干预期(针刺结束时)和随访期(针刺结束后4周)头痛穴组镇痛效应优于非穴组(P<0.05)
头痛穴组干预期的镇痛效果优于随访期(P<0.05);非穴组干预期与随访期镇痛效果的差异无统计学意义(P>0.05)。与干预前对比
头痛穴组针刺干预4周后ReHo值增高的脑区有前扣带回、中央前回、眶额上回、腹外侧核、脑岛、腹后内侧核、顶下小叶、左前扣带回、脑桥、小脑扁桃体、眶额下回(P<0.05);ReHo值降低的脑区有右脑桥、中央后回、腹后外侧核、后扣带回
左中央前回、海马(P<0.05)。非穴组针刺干预4周后ReHo值增高的脑区有右舌回、左楔前叶、前扣带回、枕下回(P<0.05);ReHo值减低的脑区有左腹后外侧核(P<0.05)。结论:平衡针针刺头痛穴的镇痛效应可能与以边缘系统为主的多个脑功能区互相作用有关。
Objective To observe the relationship between the analgesic effect of balance acupuncture and functional changes in brain in patients with migraine without aura.Methods A total of 40 cases of migraine without aura were equally randomized into a headache-acupoint group and a sham-acupoint group.When acupuncture given
a filiform needle was inserted into the headache-acupoint(the midpoint of the depression region anterior to the juncture of the first and second metatarsal bones on the dorsum of the foot)or the sham point(the midpoint of the depression region anterior to the juncture site between the 3 rd and4 th metatarsal joints of the dorsum of the foot)about 25—40 mm deep and manipulated for a while till the patient experienced feelings of electric shock and numbness
then withdrawn immediately.The treatment was conducted once daily for 4 weeks.The visual analogue scale(VAS)was used to evaluate the severity of pain
and the regional homogeneity(ReHo)analysis of resting state functional magnetic resonance imaging(fMRI)was used to assess changes of the spontaneous brain activity.Results After acupuncture
the analgesic effect of headache-acupoint was better than that of the sham-acupoint in both intervention stage and the follow-up stage(P<0.05)
and was also stronger in the intervention stage than in the follow-up stage(P<0.05).There was no significant difference in the analgesic effect between the intervention stage and the follow-up stage in the sham-acupoint group(P>0.05).Compared with pre-intervention
4-weeks' intervention at the headache-acupoint showed an increase of ReHo values in the anterior cingulate gyrus
anterior central gyrus
superior orbital frontal gyrus
insula
inferior lobule
left anterior cingulate gyrus
ventral lateral nucleus and ventral posteromedial nucleus of the thalamus
pontine nucleus
cerebellar tonsils and orbital frontal inferior gyrus of the brain(P<0.05)
and a decrease of ReHo values in the right brain bridge
central posterior gyrus
posterior cingulate gyrus
left central anterior gyrus
posterolateral nucleus of thalamus
and hippocampus(P<0.05)
separately.In the sham-acupoint group
the ReHo value was increased in the right tongue gyrus
the left anterior lobe
the anterior cingulate gyrus and the lower occipital gyrus of the brain(P<0.05)
and reduced in the left ventral posterolateral nucleus of the thalamus
separately(P<0.05).Conclusion Balance acupuncture stimulation of headache acupoint has an analgesic effect in migraine patients without aura
which may be related to its effect in regulating resting state brain function of the limbic-system-dominated multiple brain regions.
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