原发性痛经患者关元穴艾灸前后的静息态功能磁共振研究  

Moxibustion of Guanyuan point for primary dysmenorrhea:a resting state functional magnetic resonance imaging study

作　　者：宋云娥[1] 徐放明[1] 唐成林[1] 陈日新[2] 易洋 李腊梅[1] 罗天友[4] 

机构地区：[1]重庆医科大学中医药学院针灸推拿教研室,重庆400016 [2]江西中医学院附属医院针灸康复科,南昌330006 [3]武警安顺市支队卫生队,安顺561003 [4]重庆医科大学附属第一医院影像科,重庆400016

出　　处：《重庆医科大学学报》2012年第9期753-758,共6页Journal of Chongqing Medical University

基　　金：国家重点基础研究发展计划(973计划)资助项目(编号:2009CB522902)

摘　　要：目的:采用静息态功能磁共振成像(Resting state functional magnetic resonance imaging,rsfMRI)技术采集原发性痛经患者脑血氧水平依赖(Blood oxygenation level-dependent,BOLD)信号,并采用低频振幅(Amplitude of low-frequency fluctuation,ALFF)数据分析方法研究原发性痛经患者艾灸关元穴前后的脑功能活动,从脑代谢活动强度的角度探讨艾灸关元穴可以有效治疗原发性痛经的中枢镇痛机制。方法:20例原发性痛经患者分别在艾灸关元穴前及艾灸关元穴5 min后进行rsfMRI扫描,采用ALFF算法进行数据处理,进行艾灸前后配对t检验,比较艾灸前后ALFF值改变情况。结果:关元穴艾灸后ALFF信号显著活跃的脑区为:右侧扣带回、左侧岛叶、左侧楔前叶、右侧中央后回、左侧钩回、左侧颞上回、颞中回、左侧中央前回、左侧额中回、右侧额下回(P<0.05,校正后);显著抑制的脑区为:左侧枕叶、右侧额上回、左侧额内侧回、左侧额中回、右侧小脑后叶山坡、右侧颞上回(P<0.05,校正后)。结论:运用rsfMRI ALFF算法可以对艾灸关元穴引起的脑活动改变情况进行研究。艾灸关元穴引起了多个与疼痛相关脑区的功能变化,为临床上艾灸关元穴可以有效治疗原发性痛经的中枢镇痛机制提供了可能的影像学依据。Objective： To investigate the central analgesic mechanism of using moxibustion of Guanyuan point to treat patients with primary dysmenorrhea through collecting the blood oxygenation level-dependent（BOLD） signal by restingstate functional magnetic resonance imaging（rsfMRI） technology and analyzing the brain functional change of patients with primary dysmenorrhca before and after moxibustion of Guanyuan point by amplitude of low frequency fluctuation （ALFF） method. Methods：RsfMRI scanning was per- formed on 20 primary dysmenorrhea patients before the treatment（moxibustion of Guanyuan point） and at 5 rain after the treatment. All data were analyzed by ALFF. Paired t-test was used to process the data and to compare the ALFF value before and after the treat- ment. BOLD signal changes after moxibustion on Guanyuan point were observed from the view of brain metabolic activity. Results： ALFF values of the right cingulate gyms,left insula,left precuneus,right postcentral gyms,left uncus, left superior temporal gyms, middle temporal gyms,left precentral gyms,left middle frontal gyms, right inferior frontal gyrus were increased significantly after moxibustion （P〈0.05, after correction）, while the ALFF values of the left occipital lobe, right superior frontal gyms, left medial frontal gyms,left middle frontal gyms, right posterior lobe of cerebellum and right superior temporal gyms were decreased（P〈0.05, after cor- rection）. Conclusions：RsfMRI technology and ALFF method can be used to study the activity changes of brain after moxibustion of Guanyuan point. The treatment of moxibustion of Guanyuan point may arouse the functional changes of a series of pain-related brain regions,which may provide imaging evidence for the study of the mechanism of central analgesic by moxibustion of Guanynan point.

关 键 词：艾灸 关元 静息态功能磁共振 低频振幅 

分 类 号：R245.8[医药卫生—针灸推拿学] R246.3[医药卫生—中医临床基础]