哮喘患者痛觉异常的神经影像学研究  

Neuroimaging study of abnormal feeling of pain in patients with asthma

作　　者：魏翔宇 陈慧 詹松华[1] WEI Xiangyu;CHEN Hui;ZHAN Songhua(Department of Radiology,Shuguang Hospital Affiliated of Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院放射科,上海201203

出　　处：《中国中西医结合影像学杂志》2021年第6期554-558,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：上海市2018年度“科技创新行动计划”临床医学领域项目(18401970900);上海中医药大学重大成果培育项目(ZDCG201701);国家自然科学基金孵育项目(SGYYYX-202001)。

摘　　要：目的:探究哮喘患者痛觉异常的神经影像学机制。方法:分别纳入哮喘患者与健康受试者各30例作为观察组和对照组。所有受试者首先接受第1期静息态fMRI扫描,随后选取大椎、风门、肺俞穴行电针干预并记录针感视觉模拟评分(针感评分),电针后即刻行第2期扫描。分析2组针感评分、电针后低频振荡振幅(ALFF)值差异,以及针感评分与临床指标的相关性。结果:2组电针后针感评分中的疼痛评分差异有统计学意义(P<0.05)。2组电针前比较,观察组较对照组左侧额上回ALFF值降低,右侧额下回、右侧中央前回ALFF值升高;2组电针后即刻比较,观察组较对照组双侧额上回、右侧额中回、右侧额下回ALFF值升高,右侧枕中回ALFF值降低。观察组电针后左侧额中回、双侧额上回ALFF值较电针前升高;对照组电针后右侧中央前回、右侧中央后回ALFF值较电针前升高。观察组疼痛评分与病程呈负相关(r=-0.604,P=0.002)。结论:通过电针形式首次证实哮喘患者痛阈升高的现象,提示哮喘患者呼吸困难与痛觉感知可能共享了特定的神经环路。Objective:To explore the the neuroimaging mechanism of abnormal pain feeling in patients with asthma.Methods:30 patients with asthma(observation group)and 30 healthy subjects(control group)underwent the first phase of resting-state fMRI followed by electroacupuncture at Dazhui,Fengmen and Feishu acupoints.The acupuncture sensation scores were recorded and the second phase of fMRI scanning was performed immediately after electroacupuncture.The acupuncture sensation scores and the amplitude of low-frequency fluctuations(ALFF)value between two groups were analyzed as well as the correlation of the acupuncture sensation scores and clinical indicators.Results:There was a significant difference of the acupuncture pain score in the two groups(P<0.05).Compared with the control group before electroacupuncture,ALFF value of left superior frontal gyrus was decreased while that of right inferior frontal gyrus and right precentral gyrus was increased in the observation group.Compared with the control group after electroacupuncture,ALFF value of bilateral superior frontal gyrus,right middle frontal gyrus,right superior frontal gyrus was increased while that of right middle-occipital gyrus was decreased in the observation group.ALFF value of left middle frontal gyrus and bilateral superior frontal gyrus in observation group and ALFF value of right precentral gyrus and right postcentral gyrus in control group were increased after electroacupuncture.The pain score of the observation group was negatively correlated with the duration of the disease(r=-0.604,P=0.002).Conclusions:The increase of pain threshold in asthmatic patients is confirmed by electroacupuncture for the first time,suggesting that dyspnea and pain perception in asthmatic patients may share a specific neural circuit.

关 键 词：哮喘 针刺 磁共振成像 呼吸困难 疼痛 

分 类 号：R562.25[医药卫生—呼吸系统] R445.2[医药卫生—内科学]