Explore The Acupuncture Effects On The Amplitude Of Low Frequency Fluctuation And Fractional Amplitude Of Low Frequency Fluctuation In Patients With Chronic Stable Angina At PC6 And HT5

Objective:In this study,we conducted a resting-state fMRI study on chronic stable angina patients by using the method of amplitude of low frequency fluctuation and fractional amplitude of low frequency fluctuation of whole brain,which is aiming to observe the effect of acupuncture on acupoints and non-acupoints treatment of chronic stable angina patients with brain functional activity.Thereby,to explore the central response characteristics of acupuncture treatment of chronic stable angina pectoris by Meridian Acupoints,and to provide scientific basis for the treatment of chronic stable angina by puncturing at the acupoints on the involved meridian.Methods:1.Using randomized,controlled experimental methods,26 patients who matched the inclusion criteria were randomly divided into acupoint group(group A,the selection of PC-6,HT-5)and non-acupoint group(group B,the selection of non-acupoint 1,non-acupoint 2).All patients were treated with acupuncture once a day,30 minutes at a time,five days for a session with two-day interval between sessions and the treatment lasts 10 times.We adopted angina attack times,VAS score,SAQ,SAS,SDS to evaluated angina attack and emotional state variability prior and posterior to acupuncture intervention.2.In two groups of patients with angina pectoris,a static functional MRI scan was performed before and after acupuncture.fMRI data were computed by using amplitude of low frequency fluctuation(ALFF)and fractional amplitude of low frequency fluctuation(fALFF)methods with DPARSF and SPM8 software based on MATLAB platform,to compare and analyze the effects of different acupuncture interventions on ALFF and fALFF in patients with chronic stable angina.Results:1.The baseline demographic and disease-related data of the patients with angina pectoris was comparable between acupoint group and non-acupoint group(p>0.05).2.After two-week intervention,patients from acupoint group significantlyimproved in frequency of onset(P<0.05),the physical activity limitation and stable state of angina from SAQ has increased significantly(P<0.05),also the anxiety and depression state were improved(P<0.05).While in non-acupoint group,VAS score decreased(P<0.05),and the anxiety state were improved(P<0.05).Only VAS score revealed significantly improvement between these two groups after intervention(P<0.05).3.After two-week intervention,the brain regions with increased ALFF signals following the meridian acupoints were the anterior insula,posterior insula,anterior cingulate gyrus,entorhinal area,inferior frontal gyrus,posterior orbital gyrus,precentral gyrus,superior temporal gyrus and cerebellum;the ALFF signal decreased in the brain region of supramarginal gyrus and posterior insula.The brain region with ALFF signal increased in non-acupoint group was inferior tempotal gyrus,anterior insula,lentiform nucleus,midbrain and cerebellum;and the brain region with ALFF signal descending was caudate nucleus,superior temporal gyrus,middle orbital gyrus and cerebellum.Compared with the non-acupoint group,the ALFF signal of the acupoint group increased significantly in the inferior frontal gyrus,while the ALFF signal decreased significantly in the amygdala and inferior temporal gyrus.4.After acupuncture,the brain areas with increased fALFF signals following the meridian acupoints were superior temporal gyrus,anterior insula,cerebellum and brainstem;and the fALFF signal decreased in the calcarine cortex,middle frontal gyrus,superior frontal gyrus,anterior orbital gyrus and precuneus.The brain region with fALFF signal increased in non-acupoint group was cerebellum,and the brain region with fALFF signal descending was fusiform gyrus.Compared with the non-acupoint group,the fALFF signal of the acupoint group increased significantly in the superior temporal gyrus,while the fALFF signal decreased significantly in the calcarine cortex,supramarginal gyrus,precuneus,middle frontal gyrus and superior frontal gyrus.Conclusions:1.Acupuncture improved clinical symptoms and emotional state in patients with stable angina pectoris,puncturing at acupoints from disease-related meridians showedmore promise than at point from non-related meridians in improving the severity of angina.2.Compared to the non-acupoint,the specific regulation of pain and emotion-related brain regions in the right insula,anterior cingulate gyrus,precentral gyrus,amygdala,middle frontal gyrus,anterior orbital gyrus and precuneus may be the characteristics of Meridian acupuncture in the treatment of chronic stable angina.