针灸原发性痛经患者的脑功能网络分析:基于rs-fMRI数据  

Brain function network analysis of patients with primary dysmenorrhea after acupuncture and moxibustion:based on rs-fMRI data

作　　者：张中旭 马萧童 周锋 杨艺超 王志群 郑运松 ZHANG Zhongxu;MA Xiaotong;ZHOU Feng;YANG Yichao;WANG Zhiqun;ZHENG Yunsong(Department of Medical Imaging,Shanaxi University of Traditional Chinese Medicine Affiliated Hospital,Xianyang 712000,China;Department of Research,Shanaxi University of Traditional Chinese Medicine Affiliated Hospital,Xianyang 712000,China;School of Medical Technology,Shanaxi University of Traditional Chinese Medicine,Xianyang 712046,China;Department of Imaging,Beijing Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]陕西中医药大学附属医院医学影像科,陕西咸阳712000 [2]陕西中医药大学附属医院科研科,陕西咸阳712000 [3]陕西中医药大学医学技术学院,陕西咸阳712046 [4]北京航天中心医院影像科,北京100049

出　　处：《分子影像学杂志》2025年第2期138-144,共7页Journal of Molecular Imaging

基　　金：陕西省科学技术厅重点研发计划项目(2024SF-YBXM-524);秦创原中医药产业创新聚集区项目(L2024-QCY-ZYYJJQ-Y07)。

摘　　要：目的采用静息态功能MRI(rs-fMRI)图论及连边分析方法探讨原发性痛经(PDM)患者针灸前后脑功能网络改变。方法纳入35例女性PDM患者,所有患者于经前7 d接受针灸治疗至月经来潮,取关元穴、双侧三阴交,每天治疗30 min。收集PDM患者针灸前后经期视觉模拟评分(VAS)、痛经症状评分(CMSS)、焦虑自评分(SAS)、抑郁自评分(SDS)及颅脑fMRI数据。使用GRETNA软件对PDM患者针灸前后的脑功能数据进行图论及连边分析,并与临床评分作相关分析。结果针灸后,PDM患者经期VAS、CMSS、SAS、SDS减低(P<0.05);脑网络全局效率增高,平均集聚系数、平均路径长度减低(P<0.05);右侧脑岛与右侧额中回间、左侧中央沟盖与右侧颞上回间的功能连接(FC)增强;右侧中央前回与双侧丘脑、右侧豆状核间,右侧中央后回与左侧额中回、左侧补充运动区间,右侧前扣带回与左侧前扣带回、右侧后扣带回间,左侧中央前回与左侧丘脑间,右侧后扣带回与左侧颞中回间,左侧中央后回与左侧丘脑间的FC减弱(P<0.001);左侧中央前回与左侧丘脑间FC变化与SDS变化呈正相关(r=0.516,P=0.002)。结论本研究针灸疗法有较好的疗效,针灸可能使PDM患者脑网络镇痛相关的信息整合效率得到提高,疼痛相关的信息传递效率得到抑制;针灸起效涉及的神经通路可能为丘脑-感觉运动皮层回路、扣带皮层回路、突显网络,3条主线共同担负起镇痛、舒缓情绪和疼痛注意力转移的任务。Objective To investigate the changes in brain functional network before and after acupuncture in patients with primary dysmenorrhea(PDM)using resting-state functional MRI(rs-fMRI)graph theory and edge analysis.Methods Thirtyfive women with PDM were enrolled in this study,and the patients with PDM were treated with acupuncture 7 days before menstruation until the onset of menstruation,taking Guanyuan point and bilateral Sanyinjiao for 30 min per day.The data of visual analogue score(VAS),the cox menstrual symptom score(CMSS),self-rating anxiety score(SAS),self-rating depression score(SDS)and brain fMRI of PDM patients before and after acupuncture and moxibustion were collected.GRETNA software was used to analyze the brain function data of PDM patients before and after acupuncture and moxibustion by graph theory and edge analysis,and correlated with the clinical score.Results After acupuncture,the menstrual VAS,CMSS,SAS,and SDS were reduced in PDM patients(P<0.05).The global efficiency of brain networks increases,while the mean clustering coefficient and average path length decrease(P<0.05).Functional connectivity(FC)was enhanced between the right insula and the right middle frontal gyrus,and between the left rolandic operculum and the right superior temporal gyrus.between the right precentral gyrus and bilateral thalamus and the right putamen,between the right postcentral gyrus and the left middle frontal gyrus and the left supplementary motor area,between the right anterior cingulate and the left anterior cingulate and right posterior cingulate,between the left precentral gyrus and the left thalamus,between the right posterior cingulate gyrus and the left middle temporal gyrus,and between the left postcentral gyrus and the left thalamus with diminished FC(P<0.001).the change in FC between the left precentral gyrus and the left thalamus was positively correlated with the change in SDS(r=0.516,P=0.002).Conclusion The present acupuncture therapy had good efficacy.Acupuncture and moxibustion may improve the integrati

关 键 词：原发性痛经 针灸 功能MRI 脑网络 

分 类 号：R246.3[医药卫生—针灸推拿学]