基于多模态功能磁共振成像的艾灸治疗原发性痛经的中枢镇痛机制研究

项目名称： 基于多模态功能磁共振成像的艾灸治疗原发性痛经的中枢镇痛机制研究

项目编号： No.81503652

项目类型： 青年科学基金项目

立项/批准年度： 2016

项目学科： 医药、卫生

项目作者： 郝瑛

作者单位： 北京中医药大学

项目金额： 18万元

中文摘要： 艾灸疗法是中医学特色疗法，在治疗原发性痛经（PD）等痛症方面具有独特的临床优势，然而其中枢镇痛机制尚不明确。本项目选用PD为疾病载体，以艾灸-安慰灸设计随机对照试验，运用包括动脉自旋标记技术、磁共振波谱、血氧水平依赖成像在内的多模态功能磁共振成像技术，结合临床疗效评价（VAS评分等），首先通过比较PD组与健康对照组组间基线多模态磁共振成像结果，分析脑血流灌注、功能代谢、脑功能连接的改变，明确PD的病理性中枢靶点；然后分别从即刻效应（30分钟）和累积效应（3个月）入手，分析比较艾灸关元穴前后PD靶脑区功能参数变化，发现艾灸短期干预过程中的中枢动态改变及其后效应，验证长期艾灸治疗对PD病理靶点脑区的调制作用。结合不同时间尺度下艾灸对PD中枢靶点的调控作用，阐明艾灸治疗PD的中枢镇痛机制。该研究从“中枢靶点-干预”的角度为艾灸机理研究开辟新的视角，为艾灸疗法的临床推广提供科学依据。

中文关键词： 艾灸疗法；原发性痛经；功能磁共振成像；多模态；动态效应

英文摘要： Moxibustion is a typical therapeutic method in TCM, which has a particularly clinical superiority in treating some painful disorders such as primary dysmenorrhea (PD). Nevertheless, the central analgesic mechanism of moxibustion is not clear yet. This study includes 80 PDs and 20 healthy controls to carry out a randomized, placebo-controlled, single-blinded trial in evaluating the effects of moxibustion treatment and further investigating the central analgesic mechanism. Multimodal functional Magnetic Resonance Imaging (fMRI) modalities, including arterial spin labeling (ASL), magnetic resonance spectroscopy (MRS), blood-oxygen-level dependent (BOLD) imaging, will be used to testify the state-changes among PD-targeted brain areas or PD-related brain networks after 30min/3-month moxibustion. Combined with the evaluation of clinical parameters (VAS, etc.), we could analyze the brain response to the long-term therapeutic effect (3 months) and immediate effect (30 min) focusing on those brain regions involved in PD’s central difference. This study reveals that the moxibustion can attain analgesic treatment effect via acting on pathologically-targeted brain areas and brain networks of PD. The study could open up a new perspective for research on the analgesic mechanism of moxibustion from the peripheral afference-induced central analgesia, which provides scientific basis for the clinical extension of moxibustion.

英文关键词： Moxibustion;Primary dysmenorrhea;Functional MRI;Multi-modality;Time-varied effects