The Therapeutic Mechanism Of Migraine From Liver-spleen-Stomach Coordination Based On Brain FMRI

BankgrroudMigraine is one of the most serious chronic dysfunction diseases in the world.In China,the annual prevalence rate is 9.3%,and the ratio of male to female is about 1:3[1],which is related to gender factors[2].Migraine may be associated with a variety of disorders such as anxiety,depression,and stroke.The pathogenesis and treatment of the disease have been studied diligently and the results are still not satisfactory.Treating headache at distribution stage for treatment and headache intermittent preventive treatment,western medicine therapy on commonly chosen non-steroidal anti-inflammatory drugs,triptan-based,ergotamine,CGRP receptor antagonist and estrogen medicines for headache has certain effect,but the side effect also cannot be ignored,and cannot effect a radical cure,repeated attacks,even in delay no more,the problem such as drug dependence,for how to improve the curative effect of migraine is still a medical is a big problem.My supervisor,hua rong,has been engaged in the clinical research of traditional Chinese medicine encephalopathy for 30 years.After long-term observation and summary of clinical symptoms,she believes that migraine is not a simple headache with complicated clinical manifestations and long and repeated delay in the course of disease.It is necessary to start from the overall concept and syndrome differentiation of zang-fu organs,and start from the Liver-Spleen-Stomach Disorder[5].The self-designed "Jieyu HeZhong Tang"is applied to treat zang-fu organs simultaneously with mind and body,and the clinical effect is satisfactory.In recent years,resting state fMRI technology has been used to study the increase but not decrease of migraine patients' pain matrix brain function network orgasm.This study will evaluate the clinical efficacy of treating migraine from Liver-Spleen-Stomach Co-ordination.Meanwhile,the resting state fMRI technology will be used to explore the central mechanism of Jieyu HeZhong Tang in the treatment of migraine.Objectives1.Treating migraine from the Liver-Spleen-Stomach Coordination,and using the self-made Jieyu HeZhong Tang treatments to observe the curative effect under the guidance of this theoretical pathogenesis,and opening up new treatment for migraine with Chinese medicine treatment.Ideaing to expand clinical applications.2.Imaging data and regional homogeneity analysis method(ReHo)for data processing were obtained using the resting state fMRI technology.The "pain matrix" brain before and after treatment of migraine withLiver-Spleen-Stomach Disorder was observed.Functional changes,and then study on the central mechanism of its effects.MethodsThis study used its own pre-and post-controlled trial design,according to the diagnostic criteria of the self-made "TCM migraine syndrome differentiation diagnostic scale of Liver-Spleen-Stomach Disorder",which will meet the inclusion criteria,and the four diagnostic syndromes for the Liver-Spleen-Stomach Disorder type migraine patients will be included in 20 cases.A 4-week baseline observation was performed,followed by self-explanatory Jieyu HeZhong Tang treatment.The pain level and quality of life of the subjects were evaluated before the intervention and after 4 weeks of treatment,All patients underwent resting state fMRI scanning twice,and the changes in brain functional areas of the "pain matrix" were observed by ReHo analysis.Results1.The differences in headache score,VAS score,qol score between baseline and intervention period were significant(p<0.01).2.Before treatment and after treatment,the ReHo value in the brain matrix of the pain matrix is enhanced by the right Insula,the right Supp Motor area,and the right Cingulum Mid.The ReHo value in the brain region is weakened by the right Precentral and right Postcentral,left Supp Motor area,left Frontal Sup,left Frontal Med Orb,left Frontal Sup Orb,left Frontal Sup Medial,and left Cingulum Mid.Conclusion1.From the Liver-Spleen-Stomach Coordination treatment of migraine patients has a positive effect in relieving pain,relieving many migraine symptoms and improving the quality of life.2.From the process of Liver-Spleen-Stomach Disorder in the treatment of migraine,the traditional Chinese medicine has a regulatory effect on the periphery,followed by the inner and outer conduction system of pain,represented by the Insula,the Supp Motor area,and Cingulum Midetc.Multiple brain regions interact to treat migraine in an integrated manner.