| Objective:To observe the changes of cerebral glucose metabolism by puncturing at the acupoints on the involved meridian for migraine patients in the attack stage and explore the central mechanism of instant analgesic effect of puncturing at acupoints on the involved meridian for migraine patients.Methods:40 patients who matched the inclusion criteria were randomly divided into 4 groups. Three groups were administered puncturing at different acupoints:Group A: specific acupoints on the involved meridian(GB20,SJ5,GB34);Group B:acupoints on the non-involved meridian(ST8,LI6,ST36);Group C:non-specific acupoints on the involved meridian(SJ19,SJ8,GB33). Group D was waiting-list group. The former three groups were administered acupuncture treatment once. Headache intensity grading and VAS were assessed before and after acupuncture treatment to observe instant analgesic effect of puncturing at different acupoints. Positron emission tomography-computed tomography (PET-CT) was performed to detect the cerebral glucose metabolism among 40 patients after the first administration of puncturing. Then the difference among them was analyzed by SPM2, which was used to discuss the central mechanism of instant analgesic effect of puncturing at acupoints on the involved meridian for migraine patients.Results:1. The baseline of glucose, headache intensity grading and VAS before scanning, gender, age, weight, height, attack duration were no difference and comparable.2. Different instant analgesic effects of different puncturing methods before and after acupuncture treatment:â‘ Headache intensity grading:Group A. Group B and Group C was of statistical significance(P<0.05); Group D was of no statistical significance (P>0.05);Group A was apparently lower than those of the other three groups (P<0.05);Group C was apparently lower than that of Group D (P<0.05); No statistical significance was found between Group B and Group D.â‘¡Headache intensity improvement:Group A> Group B,C> Group D; Group A was significantly better than the other three groups (P<0.05); Apparent statistical significance was found between Group B and Group D(P<0.05); Apparent statistical significance was found between Group C and Group D (P<0.05); No statistical significance was found between Group B and Group C (P>0.05)â‘¢VAS:Group A, Group B and Group C was of statistical significance(P<0.05); Group D was of statistical significance (P<0.05); The tendency of Group A0.05); No significance was found between Group B and Group D (P>0.05); No significance was found between Group C and Group D (P>0.05); No significance was found between Group B and Group C (P>0.05)â‘£VAS improvement:Group A>Group B>Group C>Group D; Group A was significantly better than the other three groups (P<0.05); Significance was found between Group B and Group D (P<0.05); Significance was found between Group C and Group D (P<0.05); No significance was found between Group B and Group C (P>0.05)3. The characters of cerebral activities in migraine patientsâ‘ The difference in cerebral activities between Group A and Group D: Compared to the Group D, the patients in Group A showed increased glucose metabolism in Middle Temporal(BA 17),Insula(BA 13),Medial Frontal(BA 9,10),Precuneus(BA31,39),ACC(BA32),MCC(BA31)å’ŒPCC(BA23,31); decreased glucose metabolism in Left Hippocampus, Parahippocampal Gyrus, Fusiform Gyrus(BA18,19), Postcentral Gyrus(BA2) and Cerebellum;â‘¡The difference in cerebral activities he difference in cerebral activities between Group C and Group D:Compared to the Group D, the patients in Group C showed increased glucose metabolism in Middle Frontal (BA6,11),Postcentral Gyrus (BA7),Precuneus (BA7),MCC (BA32),Parahippocampus (BA34,35)å’ŒCerebellum; decreased glucose metabolism in Middle Temporal (BA21)â‘¢The difference in cerebral activities he difference in cerebral activities between Group B and Group D:Compared to the Group D, the patients in Group B showed increased glucose metabolism in Middle Temporal (BA21) and MCC(BA31); decreased glucose metabolism in Fusiform Gyrus (BA18,19) and Cerebellum.Conclusions:1 Different puncturing method has instant analgesia effect in different degree, while the analgesia effect of puncturing at specific acupoints on the involved meridian was superior to that of puncturing at acupoints on the non-involved meridian.2 The effect of puncturing at the acupoints on the involved meridian and non-involved meridian to cerebral activities differed significantly. The difference primarily was reflected by the influence of specific acupoints in the involved meridian to cerebral activities, especially to regions related with pain, including Middle Cingulate Gyrus, Posterior Cingulate Gyrus, Insula, Hippocampus, and Parahippocampal Gyrus, etc... |
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