Low-frequency fluctuation amplitude analysis of resting-state fMRI for functional brain response differences between acupuncture and moxibustion at Zusanli (ST 36) in patient with functional dyspepsia

Objective

To compare and analyze functional brain response characteristics by applying acupuncture or moxibustion to Zusanli (ST 36) in patients with functional dyspepsia (FD) and investigate the differences of central action mechanism resulting from acupuncture or moxibustion.

Methods

A total of eligible 24 FD cases were divided into two blood-oxygen-level dependent (BOLD) sequences for functional magnetic resonance imaging (fMRI) scan. The amplitude of low frequency fluctuation (ALFF) analyses were conducted on the data of location phase, structure phase, resting state before acupuncture/moxibustion, working state during acupuncture/moxibustion and resting state after acupuncture/moxibustion using Data Processing Assistant for Resting-State fMRI (DPARSF) software.

Results

Acupuncture and moxibustion produced significant differences in functional brain response. The working state during acupuncture/moxibustion mainly decreased ALFF values in the right supramarginal gyrus, right superior parietal lobule, right frontal gyrus, upper right occipital lobe, right precuneus and right cingulate gyrus. At the same time, it increased ALFF values in the left cerebellum, right caudate nucleus, right cerebellum and left inferior gyrus. The differences during the resting state after acupuncture/moxibustion were significantly smaller than the working state in intensity and size. It mainly resulted in decrease in ALFF values in the right postcentral gyrus and right supramarginal gyrus and increase in ALFF values in the left precuneus, orbital part of inferior frontal gyrus and right cerebellar peduncles.

Conclusion

Needling and moxibustion at Zusanli (ST 36) can produce significant differences in immediate functional brain response.

     

针灸治疗功能性消化不良的研究进展

正功能性消化不良(FD)是经生化、内镜等检查排除可解释的器质性疾病,以餐后饱胀不适、早饱、上腹痛、上腹烧灼感等四大症状为主,伴随恶心、嗳气、反酸等次要症状的一组临床症候群。据报道FD的全球患病率为11.5%~14.5%~([1]),而我国为18.92%~23.29%~([2-3])。据调查FD患者在生理功能、生理职能、躯体疼痛、情感职能、精神健康、     

针灸治疗偏头痛随机对照临床研究文献的Meta分析

目的:通过Meta分析评价针灸治疗偏头痛的疗效及安全性。方法:计算机检索中国知网、维普及万方等数据库,检索2000~2017年的相关文献,收集针灸治疗偏头痛的随机对照试验。评价研究质量,提取资料,并采用Review Manage5.2进行系统分析。结果:共纳入文献18篇,包含1730例患者,Meta分析结果显示,针灸治疗组的总有效率优于对照组[OR=5.11,95%CI为(3.83,6.85),P0.01];治愈率优于对照组[OR=1.62,95%CI为(1.41,1.86),P0.01];不良反应率低于对照组[OR=1.13,95%CI为(0.05,0.34),P0.01]。漏斗图的结果显示左右不对称,提示纳入评价的文献很可能存在发表性偏倚。结论:针灸治疗偏头痛疗效优于单纯西药治疗,但由于本系统评价纳入研究质量较低,尚需更多高质量的随机对照试验验证其疗效及安全性。     

Overview of researches on central action mechanism of needling Zusanli (ST 36)

The contents about the central action mechanisms of needling Zusanli (ST 36) were sorted by summarizing the relevant literatures published in the past 10 years, and it was found that: by comparing acupuncture at Zusanli (ST 36), other acupoints or sham points, most studies showed that Zusanli (ST 36) had relatively specific characteristics in the brain function response; studies on the central action mechanisms of Zusanli (ST 36) were mainly focused on sequelae of cerebral apoplexy, pain, gastrointestinal diseases, weight loss and drug addiction withdrawal and so on; acupuncture manipulations, stimulation methods, individual differences, stimulation quantity, and stimulation duration, etc. could also induce different brain function responses; acupuncture at Zusanli (ST 36) had an after-working effect, also called long-term effect, but with poor repeatability. So, it was suggested that the future studies should focus on the factors that affect the clinical efficacies and experimental results, including the compatibility effects of the acupoints, reproducibility of research results, sample size, acupuncture methods, long-term effects and disease entities.