不同推拿手法影响腰椎间盘源性慢性腰痛脑网络连接的时空机制

项目名称： 不同推拿手法影响腰椎间盘源性慢性腰痛脑网络连接的时空机制

项目编号： No.81503595

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： 谭文莉

作者单位： 上海中医药大学

项目金额： 18万元

中文摘要： 已证实腰椎间盘源性慢性腰痛患者存在异常的脑激活区域与异常的脑网络连接。脊柱推拿可以有效缓解慢性腰痛症状，但其产生疗效的中枢镇痛机理及不同脊柱推拿手法起作用的靶点不清。本课题旨在通过BOLD fMRI研究不同脊柱推拿手法缓解腰椎间盘源性慢性腰痛的皮层调节机理。前瞻性收集40例健康志愿者（随机分为空白组、软组织手法组）和60例腰椎间盘源性慢性腰痛受试者（随机分为药物组、软组织手法组、软组织手法+脊柱调整组），实施2疗程相应的干预。分别于干预前、干预后即刻、干预后20天进行BOLD fMRI检查。比较不同受试者、不同干预手法、不同干预时间点间脑激活区域及脑网络连接的差异情况。从而探索脊柱推拿缓解腰椎间盘源性慢性腰痛的特异的中枢镇痛机制，阐释不同脊柱推拿手法产生疗效的特异的中枢作用靶点，确定脊柱推拿手法对脑网络影响的时空机制。

中文关键词： 磁共振；椎间盘源性腰痛；推拿手法

英文摘要： It has been reported that there are different brain activations and abnormal connectivity within various resting state networks in the patients with chronic back pain. Spinal manipulation could relieve pain of these patients; however the central nervous mechanism of spinal manipulation and the value of different spinal manipulation was unclear. The aim of this study is to research central analgesic effects of different spinal maniplulation treatment in the patients with chronic low back pain (LBP) by disc herniation based on blood oxygenation level-dependent functional magnetic resonance imaging (BOLD fMRI). Forty healthy volunteers (divided into blank group and soft tissue manipulation group) and 60 patients with chronic LBP (divided into medicine group, soft tissue manipulation group and oblique-pulling group) due to lumbar disc herniation will be collected. BOLD fMRI will be performed before, immediately after and 20 days after intervention. The fMRI data among different experimenter, different intervention, different time node will be analyzed. Through all these analysis, we could provide the objective imaging proof for spinal manipulation to relief chronic low back pain, and we will explore the central nervous mechanism of spinal manipulation in relieving the chronic low back pain. The central target and temporal mechanism for different spinal manipulation will be confirmed.

英文关键词： megnatic resonance imaging;chronic low back pain;manipulation