温和灸功能性消化不良患者足三里的中枢即刻响应特征

Instant Response of Cerebral Regions on Zusanli of Functional Dyspepsia with Warm Moxibustion

目的:探讨温和灸功能性消化不良(Functional Dyspepsia,FD)患者足三里的即刻脑功能响应特征。方法:选取符合纳入与排除标准的FD患者38例,分定位相、结构相、艾灸前静息态(6 min)、艾灸足三里任务态(3 min)与艾灸后静息态(10 min)五个步骤进行BOLD-f MRI扫描,对采集数据运用DPARSF软件分析,足三里穴均取左侧,温和灸持续3 min。结果:与艾灸前相比,艾灸足三里时FD患者的左壳核、右额中回、右中央前回、左颞中回和左小脑等脑区磁共振数据降低;与艾灸后静息相比,艾灸足三里时FD患者的左枕叶中部,小脑,右枕叶中部等脑区磁共振数据降低;与艾灸后静息相比,艾灸前静息FD患者的左海马、右小脑脚等脑区磁共振数据降低。结论:温和灸FD患者足三里穴的中枢即刻响应特征可能为通过协调左小脑、左颞极、左颞中回脑区活动降低内脏敏感性,调节前额叶、中央前皮质、颞中回、颞上回、海马等脑区活动来抑制内脏感受传导,提高疼痛、饱胀等感觉的阈值。

Objective： To investigate the brain functional response characteristics of moxibustion on Zusanli （ST 36） of patients with functional dyspepsia （FD） . Methods： Thirty-eight FD patients met the inclusion and exclusion criteria were included, under- going functional magnetic resonance imaging （fMRI） scan from location phase, structure phase, resting state before moxibustion, task phase when moxibustion on ST36 and resting state after moxibustion, then analyzed the data collected by DPARSF software. Results： Contrast between moxibustion and resting before moxibustion, the difference is negative activation in the left puta- men, fight frontal gyrus, fight precentral gyrus, left middle frontal gyrus, left epencepha and other brain regions, there was a statis- tically significant （P 〈 0. 01 ） ; Contrast between moxibustion and resting after moxibustion, the difference is negative activation in the medial of left occipital lobe, epencepha, The middle leaves of fight occipital lobe. there was a statistically significant （ P 〈 0.01 ） ; the experimental results between after moxibustion and moxibustion before show that the left hippocampus, fight cerebellum showed negative activation, there was significant difference was statistically significant （P 〈 0. 01 ） . Conclusion： The nervous system mechanism of moxibustion at ST36 in patients of FD may be the inhibition of left cerebellum, the left temporal pole, left middle frontal gyrus, the medial of left occipital lobe to reduce visceral sensitivity, the modulation of the prefrontal lobe, the precentral cortex, the middle temporal gyrus, superior temporal gyrus and hippocampus to inhibit the conduction of visceral sensory, increase the threshold of pain and feeling of repletion.