中医康复疗法干预膝骨关节炎的脑网络机制研究进展

Research progress on the brain network mechanism of Chinese medicine rehabilitation therapy intervention in knee osteoarthritis

膝骨关节炎(knee osteoarthritis, KOA)是一种多发于老年人的骨关节性疾病,传统运动、针灸、推拿等中医康复疗法是缓解KOA的临床方法。MRI显示KOA与脑皮质变薄、脑区功能连接异常等大脑结构和功能网络变化相关,而中医康复疗法通过恢复KOA患者脑功能、结构的异常变化来发挥作用。因此,本综述基于MRI技术在以下方面进行回顾总结:(1)KOA疼痛会导致皮质变薄、灰质体积、密度缩小等大脑结构网络异常改变;(2)KOA会出现特定脑区异常激活、不同脑区功能连接异常改变等功能网络变化;(3)规范的运动训练可以调节大脑网络;(4)针灸、推拿可以改善多个脑区的功能结构。以期通过本综述为促进中医康复与影像学技术结合,及为通过中医康复缓解KOA症状、减轻患者痛苦提供新思路。

Knee osteoarthritis(KOA) is an osteoarthritic disease that occurs in the elderly. Traditional exercise, acupuncture, and Tui-na rehabilitation therapies are clinical approaches to alleviate KOA. MRI shows that KOA is associated with changes in brain structure and functional networks such as cortical thinning and abnormal functional connectivity of brain regions. Chinese medicine rehabilitation therapy works by restoring abnormal changes in brain function and structure in KOA patients. Therefore, this review is based on MRI technology to review and summarize it:(1) KOA pain causes cortical thinning, gray matter volume, density reduction, and other abnormal changes in the structural network of the brain;(2) KOA shows changes in functional network such as abnormal activation of specific brain regions and abnormal changes in functional connectivity of different brain regions;(3) standardized exercise training can modulate brain networks;(4) acupuncture, moxibustion, and massage can improve the functional structure of multiple brain regions. To provide new ideas for promoting the combination of traditional Chinese medicine rehabilitation and imaging technology, and to relieve the symptoms of KOA and relieve the pain of patients with traditional Chinese medicine rehabilitation.