Evaluation Of Acupuncture Analgesic Effect In Different Innervated Areas During Migraine Attack And Comparison Of FMRI

Objective:(1)Compare the acupuncture analgesic effect of the acupoint group of the occipital nerve innervation zone,the trigeminal nerve innervation zone,and the spinal innervation zone acupoint during the migraine attack period,and explore the acupuncture treatment of acupuncture in the different innervation zone acupoint group for migraine attack.Relative Specificity of Pain Effects and Its Regularity(Individual analgesic time,analgesic intensity,analgesic location.(2)From the perspective of fMRI,the fMRI manifestations of the relative specific differences in acupuncture analgesic effects of acupuncture points in different nerve distribution areas were initially observed.Method:99 patients who met the criteria for migraine attack were randomly divided into 3 groups.In group A(occipital nerve distribution area acupoint group),acupuncture in the occipital acupoint group was performed with a way of Pai-zhen-ping-ci,nao-kong to feng-chi,nao-hu to feng-fu,the needle was inserted approximately 1 inch subcutaneously,and the needle was left for 2 hours;The needles were used to puncture the frontotemporal acupoint group,han-yan(to)yuan-li,Shen-ting(to)Yin-tang,mei-chong(to)can-zhu,tou-lin-qi(t0)yu-yao,tou-wei(to)si-zhu-kong,the needle was inserted about 1 inch,and the needle was left for 2h.Group C(the spinal nerve innervation area acupoint group)remote syndrome differentiation and acupoint selection group,except for the acupuncture point,using conventional acupuncture,leaving the needle for 2h.Visual analogue scores were used to compare the VAS scores,VAS improvement values,and 2h effectiveness of the three groups before acupuncture treatment,immediately after acupuncture treatment,5min,30min,and 2h.The degree of remission was compared between the three groups.The relative specificity of acupuncture analgesic effect in acupoint groups with different innervation areas was compared.The functional magnetic resonance examination of this study included 12 patients who met the criteria without threatened migraine onset,of which 6 were in group A(occipital innervation zone acupoint group),group B(trigeminal nerve innervation zone acupoint group)6 cases,two groups Acupuncture treatments were performed separately.The acupuncture scheme was the same as before.BOID-fMRI scans were performed before acupuncture and 2 h after acupuncture.The changes in related indicators were observed and the effect difference mechanism was observed.Result:1.Comparison of VAS scores immediately after treatment,5 min,30 min,and 2 h between groups:The scores of the three groups of patients decreased after treatment,and the differences in VAS scores of subjects at different time points between the three groups were statistically significant P<0.01).Among them,immediately after treatment,the VAS scores of the A(occipital nerve innervation area acupoint group)and the B(trigeminal nerve innervation area acupoint group)were lower than those of the C(spine innervation area acupoint group)(P<0.01),A There was no significant difference in VAS score between group B and group B(P>0.05);At 5min and 2h after treatment,the VAS scores of groups A and B were significantly lower than those of group C(P<0.01),and the VAS scores of group A were significantly lower than those of group B(P<0.01);At 30 minutes after treatment,the VAS scores of groups A and B were significantly lower than those of group C(P<0.01),and the VAS scores of group A were lower than those of group B(P<0.05).2.Comparison of VAS improvement values immediately after treatment,5 minutes,30 minutes,and 2 hours between treatments:Differences in VAS improvement values of subjects at different time points between the three groups were statistically significant(P<0.01).Among them,immediately after treatment,5 minutes,30 minutes,and 2 hours between treatments,the improvement values of VAS in group A and B were significantly higher than those in group C(P<0.01),and there was no statistical difference in the improvement of VAS between group A and group B(P>0.05).3.The efficiency was evaluated at 2 hours in each group.The effective rate of group A was 93.9%,the effective rate of group B was 75.8%,and the effective rate of group C was 31.3%.P<0.01).The curative effect of group B was significantly better than that of group C.4.Comparison of the relief of headache sites in each group.The relief rates of the occipital and frontotemporal orbits after acupuncture for 2 hours in group A were 100%and 86.7%.The remission rates of the occipital and frontotemporal orbits after acupuncture for 2 hours in Group C were 36.3%and 28.6%,respectively.5.Analysis of fMRI data showed that patients with migraine had acupuncture through the occipital nerve innervation area after acupuncture and compared with before treatment.The brain areas with enhanced ALFF values were the left occipital gyrus,right occipital lobe,bilateral superior temporal gyrus,Right inferior temporal gyrus,left fusiform gyrus,bilateral inferior frontal gyrus,midbrain,left cingulate gyrus,angular gyrus,bilateral parietal lobes,left anterior cerebellum,etc.Brain regions with weakened ALFF values include left frontal lobe,right Frontal gyrus,right marginal lobe,right cerebellar tonsil,left and right cerebellar lobes,bilateral cingulate gyrus,left anterior wedge,right hippocampal gyrus,left straight gyrus,etc.After acupuncture in the acupuncture group of the trigeminal nerve innervation group,compared with before treatment,the brain areas with enhanced ALFF values include the posterior cerebellum,central posterior gyrus,right cingulate gyrus,bilateral inferior temporal gyrus,right middle temporal gyrus,and right superior temporal gyrus.Gyrus,fusiform gyrus,left lower frontal gyrus,right middle frontal gyrus,bilateral inferior parietal lobes,etc.,brain regions with reduced ALFF values include the medulla oblongata,midbrain,thalamus,anterior cerebellum,central anterior gyrus,central posterior gyrus,and margins Leaves,left frontal lobe,left frontal gyrus,left lower frontal gyrus,right temporal gyrus,etc.Conclusion:1.Acupuncture at different acupuncture points can alleviate headache intensity and have certain analgesic effects,but its indications are different and relatively specific,2.Acupuncture of the acupoints of the occipital nerve can significantly alleviate occipital pain,and has a good analgesic effect on the frontotemporal orbital pain;acupuncture of the points of the trigeminal nerve can significantly relieve the frontotemporal orbital pain,but it can relieve the pain of the occipital pain The analgesic effect is relatively poor;the acupuncture spinal nerve distribution area acupoint group(remote syndrome differentiation and acupoint selection group),its analgesic effect is not significant,there may not be relative specificity.3.The effect of acupuncture on local acupoint combination is better than that of remote acupoint combination.4.There were changes in the activity of relevant functional brain areas before and after acupuncture in different innervation areas of patients with migraine attacks,indicating that there is a complex central regulatory mechanism for acupuncture analgesic effects,and this mechanism is based on the coordinated changes of multiple functional brain areas Among them,the gray matter system,limbic system and pain central network around the midbrain aqueduct played an important regulatory role.The above conclusions provide functional imaging support for exploring the analgesic effects of migraine.