不同远近配穴法治疗月经性偏头痛的脑功能局部一致性分析

Analysis of cerebral functional regional homogeneity of treating menstrual migraine with different distal-proximal points combination

目的观察不同远近配穴法针刺治疗对月经性偏头痛患者脑功能活动的调节差异,探讨远近配穴法治疗月经性偏头痛的神经影像学机制。方法以22例月经性偏头痛患者为研究对象,同时纳入10例健康受试者作为对照;将月经性偏头痛患者随机分为远部配穴组(风池、率谷配伍太冲)和近部配穴组(风池、率谷配伍内关),分别进行3个月经周期的针刺治疗,在治疗前后给予静息态功能磁共振扫描。观察两组患者针刺前后各脑区ReHo及头痛VAS评分的差异;并对差异脑区ReHo变化和VAS评分变化进行相关分析。结果针刺后远部配穴组患者的头痛VAS评分有显著改善(P<0.05),与健康人相比,月经性偏头痛患者ReHo差异脑区有枕叶、顶叶、边缘叶、额叶;与治疗前相比,远部配穴组患者ReHo变化的脑区有枕叶、顶叶与额叶;近部配穴组患者ReHo变化的脑区有顶叶与额叶。结论本研究初步发现远部配穴组针刺治疗月经性偏头痛在头痛程度方面有改善,远部配穴组针刺对患者脑功能活动的调节可能与枕叶和楔前叶有关。

Objective To observe the differences in the regulation of brain function activity of patients with menstrual migraine by acupuncture treatment of different distal-proximal points combination, and to explore the neuroimaging mechanism of the treatment of menstrual migraine by distal-proximal points combination. Methods Twenty-two menstrual migraine patients were taken as the research object, and 10 healthy subjects were included as controls;the menstrual migraine patients were randomly divided into the distal points group(GB20, GB8 compatibility LR3) and the proximal points group(GB20, GB8 compatibility PC6) were treated with acupuncture for 3 menstrual cycles. Observe the differences in ReHo and headache VAS scores of the two groups of patients before and after acupuncture;and analyze the changes in ReHo and VAS scores in different brain areas. Results The VAS scores of patients with headache in the distal acupoint matching group were significantly improved after acupuncture(P<0.05). Conclusion This study preliminarily found that acupuncture in the distal acupoint treatment group can improve the degree of headache in the treatment of menstrual migraine, and the regulation of brain function activity in the distal acupoint treatment group may be related to the occipital lobe and precuneus.