| Objective:(1)By comparing the analgesic effects of acupuncture in patients with migraine attacks in different innervation areas(occipital nerve distribution area,trigeminal nerve distribution area)and the changes in serum CGRP concentrations before and after treatment,again To verify the relative specificity of the analgesic effects of acupuncture at different innervated areas during migraine attack on analgesic intensity.(2)Through animal experiments,it aims to verified the specificity of acupuncture analgesia in different innervated areas during migraine attacks is related to the specific regulation of CGRP and NLRP3 expression in the TGVS neural pathway.(3)Finally,it aims to provide a basis for clinical optimization of acupoint selection and improvement of curative effect.Method:This paper is mainly divided into two parts:clinical experiment and animal experiment:(1)Clinical trials:In clinical trials,70 patients with acute migraine were included,and 4 patients with non-cooperation and shedding were excluded.Finally,33 patients were included in the efficacy evaluation:occipital acupoint group(occipital innervation area),and temporal acupoint group(trigeminal innervation area)33 cases,observe the effects of acupuncture at different innervation areas on the expression of serum CGRP the intensity of analgesia.(2)NTG model rat experiment:The rats were randomly divided into 5 groups after adaptive feeding.Treatment method:①Blank group:no NTG,subcutaneous injection of NS,once a day,5 consecutive injections;②Model Group:Conventional modeling,without any intervention after modeling;③Syndrome differentiation group(distal spinal nerve innervation area):Conventional modeling,30～60 minutes after the fifth modeling,acupuncture on both sides of Waiguan and Yanglingquan ④Fengchi group(occipital nerve innervation area):conventional modeling,30-60min after the fifth modeling,acupuncture bilateral Fengchi;⑤Taiyang group(trigeminal nerve innervation area):conventional modeling,fifth After the second model building,the sun was needled on both sides.In the syndrome differentiation group,the wind pool group,and the sun group,the needles were retained for 30 minutes.During the period,the needles were flattened and relieved.Twisted once every 5 minutes at a frequency of 120 times/min.TG.We use ELISA to detect the plasma CGRP content of rats in each group,and use Western Blot technology to detect protein expression of CGRP and NLRP3 in TG and TCC.Result:(1)There is no significant difference in the VAS score relief effect of acupuncture at the occipital point and the temporal point on the pain degree of patients with migraine in the acute phase(P>0.05);but the content of CGRP in the peripheral serum of the acupuncture at the occipital point lower(P<0.05).(2)Acupuncture at the occipital acupoints,temporal acupoints,and distal syndrome differentiation points can reduce the CGRP content in the peripheral plasma of NTG rats(P<0.05),but the effect of acupuncture at the occipital acupoints is more significant(P<0.01).(3)Compared with the model group,the Fengchi group’s the expression of CGRP and NLRP3 in TCC decreased significantly(P<0.05).Compared with the model group,the expression of CGRP and NLRP3 in the TG of the Taiyang group was significantly reduced(P<0.05).Conclusion:(1)Acupuncture at different innervated areas can reduce the concentration of CGRP in peripheral blood of patients with migraine attacks,thereby producing immediate analgesia,and the analgesic effect is relatively specific;(2)Acupuncture at points in different innervated areas can effectively improve the behavioral symptoms of NTG rats.Compared with simple remote point differentiation(distal spinal nerve innervation area),acupuncture at the Taiyang(trigeminal innervation area),Fengchi(occipital nerve innervation area)has better effect;(3)Acupuncture at points of different innervation areas can reduce the expression of inflammatory factors in peripheral blood,TCC and TG in NTG rats to exert immediate analgesic effects,and there is relative specificity. |
