To Study The Functional Regions Of Acupuncture At Sanyinjiao(SP6) Treatment On Primary Dysmenorrhea

Objective: Explore the possible brain function mechanism of acupuncture treatment onprimary dysmenorrhea.Methods: The20cases of primary dysmenorrhea were randomly divided into realacupuncture group, sham acupuncture group,10cases each group. By the resting state ofmagnetic resonance imaging (resting-state functional magnetic resonance imaging, rfMRI)technology, in two groups of patients with primary dysmenorrhea of menstrual cramps andpain in48h immediately like structure (T1), resting state scans (Rest1, R1), scan time is8min20s; the two sequence scan completion acupuncture, sham acupuncture bilateralSanyinjiao left after the scan (Acupuncture, AP): real acupuncture group bilateral Sanyinjiaovertically into the needle, a depth of1to1.5inch. Acupuncture Deqi, each acupoint needling0.5min, twirling60/min, range180°~360°; sham acupuncture group with shamacupuncture mold, with special blunt head acupuncture a sponge to reach the skin surface(do not penetrate into skin), at each surface point twisting the needle for0.5minutes, thefrequency is60times/divided, range of180°~360°. Really, sham acupuncture group thescan time is8min20s. To go after the needle like structure, for the second time (T1’) andresting state scans (Rest2, R2), scan time is8min20s. Application of low-frequencyoscillation amplitude (amplitude of low frequency fluctuation, ALFF) as the measuring index,analysis and statistics related to the rfMRI data acquisition.Results:(1)The value of pain after real acupuncture was obvious lower than that before realacupuncture (P<0.05);(2)The value of pain after shame acupuncture was no obvious lowerthan that before shame acupuncture (P＞0.05);(3)Acupuncture Sanyinjiao point16minutes,real acupuncture group and sham acupuncture groups was statistically significant(P＜0.05).(4)The two-sample paired t-tests indicated brain regions with differences in ALFFbetween R1and AP of real acupuncture. The increased ALFF (AP>R1) appeared inhippocampus, the left superio temporal gyrus(BA38), the right anterior cingulate gyrus(BA31), right caudate nucleus, left superior frontal gyrus(BA6), right medial frontalgyrus(BA6), corpus callosum;(4)The two-sample paired t-tests indicated brain regions withdifferences in ALFF between R2and AP of real acupuncture. The decreased ALFF (AP>R1)appeared in hippocampus, pons, right caudate nucleus, insula, thalamus, the right anteriorcingulate gyrus(BA31), left superior frontal gyrus；(5) The two-sample paired t-testsindicated brain regions with differences in ALFF between R1and AP of shame acupuncture.the area of the brain does not appear ALFF signal enhancement (SAP> R1); R2and SAPpaired t test results showed that the brain does not appear ALFF signal weakened (R2<SAP)region.(6) Sham acupuncture state of retaining needle (AP) on brain structure and functionchange in a single sample t-test: bilateral pre-cuneus (BA7),lingual gyrus(B18).Conclusion:(1) acupuncture at sanyinjiao (SP6) can obviously relieve the pain of patientswith primary dysmenorrhea.(2)During the acupuncture, the possible mechanism ofacupuncture analgesia is that acupuncture can activate the pain control system of brain, such asbrainstem,thalamus. Meanwhile, the pain-related brain regions of limbic system (cingualtegyrus, insula, hippocampus, entiform nucleus, and so on) were activated. Primarydysmenorrhea is cured mainly by activating the areas involved in pain.(3)Sham acupuncture inretaining needle state (AP) pathway activation related pain and emotional processing,such asbilateral pre-cuneus, lingual gyrus, Sham acupuncture placebo effect may exist, but this mayonly be a factor in acupuncture effect rather than a decisive factor.