针刺对不同病程的无先兆偏头痛患者脑结构网络效率的影响  

Effect of Acupuncture on the Efficiency of Brain Structure Network in Patients with Migraine without Aura in Different Courses

作　　者：吴康 徐玲玲 李匡时[1] 任毅[1] 邹忆怀[1] 江澜[1] 陈琛 刘蕊嘉 武琳璐 WU Kang;XU Lingling;LI Kuangshi;REN Yi;ZOU Yihuai;JIANG Lan;CHEN Chen;LIU Ruijia;WU Linlu(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,100700)

机构地区：[1]北京中医药大学东直门医院,北京市100700

出　　处：《中医杂志》2020年第24期2184-2189,共6页Journal of Traditional Chinese Medicine

摘　　要：目的探讨针刺对无先兆偏头痛慢性进展的影响及其可能的作用机制。方法纳入符合诊断标准的无先兆偏头痛患者,包括短病程组10例(病程≤5年)、长病程组10例(病程>5年),并设健康者10名为对照组。长病程组、短病程组患者选取患侧丝竹空、率谷、太阳、风池及双侧合谷、太冲、足临泣、阳陵泉、外关针刺,各穴均使用平补平泻手法,得气后留针30 min,每周针刺3次,治疗4周。对照组不作处理。通过磁共振扫描仪采集各组受试者脑结构网络的传递效率值(包括小世界属性值、网络全局效率值)并进行比较,采用视觉模拟量表评分评价两组患者治疗前后头痛强度,并对病程与小世界属性值进行相关性分析。结果治疗前各组受试者小世界属性值及网络全局效率值差异无统计学意义(P>0.05),治疗后短病程组与长病程组均有显著变化(P<0.05),并且两组患者呈现不同的趋势(短病程组上升,长病程组下降);治疗后短病程组与长病程组的头痛强度均显著下降(P<0.05或P<0.01);相关性分析显示,针刺治疗后的脑网络小世界属性值与患者病程呈中等强度负相关(r=-0.510,P<0.05)。结论无先兆偏头痛患者的脑结构网络信息传递效率的变化可能是其发病的潜在机制,针刺可能通过双向调节作用,即提高短病程患者的网络效率、降低长病程患者的网络效率,控制偏头痛的发作强度,从而缓解症状。Objective To explore the effect of acupuncture on the chronic progression of migraine without aura and its possible mechanism.Methods The patients with migraine without aura who met the diagnostic criteria were enrolled,including 10 cases in the short course group(disease course≤5 years),10 cases in the long course group(disease course>5 years),and 10 healthy people were set up as the control group.The long course group and the short course group of patients were given acupuncture at affected side Sizhukong(TE23),Shuaigu(GB8),Taiyang(EX-HN5),Fengchi(GB20)and bilateral Hegu(LI4),Taichong(LR3),Zulinqi(GB41),Yanglingquan(GB34),and Waiguan(TE5).All acupoints were treated with the even reinforcing-reducing method,keeping the needle for 30 minutes after qi arrival,acupuncture 3 times a week for 4 weeks.The control group was left untreated.The transfer efficiency value of the brain structure network(including the small-world attribute value and the global network efficiency value)of each group of subjects was collected and compared by a magnetic resonance scanner.The visual analog scale was used to evaluate the headache intensity of the 2 groups before and after treatment,and the correlation between the course of the disease and the value of the small world attribute was analyzed.Results Before treatment,there was no significant difference in the small-world attribute values and global network efficiency values of the subjects in all groups(P>0.05).After treatment,there were significant changes in the short-course group and the long-term group(P<0.05),and the 2 groups of patients presented different trends(increased in the short course group,decreased in the long course group);after treatment,the headache intensity of the short course group and the long course group decreased significantly(P<0.05 or P<0.01).Correlation analysis showed that after acupuncture treatment the value of the small-world attribute of the brain network was negatively correlated with the patient's course of disease(r=-0.510,P<0.05).Conclusion Ch

关 键 词：无先兆偏头痛 针刺治疗 脑结构网络 小世界属性 网络效率 病程 

分 类 号：R246.6[医药卫生—针灸推拿学]