| [Objective]Moxibustion is an important part of TCM treatment.It has unique advantages in the treatment of some painful diseases,especially in the treatment of primary dysmenorrhea.The clinical effect is very significant.There are also some immediate central analgesic mechanisms for moxibustion treatment of primary dysmenorrhea,but the long-term cumulative analgesic mechanism of moxibustion for primary dysmenorrhea is not clear.This study used the blood oxygen level-dependent functional magnetic resonance imaging(BOLD-fMRI)technique and Arterial spin labeling-functional magnetic resonance imaging(ASL-fMRI)technique to study the central nervous system after three months of moxibustion intervention.Dynamic changes to clarify the central long-acting analgesic mechanism of moxibustion for primary dysmenorrhea;to explore the correlation between VAS pain scores in primary dysmenorrhea patients and local ReHo values and CBF values in various brain regions,and to identify primary dysmenorrhea Patients with long-term treatment with moxibustion produce significantly different brain regions.The perspective of "relevant research-intervention" in this study will provide new ideas for the research of moxibustion mechanism,and also provide a scientific basis for the clinical promotion of moxibustion therapy.[Method]In this study,patients with primary dysmenorrhea were selected as the carrier of disease,and moxibustion Guanyuan acupoint was used as the research object.According to the completely random number method,24 patients were randomly divided into 12 patients in the moxibustion group and 12 patients in the comfort moxibustion group.The treatment of the two groups starts from about 7 days before menstruation,once every other day,each time for 30 minutes of continuous moxibustion,the end of treatment during menstruation,3-5 times per menstrual cycle,with a complete course of treatment with three menstrual cycles.The fMRI scan was performed before and after the intervention,and the visual analogue(VAS)of the subjects before and after treatment was recorded.To explore the brain regions of patients with primary dysmenorrhea before and after treatment with ReHo and CBF values after long-term moxibustion at Guanyuan Point.Compare long-term cumulative effects with long-term treatment of PD target brain function parameters,and explore moxibustion treatment for PD.The long-term cumulative central analgesic mechanism.[Results]1 Clinical observation of moxibustion at Guanyuan1.1 Pain Visual Analog Scale(VAS-P)After three menstrual cycles,the difference between the moxibustion group and the control group was statistically significant(P<0.01).The VAS pain score after treatment in the moxibustion group was significantly lower than that of the control group,indicating that compared with the comfort moxibustion,Moxibustion significantly improves the degree of dysmenorrhea in patients with PD.There was significant difference between the moxibustion group before and after treatment(P<0.01).There was no significant difference between the control group and the treatment group(P>0.05).The results showed that after three months of treatment in the moxibustion group,the degree of dysmenorrhea in PD patients improved significantly,while the comfort moxibustion did not improve the degree of dysmenorrhea in PD patients.1.2 Anxiety Visual Simulation Score(VAS-A)After three menstrual cycles,the difference between the moxibustion group and the control group was statistically significant(P<0.01).The VAS anxiety score of the moxibustion group was lower than that of the control group,indicating that compared with the comfort moxibustion,Moxibustion can improve the anxiety symptoms of PD patients during menstruation.There was significant difference between the moxibustion group before and after treatment(P<0.01).There was no significant difference between the control group and the treatment group(P>0.05).The results showed that after three months of treatment in the moxibustion group,the anxiety symptoms of PD patients during menstruation improved to some extent,while the comfort moxibustion did not improve the anxiety symptoms of PD patients during menstruation.2 The change of brain regionsafter moxibustion2.1 Brain regions with significant changes in ReHo valuesIn the moxibustion group-supplemented moxibustion group,the brain area with increased ReHo value before and after treatment had a Fusiform_R,Angular_L and Frontal Sup L.After treatmentthe brain area with reduced ReHo value in the moxibustion group had Occipital_Inf_L,Temporal_Mid_L,Occipital Mid/Occipital_Sup_R,Frontal_Sup_L,Paracentral Lobule R.2.2 Brain regions with significant changes in CBF valuesThe brain area with increased CBF difference after treatment in the moxibustion group had a Precuneus R,SupraMarginal_R,Temporal Mid,Temporal_Sup_R,Angular L,Occipital_Sup_L,Parietal_Inf_L,Precentral L.The brain area with reduced CBF difference after treatment in the moxibustion group had Caudate_L,Temporal_Mid_L,Frontal_Mid_Orb_R,Occipital_Inf_R,Occipital_Mid_L,Frontal_Mid_L,Frontal_Mid_R,Cingulum_Ant_L.[Conclusion](1)Moxibustion has a certain long-term analgesic effect on primary dysmenorrhea,and has a certain cumulative effect,while comfort moxibustion does not have the corresponding effect.(2)Moxibustion has a certain degree of relief effect on anxiety caused by primary dysmenorrhea,while comfort moxibustion has no statistical significance after VAS anxiety score before and after treatment,but the VAS value is slightly lower than before treatment,so comfort moxibustion The group may have a certain comforting effect on primary dysmenorrhea.(3)It can be inferred that moxibustion Guanyuan acupoint can cause local consistency of multiple pain-related brain regions and increase or decrease of cerebral blood flow.These brain regions may be the targets of analgesic effect of moxibustion Guanyuan acupoint.It may provide a preliminary imaging basis for studying the central analgesic mechanism of moxibustion Guanyuan acupoint in the treatment of primary dysmenorrhea. |
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