切换至 "中华医学电子期刊资源库"

中华针灸电子杂志 ›› 2018, Vol. 07 ›› Issue (01) : 15 -20. doi: 10.3877/cma.j.issn.2095-3240.2018.01.006

所属专题: 文献

综述

针刺治疗偏头痛fMRI机制研究进展
颜铭航1, 蔡依妏1, 裴建1,()   
  1. 1. 200032 上海中医药大学附属龙华医院针灸科
  • 收稿日期:2017-12-13 出版日期:2018-02-15
  • 通信作者: 裴建
  • 基金资助:
    上海市科委科研重点项目(14401971300; 1640197030); 上海市卫计委重点项目(ZY3-CCCX-1-1007); 上海市卫计委针灸特色诊疗项目(ZJ2016001)

Research progress of fMRI study on acupuncture treatment in migraine

Minhang Gan1, Yiwen Tsai1, Jian Pei1,()   

  1. 1. Department of Acupuncture, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
  • Received:2017-12-13 Published:2018-02-15
  • Corresponding author: Jian Pei
  • About author:
    Corresponding author: Pei Jian, Email:
引用本文:

颜铭航, 蔡依妏, 裴建. 针刺治疗偏头痛fMRI机制研究进展[J]. 中华针灸电子杂志, 2018, 07(01): 15-20.

Minhang Gan, Yiwen Tsai, Jian Pei. Research progress of fMRI study on acupuncture treatment in migraine[J]. Chinese Journal of Acupuncture and Moxibustion(Electronic Edition), 2018, 07(01): 15-20.

偏头痛是发病率较高的中枢神经系统性疾病,可严重影响患者的生活质量。文章通过对PubMed、MEDLINE、Cochrane、中国知网和维普等数据库,近10年国内外功能性磁共振成像(fMRI)观察偏头痛的针刺治疗机制研究相关文献进行检索,共纳入8篇文献。fMRI研究结果显示针刺治疗可以对偏头痛患者失调的三叉神经痛觉通路、前额顶网络、默认模式网络、下行疼痛调节机制、疼痛矩阵或疼痛调节相关脑区进行调节,达到治疗作用。对8篇临床研究所纳入的对象与对照的选择、扫描时点、fMRI分析方法、穴位选择、研究结果分析等方面对所纳入研究进行分析、总结,以期为进一步研究的开展提供可靠的循证依据与新思路。

Migraine, a central nervous system disease with high prevalence, can severely disrupt the quality of migraineurs′ life. In this review, 8 papers were included through searching published literature on fMRI studies over the past ten years on acupuncture treatment in migraine in PubMed, MEDLINE, COCHRANE, CNKI, VJIP databases. The results show that acupuncture therapy can regulate the altered brain areas in migraine patients, such as trigeminal nerve pain pathway, frontoparietal network, default mode network, descending pain modulatory system, pain matrix, or pain regulation related brain areas. The selection of subjects and control groups, scanning time points, fMRI analyzing methods, selection of acupuncture points, and study results in 8 papers were analyzed and summarized, which will provide new ideas and evidences for further research.

表1 偏头痛的fMRI针刺治疗文献资料
作者(年份) 穴位 针刺组 对照组 扫描时点 分析方法
Li,et al. (2017)[10] 治疗组1阳陵泉(GB34)、丘墟(GB40)和外关(SJ5) MwoA 11例VA1、11例VA2、13例VA3 MwoA11例SA、16例(WT) 两组:治疗4周后和治疗8周后 ALFF
治疗组2膝阳关(GB33)、地五会(GB42)和三阳络(SJ8)
治疗组3足三里(ST36)、冲阳(ST42)和偏历(L16)
Li, et al. (2017)[11] 治疗组1阳陵泉(GB34)、丘墟(GB40)和外关(SJ5) MwoA 12例VA1、14例VA2、15例VA3 MwoA13例SA、18例WT 两组:治疗4周后和治疗8周后 ICA定楔前叶为种子点楔前叶为种子点的SBA
治疗组2膝阳关(GB33)、地五会(GB42)和三阳络(SJ8)
治疗组3足三里(ST36)、冲阳(ST42)和偏历(L16)
Li, et al. (2015)[13] 治疗组1阳陵泉(GB34)、丘墟(GB40)和外关(SJ5) MwoA 11例VA1、11例VA2、13例VA3 MwoA11例SA、16例(WT) 两组:治疗4周后和治疗8周后 PAG为种子点的SBA
治疗组2膝阳关(GB33)、地五会(GB42)和三阳络(SJ8)
治疗组3足三里(ST36)、冲阳(ST42)和偏历(L16)
刘宏伟,等(2016)[12] 足临泣 15例MwoA 13例HC 两组:受试者针刺前30 min静息态扫描,进针时、进针后留针10 s,平补平泻捻转1 min,留针8 min后出针连续扫描 AAL模板获得脑区时间曲线,Pearson相关分析
Zhang, et al.(2015)[14] 双侧丝竹空(SJ23) 、率谷(GB8)、风池(GB20)、太阳(EX-HN5)、合谷(LI4)、太冲(LR3)外关(SJ5)、阳陵泉(GB34)和足临泣(GB41) 12例MwoA 12例HC 治疗组:治疗前和治疗后(4周为1个疗程)对照组:未经干预的1次扫描 ICA
Li, et al.(2015)[15] 双侧丝竹空(SJ23) 、率谷(GB8)、风池(GB20)、太阳(EX-HN5)、合谷(LI4)、太冲(LR3)外关(SJ5)、阳陵泉(GB34)和足临泣(GB41) 12例MwoA 12例HC 两组:治疗4周后和治疗8周后 ICA定ROI,进行DTI分析
Zhao, et al.(2014)[16] 治疗组(风池GB20、外关SJ5、阳陵泉GB34、丘墟GB40);对照组(耳禾髎SJ22、大陵PC7、光明GB37和太白SP3) 20例active针刺MwoA组 20例inactive针刺MwoA 两组:治疗前和治疗后(8周) ReHo
林磊,等(2013)[17] 风池、百会和行间 15例MwoA 15例头痛患者 两组:治疗前和治疗后(5 d) MRS(NAA/Cr;Cho/Cr)
1
Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability(YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010[J]. Lancet, 2012, 380 (9859): 2163-2196.
2
Wang X, Xing Y, Sun J, Zhou H, Yu H, Zhao Y, et al. Prevalence, Associated Factors, and Impact on Quality of Life of Migraine in a Community in Northeast China[J]. J Oral Facial Pain Headache, 2016;30(2): 139-149.
3
Vos T, Allen C, Arora M, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015[J]. Lancet, 2016, 388(10053): 1545.
4
Minen MT, Loder E, Tishler L, et al. Migraine diagnosis and treatment: A knowledge and needs assessment among primary care providers[J]. Cephalalgia, 2016, 36(4): 358-370.
5
Datta R, Aguirre GK, Hu S, et al. Interictal cortical hyperresponsiveness in migraine is directly related to the presence of aura[J]. Cephalalgia, 2013, 33(6): 365-374.
6
Zhao L, Liu J, Dong X, et al. Alterations in regional homogeneity assessed by fMRI in patients with migraine without aura stratified by disease duration[J]. J Headache Pain, 2013, 14(1): 85.
7
Gao Q, Xu F, Jiang C, et al. Decreased functional connectivity density in pain-related brain regions of female migraine patients without aura[J]. Brain Research, 2016(1632): 73-81.
8
佚名. 世界卫生组织认可的64种针灸适应证[J]. 针刺研究,2008(3): 168.
9
Linde K, Allais G, Brinkhaus B, et al. Acupuncture for migraine prophylaxis[J]. Cochrane Database Syst Rev, 2009(1): Cd001218.
10
Li Z, Zeng F, Yin T, et al. Acupuncture modulates the abnormal brainstem activity in migraine without aura patients[J]. Neuroimage Clin, 2017(15): 367-375.
11
Li Z, Lan L, Zeng F, et al. The altered right frontoparietal network functional connectivity in migraine and the modulation effect of treatment[J]. Cephalalgia, 2016, 37(2): 161-176.
12
刘宏伟,李匡时,宁艳哲,等. 偏头痛患者针刺足临泣对疼痛相关脑功能网络影响的fMRI研究[J]. 中华中医药杂志,2016(5): 2013-2016.
13
Li Z, Liu M, Lan L, et al. Altered periaqueductal gray resting state functional connectivity in migraine and the modulation effect of treatment[J]. Scientific Reports, 2016(6): 20298.
14
Zhang Y, Li K, Liu H, et al. Acupuncture treatment modulates the resting-state functional connectivity of brain regions in migraine patients without aura[J]. Chinese Journal of Integrative Medicine, 2016, 22(4): 293-301.
15
Li K, Zhang Y, Ning Y, et al. The effects of acupuncture treatment on the right frontoparietal network in migraine without aura patients[J]. Journal of Headache & Pain, 2015, 16(1): 33.
16
Zhao L, Liu J, Zhang F, et al. Effects of Long-Term Acupuncture Treatment on Resting-State Brain Activity in Migraine Patients: A Randomized Controlled Trial on Active Acupoints and Inactive Acupoints[J]. PLoS One, 2014, 9(6): e99538.
17
谷涛,林磊,焦晟,等. 针刺预防性治疗偏头痛脑内代谢变化的磁共振波谱研究[J]. 医学影像学杂志,2013, 23(3): 345-349.
18
马园园,郑罡,周洁敏,等. 基于fMRI的脑功能整合数据分析方法综述[J]. 生物物理学报,2011, 27(1): 18-27.
19
钟元,赵翠花,陶玲,等. 静息态fMRI分析方法及其在创伤后应激障碍研究中的应用[J]. 生物物理学报,2013, 29(10): 738-750.
20
Akerman S, Holland PR, Goadsby PJ. Diencephalic and brainstem mechanisms in migraine[J]. Nature Reviews Neuroscience, 2011, 12(10): 570-584.
21
Caterina M, Jasmine B, Nouchine H. Altered functional magnetic resonance imaging resting-state connectivity in periaqueductal gray networks in migraine[J]. Ann Neurol, 2011, 70(5): 838-845.
22
Vogt BA, Derbyshire S, Jones AKP. Pain Processing in Four Regions of Human Cingulate Cortex Localized with Co-registered PET and MR Imaging[J]. European Journal of Neuroscience, 1996, 8(7): 1461-1473.
23
Russo A, Tessitore A, Giordano A, et al. Executive resting-state network connectivity in migraine without aura[J]. Cephalalgia An International Journal of Headache, 2012, 32(14): 1041.
24
Kong J, Jensen K, Loiotile R, et al. Functional connectivity of the frontoparietal network predicts cognitive modulation of pain[J]. Pain, 2013, 154(3): 459.
25
Buckner RL, Andrewshanna JR, Schacter DL. The brain's default network: anatomy, function, and relevance to disease[J]. Annals of the New York Academy of Sciences, 2008, 1124(1): 1-38.
26
Xue T, Yuan K, Zhao L, et al. Intrinsic brain network abnormalities in migraines without aura revealed in resting-state fMRI[J]. Plos One, 2012, 7(12): e52927.
27
Chowdhury F, Haque M, Sarkar M, et al. White fiber dissection of brain; the internal capsule: a cadaveric study[J]. Turkish Neurosurgery, 2010, 20(3): 314-322.
28
Mamata H, Mamata Y, Westin CF, et al. High-Resolution Line Scan Diffusion Tensor MR Imaging of White Matter Fiber Tract Anatomy[J]. AJNR Am J Neuroradiol, 2002, 23(1): 67-75.
29
Andrews-Hanna J R, Smallwood J, Spreng RN. The default network and self-generated thought: component processes, dynamic control, and clinical relevance[J]. Ann N Y Acad Sci, 2014, 1316(1): 29-52.
30
Amin F M, Hougaard A, Magon S, et al. Altered thalamic connectivity during spontaneous attacks of migraine without aura: A resting-state fMRI study[J]. Cephalalgia, 2017.doi: 10.1177/0333102417729113. [Epub ahead of print]
31
Coppola G, Di Renzo A, Tinelli E, et al. Thalamo-cortical network activity during spontaneous migraine attacks[J]. Neurology, 2016, 87(20): 2154-2160.
32
Wager TD, Rilling JK, Smith EE, et al. Placebo-Induced Changes in fMRI in the Anticipation and Experience of Pain[J]. Science, 2004, 303(5661): 1162-1167.
33
段冬梅,图娅,陈利平,等. 电针对抑郁症患者不同脑区的影响:磁共振研究[J]. 中国针灸,2009, 29(2): 139-144.
34
林铮,李惠春,龚向阳,等. 抑郁症患者前额叶、海马磁共振质子波谱成像的研究[J]. 中华精神科杂志,2005, 38(4): 193-197.
35
Gabbay V, Hess DA, Liu S, et al. Lateralized caudate metabolic abnormalities in adolescent major depressive disorder: a proton MR spectroscopy study[J]. Am J Psychiatry, 2007, 164(12): 1881-1889.
36
Colombo B, Rocca MA, Messina R, et al. Resting-state fMRI functional connectivity: a new perspective to evaluate pain modulation in migraine?[J]. Neurological Sciences, 2015, 36(1): 41-45.
37
方继良,王小玲,王寅,等. 电针正常人足三里和关元穴中枢效应的fMRI脑功能成像比较[J]. 针刺研究,2012, 37(1): 46-52.
38
方继良,Hui KS Kathleen,Liu Jing,等. 针刺太冲穴得气及疼痛激发相对抗的脑功能网络效应fMRI研究[J]. 中国中西医结合影像学杂志,2012, 10(1): 4-9.
[1] 丁建民, 秦正义, 张翔, 周燕, 周洪雨, 王彦冬, 经翔. 超声造影与普美显磁共振成像对具有高危因素的≤3 cm肝结节进行LI-RADS分类诊断的前瞻性研究[J]. 中华医学超声杂志(电子版), 2023, 20(09): 930-938.
[2] 张莲莲, 惠品晶, 丁亚芳. 颈部血管超声在粥样硬化斑块易损性评估中的应用价值[J]. 中华医学超声杂志(电子版), 2023, 20(08): 816-821.
[3] 刘冰茹, 刘皓希, 陈莹, 赖世伟, 陈蓉. 疑似乳腺癌的韧带样纤维瘤病一例[J]. 中华乳腺病杂志(电子版), 2023, 17(05): 314-317.
[4] 方心俞, 黄昌瑜, 胡洪新, 林溢铭, 陈旸, 张楠心, 张文明. 膝关节软骨下不全骨折的治疗选择与疗效分析[J]. 中华关节外科杂志(电子版), 2023, 17(04): 583-587.
[5] 董晓燕, 赵琪, 唐军, 张莉, 杨晓燕, 李姣. 奥密克戎变异株感染所致新型冠状病毒感染疾病新生儿的临床特征分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 595-603.
[6] 韩宇, 张武, 李安琪, 陈文颖, 谢斯栋. MRI肝脏影像报告和数据系统对非肝硬化乙肝患者肝细胞癌的诊断价值[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 669-673.
[7] 雷漫诗, 邓锶锶, 汪昕蓉, 黄锦彬, 向青, 熊安妮, 孟占鳌. 人工智能辅助压缩感知技术在上腹部T2WI压脂序列中的应用[J]. 中华肝脏外科手术学电子杂志, 2023, 12(05): 551-556.
[8] 王景景, 符锋, 李建伟, 任党利, 陈翀, 刘慧, 孙洪涛, 涂悦. 针刺对中型创伤性颅脑损伤后BDNF/TrkB信号通路的影响[J]. 中华神经创伤外科电子杂志, 2023, 09(04): 199-205.
[9] 钟广俊, 刘春华, 朱万森, 徐晓雷, 王兆军. MRI联合不同扫描序列在胃癌术前分期诊断及化疗效果和预后的评估[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 378-382.
[10] 吴钰娴, 冯亚园, 霍雷, 贾宁阳, 张娟. 原发性肝脏淋巴瘤的影像学诊断价值研究[J]. 中华消化病与影像杂志(电子版), 2023, 13(05): 349-353.
[11] 杜宇征. 醒脑开窍针刺法与针灸学科的五十年发展历程[J]. 中华针灸电子杂志, 2023, 12(04): 133-137.
[12] 孟智宏. 醒脑开窍针刺法治疗多系统疾病的机制研究现状[J]. 中华针灸电子杂志, 2023, 12(04): 142-145.
[13] 宁丽娜, 熊杰. 醒脑开窍针刺法结合舌部针刺治疗脑梗死后构音障碍的疗效观察[J]. 中华针灸电子杂志, 2023, 12(04): 146-150.
[14] 赵暾, 徐霁华, 何有娣, 鲁明. 误诊为脑梗死且险些溶栓的急性自发微量脑出血一例[J]. 中华脑血管病杂志(电子版), 2023, 17(04): 369-372.
[15] 于玲, 张祉昱, 张喆, 傅瑜. 偏头痛常见诱因及其在疾病管理中的应用研究进展[J]. 中华脑血管病杂志(电子版), 2023, 17(04): 400-403.
阅读次数
全文


摘要