Based On Rs-fMRI Technology To Explore The Brain Functional Connectivity Of Different Heat-sensitive Acupoints In Patients With Primary Dysmenorrhea By Moxibustion

Objective:Taking primary dysmenorrhea(PD)as the research carrier,using resting-state functional magnetic resonance imaging(rs-f MRI),and using bilateral insula as seed points to conduct brain functional connectivity.To explore the immediate central response mechanism of moxibustion on heat-sensitive acupoints of PD patients from the perspective of influencing insula brain functional connection network.Methods:The study included 40 PD patients who were openly recruited.After the exploration of heat-sensitive acupoints,two queues were screened and selected.One group was 20 patients with heat-sensitive Guanyuan acupoint.The other group was 20 patients with heat-sensitive Sanyinjiao acupoint.The two groups of patients underwent f MRI scans before and after moxibustion at the heat-sensitive Guanyuan acupoint and the heat-sensitive Sanyinjiao acupoint respectively.After obtaining the imaging data of each group before and after moxibustion,the brain functional connectivity within the group before and after moxibustion and the brain functional connectivity between the groups were compared.The subjects’ baseline data were counted by SPSS 26.0 software,image data preprocessing and statistical analysis,and completed by RESTplus 1.2 and SPM 12 based on MATLAB 2013 b platform.The statistical threshold was set as voxel level P <0.005,and multiple comparison correction was performed by Alpha Sim method.After correction,P <0.05.The report of the research results was completed by the Xjview 9.5 toolkit,and the visualization was obtained by the Brain Net Viewer 1.61 toolkit.Results:1.Differences in functional connectivity of left insula of PD patients before and after moxibustion at heat-sensitive Guanyuan acupoint:there are 4 clusters with enhanced functional connectivity.Cluster 1mainly distributes in the brain regions of bilateral precuneus,peritalar fissure cortex,cuneus,posterior cingulate gyrus,lingual gyrus,left medial and paracingulate gyrus,and supoccipital gyrus.The main brain regions of cluster 2 are bilateral medial superior frontal gyrus and dorsolateral superior frontal gyrus.The main distribution brain regions of cluster 3 are right superior temporal gyrus,middle temporal gyrus,angular gyrus and middle occipital gyrus.The brain regions included in cluster 4 are right middle frontal gyrus,dorsolateral superior frontal gyrus and medial superior frontal gyrus.There is no brain area with significantly weakened functional connection.2.Differences in the functional connectivity of the right insula in PD patients before and after moxibustion at the heat-sensitive Guanyuan acupoint: there is 1 cluster with enhanced functional connectivity.The main brain areas includes bilateral precuneus,cuneus,peritalar cortex and left posterior cingulate gyrus.There is no brain area with significantly weakened functional connection.3.Differences in the functional connectivity of the left insula in PD patients before and after moxibustion at the heat-sensitive Sanyinjiao acupoint: there is 1 cluster with weakened functional connectivity,mainly including bilateral para-central lobule,anterior central gyrus,supplementary motor area and posterior central gyrus.There is no obvious enhancement of functional connection in the brain area.4.Differences in the functional connectivity of the right insula in PD patients before and after moxibustion at the heat-sensitive Sanyinjiao acupoint: there is 3 clusters with weakened functional connectivity.Cluster 1 mainly includes left peritalar fissure cortex,middle occipital gyrus,bilateral lingual gyrus,suboccipital gyrus,right supraoccipital gyrus and fusiform gyrus.Cluster 2 mainly includes right middle frontal gyrus,inferior frontal gyrus of the triangle,and inferior frontal gyrus of insula.Cluster 3 mainly includes bilateral paracentral lobules,supplementary motor areas,left posterior central gyrus,precuneus,superior parietal gyrus,and precentral gyrus.There is no obvious enhancement of functional connection in the brain area.5.Difference of functional connectivity of left insula in PD patients by moxibustion at the heat-sensitive Guanyuan acupoint and the heat-sensitive Sanyinjiao acupoint: There are 5 clusters with enhanced functional connectivity.Cluster 1 mainly includes left middle temporal gyrus.Cluster 2 mainly includes left dorsolateral superior frontal gyrus and middle frontal gyrus.Cluster 3 mainly includes left inferior frontal gyrus of triangular part.Cluster 4 mainly contains bilateral precuneus.Cluster 5 mainly contains right dorsolateral superior frontal gyrus and middle frontal gyrus.There is no brain area with significantly weakened functional connection.6.Difference of functional connectivity of right insula in PD patients by moxibustion at the heat-sensitive Guanyuan acupoint and the heat-sensitive Sanyinjiao acupoint: There are 2 clusters with enhanced functional connectivity.Cluster 1 mainly contains left inferior temporal gyrus and inferior occipital gyrus.Cluster 2 mainly contains right dorsolateral superior frontal gyrus and middle frontal gyrus.There is no brain area with significantly weakened functional connection.Conclusions:1.The immediate central response mechanism of moxibustion at the heat-sensitive Guanyuan acupoint in PD patients may be related to the alteration of the default mode network-insula functional connectivity.2.The immediate central response mechanism of moxibustion at the heat-sensitive Sanyinjiao acupoint in PD patients may be related to the alteration of the sensorimotor network-insula functional connectivity.3.There were differences in the specific functional connectivity changes of moxibustion at different heat-sensitive acupoints in PD patients,but the main central response characteristics were similar,and they all changed the functional connectivity network between pain control-related brain regions and the insula.