组穴针刺治疗颈痛患者默认网络的ReHo研究

摘要

Objective:To explore the inlfuence of the default network (DMN) after the group acupoint treatment on the cervical spondylosis neck pain (CSNP), and to explain the mechanisms of their central nerve effect.Materials and Methods:49 CSNP patients were divided into two groups, one group given the acupuncture treatment at bailao (single acupoint), the other group at bailao and hegu (group acupoint), then we record their NPQ/MPQ/SF-36 score and scan the MRI before treatment and after, use the method of ReHo to deal with the data.Results:After the treatment of single acupoint, in DMN it shows stronger ReHo on left anterior cerebellum anterior lobe, weaker ReHo on right angular, inferior parietal lobule, middle frontal gyrus and superior frontal gyrus. The group acupoint group shows stronger ReHo on middle temporal gyrus and cuneus, weaker ReHo on left inferior temporal gyrus and inferior parietal lobule.Conclusions: The study discovered that both groups can achieve the analgesic effect in the clinical treatment on the chronic pain, and have the same curative effect. But there are different mechanisms of their central nerve effect on analgesia, and those can be useful to explain the mechanism of central nerve effect of acupuncture.%目的：探索组穴针刺治疗对颈椎病颈痛(cervical spondylosis neck pain， CSNP)默认网络的影响，以期阐明其中枢作用机制。材料与方法将49名CSNP患者随机分为两组，分别给予百劳穴(单穴)、百劳+合谷穴(组穴)针刺治疗，于治疗前后进行NPQ量表及MPQ疼痛量评分、SF-36量表调查及静息态脑功能MRI，应用局部一致性(ReHo)方法处理fMRI数据。结果单穴组治疗后默认网络中左侧小脑前叶ReHo增高，右侧角回、顶下小叶、额中回及额上回ReHo减低。组穴组右侧颞中回及楔叶ReHo增高，左侧颞下回及顶下小叶ReHo减低。结论单组穴在临床治疗慢性疼痛中均能起到镇痛效果，且疗效相当，但两组的中枢镇痛效应不同，这对进一步阐明针刺中枢机制起到一定的帮助作用。