中国中西医结合杂志2024，Vol.44Issue(7)：814-820,7.DOI:10.7661/j.cjim.20240416.076
基于"按之快然"点按力敏舒快态委中穴对腰椎间盘突出症患者的即刻功能脑网络研究
Immediate Functional Brain Networks in Patients with Lumbar Disc Herniation Using"Press-Emergence Sensation"at Pressure Pleasantly-Sensitive Weizhong Point(BL 40)
摘要
Abstract
Objective To dissect the theoretical connotations of"press-emergence sensation"from the perspective of"acupoint sensitization-central sensitization"by utilizing resting-state functional magnetic resonance imaging(rs-fMRI)to investigate the immediate functional brain networks of lumbar disc herniation(LDH)patients undergoing press stimulation at the pressure pleasantly-sensitive Weizhong point(BL 40).Methods Thirty LDH patients meeting inclusion criteria were classified as LDH group and thirty-one healthy subjects as healthy group,all of whom experienced pleasant sensations at the Weizhong point(BL 40).LDH group underwent 15 minutes of press stimulation at the Weizhong point(BL 40),and rs-fMRI scan was performed before and after treatment,while healthy group underwent rs-fMRI scans only at inclusion.The brain regions with statistically significant differences in the baseline period between the LDH group and the healthy group were analyzed,focusing on the regions of interest(ROI)with statistically significant differences for analyzing changes in functional connectivity(FC)before and after immediate treatment in the LDH group.Results Compared with the healthy group,mALFF in the right insular cortex,left orbital medial frontal gyrus,left orbital inferior frontal gyrus,and left medial frontal gyrus before treatment increased in the LDH group;and mALFF in the right lentiform nucleus decreased(P＜0.005).The left medial frontal gyrus exhibited the largest mALFF value and peak value among different brain regions.The LDH group showed a specific significant decrease in FC in the left precentral gyrus before treatment compared with the healthy group(P＜0.005).And the LDH group showed enhanced FC in the bilateral thalamus and left inferior parietal lobule after treatment compared with before treatment(P＜0.005).Conclusions Significant activation of the"prefrontal cortex-frontoparietal network-sensorimotor net work"neural circuit is present in LDH patients with chronic long-term pain.The"cingulo-opercular network-default mode network"may be the key neural circuit for the immediate analgesic effect of press stimulation at the pressure pleasantly-sensitive Weizhong point(BL 40)in LDH patients.(ClinicalTrials.gov,No.NCT05613179).关键词
力敏舒快态腧穴/点按法/腰椎间盘突出症/功能磁共振/即刻脑效应/委中穴Key words
pressure pleasantly-sensitive acupoints/point-press method/lumbar disc herniation/magnetic resonance imaging/real-time brain activity/Weizhong(BL40)引用本文复制引用
周星辰,吕智桢,吴双,田雨,胡会杰,王凯正,吕立江..基于"按之快然"点按力敏舒快态委中穴对腰椎间盘突出症患者的即刻功能脑网络研究[J].中国中西医结合杂志,2024,44(7):814-820,7.基金项目
浙江省"尖兵""领雁"重大研发攻关项目(No.2022C03123) （No.2022C03123）
国家自然科学基金资助项目(No.82274672,No.81774442) （No.82274672,No.81774442）
吕立江名老中医专家传承工作室(No.GZS2021026) （No.GZS2021026）
