中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (28): 2649-2655.doi: 10.3969/j.issn.1673-5374.2013.28.007

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

针刺治疗偏头痛的镇痛机制?

  

  • 收稿日期:2012-12-03 修回日期:2013-03-09 出版日期:2013-10-05 发布日期:2013-10-05
  • 基金资助:

    国家重点基础研究发展计划（973计划）项目“经穴效应循经特异性规律及关键影响因素基础研究”(NO. 2012CB518501)；国家自然科学基金重点项目“循经取穴治疗偏头痛的中枢响应网络研究”（NO. 30930112）。

A central analgesic mechanism of acupuncture for migraine An ongoing functional MRI study

Lei Lan1, Yujie Gao2, Fang Zeng1, Wei Qin3, Mingkai Dong1, Mailan Liu1, Taipin Guo1, Fanrong Liang1   

  1. 1 School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
    2 School of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, China
    3 Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi’an 710071, Shaanxi Province, China
  • Received:2012-12-03 Revised:2013-03-09 Online:2013-10-05 Published:2013-10-05
  • Contact: Fanrong Liang, Master, Professor, School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China, acuresearch@126.com.
  • About author:Lei Lan, M.D.
  • Supported by:

    This experiment was supported by the National Basic Research Program of China (973 Program), No. 2012CB518501, and the Key Project of the National Natural Science Foundation of China, No. 30930112/ C190301.

PDF

2063

摘要：

循少阳经取穴是针刺治疗偏头痛的主要选穴方法，但其中枢镇痛机制尚不清楚。有研究发现，即时针刺正常人的经穴可引起疼痛相关脑功能网络连接度的显著变化，但此研究结果并不完全适用于揭示偏头痛患者针刺少阳经穴的中枢镇痛机制。因此，文章拟制定如下试验方案：纳入100名无先兆偏头痛患者，随机分为5组：少阳经特定穴组、少阳经非特定穴组、阳明经特定穴组、非经非穴组和等待治疗组，并分别于针刺前、针刺10次后、针刺20次后进行3次疗效评价与功能性磁共振扫描。所有受试者经过专业医师诊断和临床体检后于入组第1-4周进入观察期。入组第5周时，受试者接受第一次临床评估和静息态磁共振扫描。上述任务完成后前4组被试于第5-8周进入针刺治疗期，每周5次，4周内共20次，于针刺10次后、针刺20次后进行第二、三次临床评估和静息态磁共振扫描；等待治疗组于入组第5-8周进入等待观察期，随后再进行一次临床评估和静息态磁共振扫描。此设计方案旨在观察：针刺少阳经特定穴后，偏头痛患者的脑功能活动及中枢网络调节的变化，此研究有助于更好地解释循少阳经取穴针刺治疗偏头痛的中枢镇痛机制。文章展示了长期针刺治疗对偏头痛患者的中枢镇痛调节机制研究的具体设计与方案细节。

关键词: 神经再生, 针灸, 偏头痛, 针刺, 镇痛, 中枢响应, 功能性磁共振, 针刺疗程, 持续的中枢活动, 试验设计, 基金资助文章

Abstract:

Shaoyang acupoints are the most frequently used in migraine treatment. However, the central anal-gesic mechanism remains poorly understood. Studies have demonstrated that single stimulus of the verum acupuncture in healthy subjects can induce significant connectivity or activity changes in pain- related central networks compared with sham acupuncture. However, these findings are not indicative of the central analgesic mechanism of acupuncture at Shaoyang acupoints. Thus, we recruited 100 migraine sufferers and randomly assigned them into five groups: Shaoyang uncommon acupoint, Shaoyang common acupoint, Yangming uncommon acupoint, non-acupoint control, and blank control groups. Subjects were subjected to evaluation of curative effects and functional MRI prior to and after 10 and 20 acupuncture treatments. All subjects were diagnosed by physicians and enrolled following clinical physical examination. Subjects were observed during 1–4 weeks after inclusion. At the fifth week, the first clinical evaluation and resting functional MRI were conducted. The Shaoyang uncom-mon acupoint, Shaoyang common acupoint, Yangming uncommon acupoint, and non-acupoint control grousp then were treated with acupuncture, five times per week, 20 times in total over 4 weeks. The second and third clinical evaluations and resting functional MRI screenings were conducted following 10 and 20 acupuncture treatments. The blank control group was observed during the 5 to 8 week pe-riod, followed by clinical evaluation and resting functional MRI. The aim of this study was to examine changes in brain functional activity and central networks in subjects with migraine undergoing acu-puncture at Shaoyang uncommon acupoints. This study provides a further explanation of the central analgesic mechanism by which acupuncture at Shaoyang acupoints treats migraine.

Key words: neural regeneration, acupuncture and moxibustion, migraine, acupuncture, analgesia, central re-sponse, functional MRI, sessions of acupuncture, continuous central activity, study design, grants- supported paper, neuroregeneration