Study On Brain Functional Magnetic Resonance Of Children With Spleen Deficiency Diarrhea By Using Tuina Pitu Acupoint For Different Duration

ObjectiveTo explore the specific mechanism of regulating the central network of children with spleen deficiency diarrhea by pushing pitu acupoint at different times.MethodsTaking 60 children in the Pediatric Massage Clinic of the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from December 2017 to December 2019 as the research object,a randomized controlled study method was used to treat healthy and spleen deficiency diarrhea children according to the computer random number method It is divided into three subgroups of massage 10 minutes,20 minutes and 30 minutes,each with 10 people.The method of pushing pitu acupoint is 200 to 300 times per minute,and tuina once a day for 5 times.Fix the operator's thumb on the surface of the skin at a specific point without direct push.Scan after 2 minutes of rest.The first 80 seconds are at rest,then the stimulation state of the pitu acupoint is pushed at a frequency of 200 to 300 times per minute,And then perform magnetic resonance scan after the massage.Magnetic resonance scans were performed before and after the first and fifth massages respectively,and the obtained image data was subjected to functional magnetic resonance imaging(f MRI),and the obtained data was corrected for head movement to eliminate the subjects in the experiment.Slight movement of the head,and then normalize the data to a standard brain template in the MNI space(the Montreal Neurological Institute space)for Gaussian smoothing,reduce errors during image creation and eliminate subtle differences in brain structure of different subjects.Pixel-by-pixel analysis of the image based on the generalized linear model.Statistical analysis uses a two-sample one-sided t-test to calculate the t value corresponding to each pixel.Finally,draw a statistical parameter map composed of t values,and there will be significant differences(P ?0.001,K>30)the brain area is fused to the standard structure image,it can be seen that the subject ' s brain area responds differently to the massage under the stimulation state,and these changed brain areas are superimposed on one by each subject.The average brain template of the structure image is shown.Finally,after copying the centralcoordinates from the above statistical parameter maps made in the SPM software package,the anatomical position of the brain function area and the positioning of the BA area were obtained.After the test,the curative effect of 30 children with spleen deficiency diarrhea was evaluated,and the differences in the apparent rate,total effective rate and treatment course of the three groups of children were analyzed and compared.Finally,the clinical curative effect evaluation results and the brain structure and function network diagram were analyzed and discussed.Results1 In normal children,push the pitu acupoint for 10 minutes to excite the frontal lobe(left central anterior gyrus,right frontal gyrus,middle frontal gyrus),parietal lobe(left central posterior gyrus),occipital lobe(bilateral wedges),temporal lobe(Right middle temporal gyrus)and right thalamus.2 The normal children group pushed the pitu acupoint for 20 minutes to excite the cerebellum(right cerebellum 6,Crus1,Crus2 area,left cerebellum Crus2 area),parietal lobe(left anterior wedge,left corner gyrus),occipital lobe(bilateral moment Zigzag),frontal lobe(bilateral frontal,middle gyrus),temporal lobe(right middle temporal gyrus,right middle temporal gyrus pole,right hippocampus).3 In normal children,push the pitu acupoint for 30 minutes to excite the cerebellum(regions 4-5,6,8 on the right cerebellum,and Crus2 region on the left cerebellum),frontal lobe(both frontal gyrus,bilateral auxiliary motor area),parietal lobe Left anterior wedge lobe,left corner gyrus),occipital lobe(right rectangular gyrus).Normal children push the spleen and acupoints at different times to jointly activate the bilateral upper forehead.Pushing the pitu acupoint for 10 minutes activated the somatosensory cortical network,including the anterior and posterior gyrus of the left side,the bilateral cuneiform lobe,thalamus and other tactile information processing brain regions.Pushing the pitu acupoint for 20 minutes activates the visceral sensory brain area,indicating that there is a neural circuit regulating the gastrointestinal tract of the cerebellum-hippocampus brain center.Pushing pitu acupoint for30 minutes excited the frontal lobe auxiliary motor area,indicating that other somatosensory sensory centers are activated.4 The spleen-deficiency diarrhea group pushes the pitu acupoint for 10 minutes to excite the frontal lobe(left central anterior gyrus,left frontal gyrus medial,left frontal gyrus,bilateral inferior frontal gyrus orbital,right inferior frontal gyrus triangle),Parietal lobe(left top and bottom leaflet),marginal lobe(left rear buckle).5 The spleen-deficiency diarrhea group pushes the pitu acupoint for 20 minutes to excite the parietal lobe(bilateral anterior wedges,bilateral central posterior gyrus),occipital lobe(bilateral supra-occipital,medial gyrus,bilateral rectangular gyrus,bilateral lingual gyrus,double Lateral wedge lobe),frontal lobe(bilateral frontal gyrus and medial,right frontal gyrus and orbit,bilateral central anterior gyrus,bilateral paracentral lobes,bilateral auxiliary motor area),temporal lobe(right temporal Middle gyrus pole,right temporal middle and lower gyrus,cerebellum(region 6 of bilateral cerebellum,region Crus1 of right cerebellum,region 8 and 9of left cerebellum),marginal lobe(right anterior cingulate,bilateral middle buckle band).6 Children with spleen deficiency diarrhea push the pitu acupoint for 30 minutes to excite the parietal lobe(left central posterior gyrus),occipital lobe(right rectangular gyrus),frontal lobe(left central anterior gyrus,Rolandic lid),temporal lobe(right Middle temporal gyrus),cerebellum(right cerebellum 6,Crus1,Crus2 area),basal ganglia(right putamen),left island lobes.The spleen deficiency diarrhea group pushed the pitu acupoint to activate the left central anterior gyrus at different times.Pushing the pitu acupoint for 10 minutes activates multiple brain regions in the frontal lobe(left midfrontal gyrus,right subfrontal gyrus orbital,triangular,etc.)and posterior buckle.Pushing the pitu acupoint for 20 minutes excited multiple cerebellar brain regions.The increased signal on the right anterior cingulate and bilateral middle cingulate indicates that there is a neural circuit of "cerebellar-buckle back" brain center regulating gastrointestinal tract.Pushing the spleen and acupoints for 30 minutes excites the right putamen and left insula lobe brain area,indicating that the centralgastrointestinal regulatory circuit is activated,but the signal is lower than 20 minutes.7 In children with spleen deficiency and diarrhea,there was no significant difference in the effective rate and total effective rate in the 20-minute,10-minute,and 30-minute groups(P>0.05),but the 20-minute effective rate was better than the other two groups.There are significant differences in the course of diarrhea groups,and pushing the pitu acupoint for 20 minutes can significantly shorten the course of diarrhea.The results of the curative effect evaluation suggest that 20 minutes is the best time to treat children with diarrhea due to spleen deficiency by Tuina pitu Acupoint.ConclusionThe results of this study suggest that normal children and children with spleen-deficiency diarrhea have specific sensory pathways for brain functional area reorganization using the frontal lobe as a tactile sensation at different operation times,and activate the plastic braingastrointestinal neural circuit at 20 minutes,20 minutes may be the best time to treat spleen deficiency diarrhea with massage of spleen and earth points.