针刺少阳经穴对慢性偏头痛患者脑内葡萄糖代谢的影响

目的:观察人脑对循经取穴针刺的响应特征,探讨循经取穴的中枢神经取效机制。方法:对6例慢性偏头痛患者进行针刺治疗。选取少阳经穴风池、外关、阳陵泉作为治疗穴位,应用正电子发射计算机断层显像(PET-CT)进行扫描,用统计参数图软件(SPM2)对重建图像进行数据分析并与健康人脑功能成像进行比较,观察针刺前后偏头痛患者脑内葡萄糖代谢变化。结果:针刺后患者的脑干、脑岛等疼痛矩阵脑区的兴奋区明显减少,脑功能减低区以右侧颞叶为主转变为双侧颞叶对称区域。结论:针刺少阳经对慢性偏头痛镇痛作用的可能靶点是脑桥、脑岛、额叶前部等脑区,针刺后引起双侧颞区脑代谢减低的转变可能是针刺足少阳经穴治疗偏头痛的机制之一。针刺可能通过对脑内能量代谢的协调再分配起到整体、良性的治疗效应。

Effect of acupuncture at acupoints of the Shaoyanl Meridian on cerebral glucose metabolism in the patient of chronic migraine

Objective To observe response characteristics of human brain to acupuncture of corresponding channel point selection and probe into the central nervous mechanism of acupuncture at the points selected along channel. Methods Six cases of chronic migraine were treated with acupuncture at Fengchi (GB 20), Waiguan (TE 5), Yang-lingquan (GB 34) on the Shaoyang Channel. Positron emission computerized tomography (PET-CT) was used for scanning and statistic parameter map (SPM2) software was used to analyze the data and compare with healthy human brain function imaging and investigate the changes of metabolism of glucose in the brain of the patient of migraine before and after acupuncture. Results After acupuncture, excitation areas of the pain brain regions such as the brain stem, insula, etc. obviously reduced, and the brain function-reducing area turned from the right temporal lobe as main to bilateral temporal lobes with symmetry. Conclusion The pons, insula, anterior frontal gyrus, etc. possibly are the target points of analgesic effect of acupuncture at the Shaoyang Channel on chronic migraine, and the change of metabolism reduction on bilateral temporal lobes induced by acupuncture possibly is one of the mechanisms for acu-puncture at points on the Shaoyang Channel for treatment of migraine. Acupuncture achieves whole and beneficial therapeutic effect possibly through coordination and redistribution of energy metabolism in the brain.