基于ReHo方法的原发性痛经静息态功能磁共振成像研究

目的利用静息态功能磁共振成像（rsfMRI，Resting．statefunctionalMagneticResonanceImaging）技术观察原发性痛经患者艾灸关元穴前后脑局部r致性（ReHo，RegionalHomogeneity）变化的特点，从脑区局部神经元协调性的角度探讨艾灸关元穴治疗原发性痛经的中枢镇痛机制。方法20例符合纳入标准的原发性痛经患者分别在艾灸关元穴前及艾灸关元穴5分钟后接受静息状态fMRI扫描，采用局部一致性方法作为测量指标进行数据分析。结果史灸后，患者多个与疼痛相关的脑区存在局部神经元活动的一致性的改变。艾灸后右侧颞上回一、左颞中回、额中回、中央前回、左侧额上回、右侧前扣带回皮质ReHo值较艾灸前显著升高（P〈0．05，校正后）；左额下回、枕叶、双侧丘脑ReHo值较艾灸前显著降低（P〈0．05，校正后）。结论艾灸关元穴可以引起多个疼痛脑区的局部一致性增高或降低，这些脑区可能是艾灸关元穴发挥镇痛作用的靶点，可能阐明了艾灸关元穴治疗原发性痛经的中枢镇痛机制。

Regional Homogeneity of Primary Dysmenorrheal：A Resting-state fMRI Study

Objective To observe the changes of regional homogeneity （ReHo） before and after moxibustion the point of Guanyuan with rest- ing-state fMRI teehnology and to investigate the central analgesic mechanism of moxibustion the point of Guanyuan in patients with primary dysmenorrhea depending on the view of concordant of local neuron in encephalic region. Methods There were 20 primary dysmenorrhea-eligi- ble patients under going rsfMRI scanning before treatment （ moxibustion the point of Guanyuan） and after 5 minutes when treatment was com- pleted. All datas were analysed by use of ReHo. Results There is a consistent change in the activity of local neuron which together with several pain-related encephalie region. ReHo values increase significantly in the right superior temporal gyrus, the left middle temporal gyrus, the right anterior cingntate, the left cingulate gyrus, the right middle frontal gyrus, the left medial frontal gyrus, the right postcentral gyrus and the left preeentral gyrus after treament. （ P 〈 0.05, after correction） How.ever, ReHo values decrease significantly in the left inferior frontal gyrus, occipital lobe and thalamus （P 〈 0.05, after correction）. Conclusion Moxibustion the point of Guanyuan plays an important role in the increasing or decreasing of ReHo value in a series of pain-related encephalic regions. These encephalic region may be the target of analgesic effect of moxibustion. That may be the conceivable central analgesic mechanism of moxibustion the point of Guanyuan for patients with primary dysmenorrhe.