浅针山根穴治疗原发性失眠静息态功能磁共振研究

A Resting-state Functional Magnetic Resonance Imaging Study of Superficial Needling at Shangen Point for Treatment of Primary Insomnia

目的探讨浅针山根穴治疗原发性失眠(PI)的中枢作用机制。方法对10例PI患者(治疗组)在浅针治疗前后及10例健康者(对照组)进行静息态功能磁共振技术(fMRI)扫描,比较2组之间及治疗组治疗前后脑区功能连接差异情况。结果治疗组与对照组比较,功能连接增强的脑区主要有双侧额中回、右侧中央前回、双侧中央后回、左侧楔前叶、右侧顶上小叶;功能连接减低的脑区主要有左侧脑岛、左侧前扣带回、右豆状核、左侧尾状核。治疗组治疗后与治疗前比较,功能连接增强的脑区主要有双侧脑岛、双侧脑干、左侧尾状核、双侧扣带回;功能连接减低的脑区主要有双侧额中回、右侧楔前叶。结论 PI患者存在情绪回路功能的异常;浅针刺激山根穴能改善情绪回路的功能,可能是浅针治疗PI的中枢机制之一。

Objective To explore the central modulating mechanism of superficial needling at Shangen point(Ex-HN33) for treatment of primary insomnia(PI). Methods 10 PI patients were chosed in the treatment group, received a resting-state functional magnetic resonance imaging(fMRI) scan before and af-ter superficial needling, and 10 healthy people as control. The differences of brain functional connectivity be-tween the two groups were analyzed, and the index in the treatment group before and after the treatment were compared. Results Compared with the control group, the functional connectivity of bilateral middle frontal gyrus, bilateral precentralgyrus, right postcentral gyrus, left precuneus and right superior parietal lobule in the treatment group were increased, and the functional connectivity of left insula, left anterior cingulate cortex, bi-lateral lentiform nucleus and left caudate nucleus in the treatment group were decreased. After the treatment of superficial needling, the functional connectivity of bilateral insula, bilateral brainstem, left caudate nucleus and bilateral cingulate cortex in the treatment group were increased, and the functional connectivity of bilater-al middle frontal gyrus and right precuneus in the treatment group were decreased. Conclusion The dysfunction of the emotional circuit has been found in PI patients. Superficial needling at Ex-HN33 can improve the function of emotional circuit, which may partly explain the mechanism of treating PI by superficial needling.