A Central Analgesic Mechanism For The Treatment Of Primary Dysmenorrhea With Moxibustion Based On Arterial Spin-labeled Functional Magnetic Resonance Imaging

Objectives:Moxibustion is a traditional Chinese medicine therapy,which has unique clinical advantages in the treatment of primary dysmenorrhea(PD),but its central analgesic mechanism is not clear.The project aims to The purpose of this study is to elucidate the immediate analgesic mechanism of moxibustion in the treatment of PD,to investigate the correlation between VAS pain score and local CBF in patients with primary dysmenorrhea,to open up a new perspective on the research of moxibustion mechanism from the perspective of"relevance study-intervention" in the brain region of patients with primary dysmenorrhea,and to provide a scientific basis for the clinical promotion of moxibustion therapy.Methods:Using PD as the vector of disease,moxibustion-comfort moxibustion design randomized controlled trial,including the use of arterial spin labeling technology,combined with clinical efficacy evaluation(VAS score,etc.).19 primary dysmenorrhea(blood deficiency,liver and kidney deficiency type,qi stagnation and stagnation type,or more than four types of staggered mixed type)patienta were randomly divided into moxibustion group 10 cases And comfort moxibustion group 9 cases.(30min)moxibustion off or moxibustion at the time of the menstrual period 1-3 days and the pain score(VAS)was greater than 40mm,and the fMRI scan was performed before and after the intervention.Subject pain score(VAS).To investigate the correlation between VAS pain score and local CBF in patients with primary dysmenorrhea,and to make clear the brain area associated with the pain of patients with primary dysmenorrhea.The title analyzed the changes of functional parameters of PD target in moxibustion before and after the effect of moxibustion to find the effect of moxibustion on the central analgesic mechanism of moxibustion.Results:1.Study on the relationship between pain symptoms and brain area in patients:The correlation between VAS pain score and the difference of CBF before and after CBF treatment was that the difference of VAS pain score before and after moxibustion treatment was negatively correlated with CBF difference.The left frog leaf was r =-0.65,p = 0.043;left occiput,r =-0.68,p = 0.0297.Before and after moxibustion treatment,the difference of VAS pain score was positively correlated with the difference of CBF:r = 0.78,p = 0.0074,left posterior margin,r = 0.82,(R = 0.86,p = 0.0015;left temporal gyrus,r = 0.81,p = 0.0036;left margin,r = 0.8,p = 0.0052(see Figure 1-5)= 0.0043;and the left central ditch cap,r ?0.63,p = 0.0499.2.Study on immediate analgesic of central mechanism of moxibustion treatment of PD:(1)CBF comparison:1)moxibustion group and comfort moxibustion group before the intervention in the brain CBF as shown in the table2-1;2)There were significant differences in CBF between 44 patients with moxibustion before and after intervention(P<0.05).There were 8 cases of left ventricular mass,left anterior cingulate gyrus,left posterior buckle back,left frontal gyrus_L medial amount of the last back,left lower edge of the horn back,left hull shell nucleus,the left edge of the back;3)CBF changes in the brain area of PD patients before and after moxibustion treatment(as shown in Table 2-4),there was no statistically significant difference(P>0.05).(2)VAS score comparison:1)There was no statistically significant difference in score of moxibustion group,comfort moxibustion group before intervention VAS pain;2)The score of VAS pain in moxibustion group was significantly lower than that before moxibustion,the difference was statistically significant;3)The score of VAS pain in the moxibustion group was slightly lower than that before moxibustion intervention,The difference was not statistically significant.Conclusions:1.Moxibustion has a short-term analgesic effect on PD,masturbation does not have the appropriate effect.2.It can be inferred that in this study,eight brain regions with rCBF were significantly increased,except that the activation of lenticular nucleus was not related to the curative effect of moxibustion on PD,and the remaining seven brain regions(left anterior cingulate gyrus and paracellum It is possible to control the pain from three different aspects of sensation,emotion,and cognition,and it is possible to control the pain,Moxibustion treatment of PD short-term analgesic possible mechanism,but the activation of the brain between the role of each other,still need a deeper scientific research.3.Can be sure to participate in the analgesic brain area for the left front and next to the button with the brain back,left the lower edge of the horn back,left edge back.4.Can be inferred involving moxibustion treatment of PD relieve pain in the two circuits,the first for the frontal cortex_basal ganglia-cerebral cortex.Which is the key component of lentiform nucleus.This circuit mediates motivations and emotions that drive the expression of goal-oriented behavior.The second is the parietal lobe-basal ganglia-margin leaf-frontal lobe,including neurotransmitter transport and mood regulation and behavioral expression.