针刺治疗下腰痛患者脑功能连接网络的影响  

Impact of Acupuncture on Brain Functional Connectivity Network in Patients with Low Back Pain

作　　者：贾润慧[1] 汪新柱[1] 陈晓飞[1] 董馥闻 周晟[1] 陈祁青[2] JIA Runhui;WANG Xinzhu;CHEN Xiaofei(Department of Radiology,Gansu Provincial Hospital of TCM,Lanzhou 730050,P.R.China)

机构地区：[1]甘肃省中医院放射影像科,兰州730050 [2]甘肃省中医院脊柱骨科,兰州730050

出　　处：《临床放射学杂志》2021年第4期646-650,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金项目(编号:81760877);甘肃省青年科技基金计划项目(编号:17JR5RA049)。

摘　　要：目的观察针刺治疗下腰痛(LBP)患者的静息态功能磁共振成像(rs-fMRI)的脑功能连接变化,初步探讨针刺治疗LBP的中枢镇痛机制。方法纳入20例LBP患者,右侧大肠俞和委中穴针刺治疗14天。均于针刺治疗前、后间隔1天行两次静息态数据采集。分析LBP患者的全脑关联模拟图,比较针刺治疗前后的功能连接差异。结果全脑关联模拟图显示,LBP患者左侧海马旁回与杏仁核、楔叶与舌回在针刺前功能连接增强,针刺后减低;LBP患者左侧的海马旁回与梭状回、嗅皮质及三角部额下回、右侧后扣带回与楔前叶在针刺前功能连接减低,针刺后增强;LBP患者左侧枕中回与内侧和旁扣带脑区、右侧的中央后回与背外侧额上回、前扣带回与枕上回在针刺前后均相互抑制,且在针刺后有新增的抑制脑区。结论 LBP患者脑功能改变为疼痛耐受、情绪抑郁、认知受损。针刺治疗LBP的机制可能是改善大脑功能连接,从而抑制痛觉敏化、缓解负性情绪、改善认知。Objective To preliminarily explore the analgesic mechanism of acupuncture by observing the changes of resting-state functional connectivity(re-FC) in patients with low back pain treated by acupuncture. Methods A total of 20 LBP patients were involved.They all accepted the treatment of acupuncture at BL40 and BL25 from the same experienced acupuncturist for 14 days.Before and after the treatment of acupuncture, BOLD-fMRIdatas of resting-state were acquired respectively with 1 day interval.We thenanalyzed the whole brain association simulation diagram and compared the differences of re-FC in LBP patients before and after acupuncture treatment. Results As they were shown in the whole brain association simulation diagram, the functional connectivity(FC) of the left parahippocampal gyrus and amygdala、the left cuneus and lingual in LBP patients was enhanced before acupuncture, but decreased after acupuncture.However, the FC of the left parahippocampal gyrus and fusiform gyrus、the left olfactory cortex and pars triangularis、the right posterior cingulate cortex and the precuneus was reduced before acupuncture, and enhanced after acupuncture.The FC of the left middle occipital gyrus and median cingulate and paracingulate gyri,the right postcentral gyrus and dorsolateral superior frontal gyrus,the right anterior cingulate cortex and the superior occipital gyrus in LBP patients were inhibited with each other before and after acupuncture. Somenew regions which showed mutual inhibition were also discovered after acupuncture. Conclusion The changes in brain’s functional network of LBP patients were pain tolerance,emotional depression and cognitive impairment. The mechanism of acupuncture LBP may be to improve brain function connections,thereby inhibiting pain sensitization,alleviating negative emotions,and improving cognition.

关 键 词：下腰痛 磁共振成像 脑功能网络 针刺 

分 类 号：R246.9[医药卫生—针灸推拿学]