Through searching the literature on the mechanism of acupuncture for primary dysmenorrhea in the last 15 years,this paper summarizes systematically the current study progress on the analgesic mechanism of acupuncture for primary dysmenorrhea,from the perspectives of animal experiment and human trials.In terms of research methods,the behavioral observation,evaluation of central and peripheral biochemical indexes,and molecular biological techniques were mainly used in the animal experiments;whilst the clinical symptoms and evaluation of peripheral serum biochemical indexes were focused on in human trials.As for the research results,the animal experiments showed that acupuncture may play an analgesic role by regulating endocrine,promoting the release of central and peripheral neurotransmitters,regulating immune function,and relieving uterine smooth muscle spasm.However,the human trials have found that acupuncture can produce analgesic effects by regulating serum prostaglandin and ovarian hormone levels,promoting the release of peripheral β-endorphin,improving the uterine artery flow status,and relieving uterine smooth muscle spasm.Although different research methods were used in animal and human studies,the similar results were obtained in acupuncture regulating endocrine levels,promoting release of peripheral neurotransmitters,and alleviating uterine smooth muscle spasms.In addition,at present stage,animal experiments are more than human trials in numbers,and there are relatively few studies on the central mechanism of acupuncture analgesia in human trials.Therefore,in view of this phenomenon,this paper proposes to use functional magnetic resonance imaging(fMRI) technology to explore the central mechanism of acupuncture analgesia in human body,so as to provide a new idea for further exploring the mechanism of acupuncture analgesia in treating primary dysmenorrhea.
目的:研究针刺治疗原发性痛经的脑功能机理。方法:运用静息态功能磁共振成像(resting-state functional magnetic resonance imaging,Rf MRI)技术,在16名原发性痛经患者月经来潮的第1或第2天小腹疼痛时对其进行静息态扫描(Rest1,R1)、针刺双侧三阴交和地机穴后留针状态扫描(Acupuncture,AP)、去针后第2次静息态扫描(Rest2,R2)。应用低频振荡振幅(amplitude of low frequency fluctuation,ALFF)作为测量指标,对采集的Rf MRI数据进行相关的处理与统计分析。结果:(1)针刺后患者疼痛值(VAS评分)比针刺前明显降低(P<0.01);(2)R2与AP配对t检验结果显示:ALFF信号减弱(R2
目的观察针刺手太阴肺经腧穴引起的大脑自发神经活动低频振荡振幅(amplitude of low frequency fluctuations,ALFF)变化,初步探索手太阴肺经的脑功能网络。方法运用功能磁共振成像(functional magnetic resonance imaging,fMRI)技术,对16名健康志愿者进行纯静息态扫描(Rest1,R1)和针刺左侧手太阴肺经全经腧穴后留针状态扫描(acupuncture,AP)。对采集的fMRI数据均进行个体ALFF图像计算。结果R1状态下,右侧楔前叶、左侧顶下小叶、双侧额中回、双侧颞上回、左侧额下回、左侧额上回、左侧额内侧回等脑区表现出显著的ALFF增强。AP状态下,ALFF显著增强的脑区出现在右侧楔前叶、双侧额上回、小脑、双侧额中回、右侧额内侧回等。与R1状态比较,针刺手太阴肺经使ALFF在右侧胼胝体下回、右侧额下回显著增强,而在右侧中央后回、左楔叶、左侧颞上回、左侧颞中回等脑区则显著降低。结论针刺肺经腧穴会显著改变大脑皮层固有活动状态,尤其是右侧半球的胼胝体下回、额下回等区域ALFF显著增强。
