基于静息态fMRI探讨针刺干预慢性颈痛的中枢机制

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Research on central mechanism of acupuncture in chronic neck pain based on resting-state fMRI LISirongl，CHENJiashan²，LINMin²

'DepartmentofdioogHospitalofhejiangeople'sredPliceHangzouO5，hna;Departmentofdiologyd AffiliatedHospitalofZhejiangChineseMedical University，Hangzhou31ool2，China.

[Abstract] Objective：To explore thecentral mechanismsof acupunctureinchronicneckpain（CNP）using resting-state fMRIMethods：Atotalof31patientswithCNPwereenoled，including16patientsinheacupuncturegroupand15patints inthecontrol group.Theacupuncturegroupreceivedtreatmentconsistingof bodyacupuncturecombined withscalpacupuncture， whilethecontrolgroupreceived simple treatmentwithoutacupuncture.Bothgroupsunderwent scoring using visual analog scale（VAS）andNorthwick Park neck painquestionnaire（NPQ）andresting-state fMRI beforeandafter treatment.The brain functionalactvitieswereanalyzedusingamplitudeoflow-frequencyfluctuation（ALFF）andregionalhomogeneity（ReHo）. Results：Theacupuncturegrouphada significantdecrease inVASand NPQ scoresafteracupuncture treatment（both P< 0.05）.While in the control group，VASand NPQ scores had no diferences before and after treatment（both P>0.05 ）.In the acupuncturegroup，theincreaseordecreaseinneuronalactivityintheprefrontalcortex，cingulatecortexinferiortemporal gyrus，cuneus，precuneus，parietallobule，anteroposteriorcentralgyrusandocipitalcortexafteracupuncturetreatmntwere revealed（all P<0.05 ）.While inthe control group，the decrease in neuronal activityin theright insula，right lenticular putamen，rightinferiorfrontalgyrusofhetriangle，andrightsuperiortemporalgyruswererevealedaftersimpletreatment（all （204号 P<0.05 ），and no brain regionswithactivated brain functionswere found.Conclusions：Acupuncture intervention demonstrates eficacyinalleviatingCNP.Thecerebralcortexexhibitssignificantactivityalterationspre-andpost-acupunctureintervention， indicatingthatacupuncturemodulatesthesebrainregionsassociatedwithsensory-cognitive-emotionalprocesestomitigatepain and ameliorate negative emotions.

[Keywords] Chronic neck pain;Acupuncture;Magnetic resonance imaging

慢性颈痛（chronic neck pain，CNP）是指持续或反复超过3个月的颈肩部疼痛或僵硬不适[1]，发病率高，病程长，高龄、女性、社会心理因素及久坐是颈部症状持续发作的危险因素[2]，不仅影响躯体运动，还能引起焦虑、抑郁等负性情绪，严重影响患者的生活质量[3]。（剩余10474字）