| BackgroundMigraine, as a common chronic diseases, starting at puberty, had a great influence on the quality of life. Its female prevalence was 3.3%~ 3.3%, the male is 0.7%~ 16.1%[1], and is associated with the onset of stroke, coronary heart disease, and with diseases such as depression, anxiety, epilepsy, but its pathological mechanism is not fully clear. Currently the treatment is divided into drugs and non-drug treatment, in which drugs are varying degrees of side effects, including triptans, non-steroidal drugs and tranquilizers. Balance acupuncture, as a non-drug interventions, has an analgesic effect and adverse reactions characteristics, widely used in clinical applications. Balance acupuncture, as a modern acupuncture therapy, is different from traditional acupuncture. It combines the essence of traditional medicine theory and modern medicine theory of neural regulation. This therapy is through acupuncture nerve to achieve the body energy substances redistribution, highlighting the role of the body’s self-regulation. Currently it has been proven in clinical practice therapeutic effect on various diseases, especially in terms of pain. Compared with the task-related functional magnetic resonance imaging (fMRI), the resting-state functional magnetic resonance imaging, as a new technology is more suitable for analysis of complex brain functions. It provides support for the study of the mechanism of Balance acupuncture effect on the brain. Therefore, the research aim to evaluate the clinical curative effect of alegesia treated in balanced acupuncture and to reveal the scientific essence of the therapeutic effect in balance acupuncture, and then to provide material base in exploring balance acupuncture of central mechanism.ObjectiveTo evaluate the clinical efficacy of Balance acupuncture treatment of migraine without aura. Using functional magnetic resonance imaging technology, to observe brain function changes of migraine without aura treated by balance acupuncture therapy, and explore possible pathophysiological mechanisms of its action.MethodsThe study was designed as a blinded randomized controlled trial, blinded subjects, information gatherers and data processor, which included 40 cases of patients with migraine without aura. After four weeks baseline observation period of the subjects, they were randomly divided into treatment group and control group,20 patients in each. The treatment group’s interventions is to acupuncture headache acupoint by balance acupuncture therapy, while The control group is to acupuncture sham acupoint. Assess the degree of pain and quality of Life before the intervention, at the end of treatment and four weeks after the end. Using resting-state functional magnetic resonance scans all subjects before acupuncture, acupuncture immediately, and after four weeks of acupuncture intervention. The imaging data was analyzed using regional homogeneity (ReHo).Results1. Visual Analogue Scale (VAS) ScoresIn the treatment period and follow-up period, the differences between treatment group and control group in VAS scores were statistically significant (P<0.05).2. Migraine-Specific Questionnaire (MSQ) ScoresIn the treatment period and follow-up period, the differences between treatment group and control group in scores of Role Restrictive (RR) were statistically significant (P<0.05). In the treatment period, the difference between treatment group and control group in scores of Role Preventive (RP) was statistically significant (P<0.05), but in follow-up period the difference was not statistically significant (P>0.05). In the treatment period and follow-up period, the differences between treatment group and control group in scores of Emotional Function(EF) were not statistically significant (P>0.05)3. Functional Magnetic Resonance Imaging (fMRI)(1) Data analysis of the treatment group showed that, compared with the image before the intervention, ReHo values increased brain regions of the image after acupuncture immediately include anterior cingulate, medial frontal gyrus, superior frontal gyrus, cerebellum Peak, insula, ventromedial nucleus on the right, cerebellar tonsil on the left; ReHo values decreased brain regions of the image include pons and posterior cingulated on the right, central gyrus, superior frontal gyrus, ventral posterior lateral nucleus and the hippocampus on the left.(2) Data analysis of the treatment group showed that.compared with the image before the intervention, ReHo values increased brain regions of the image after 4 weeks include anterior cingulate cortex, ventrolateral nucleus, medial frontal gyrus, the orbitofrontal gyrus, inferior parietal lobule, insula, ventromedial nucleus on the right, anterior cingulate cortex, pons, orbital frontal gyrus, cerebellar tonsil on the left;ReHo values decreased brain regions of the image include pons, posterior central gyrus, posterior cingulate, ventral posterior lateral nucleus on the right, central gyrus, posterior cingulate, hippocampus on the left.(3) Data analysis of the control group showed that, compared with the image before the intervention, ReHo values increased brain regions of the image after after acupuncture immediately include inferior temporal gyrus, temporal gyrus, anterior cingulate gyrus, medial frontal gyrus, post-central gyrus on the right, anterior cingulate, precuneus, angular gyrus on the left; ReHo values decreased brain regions of the image include ventromedial nucleus, ventral lateral nucleus on the right, occipital gyrus, putamen on the left.(4) Data analysis of the control group showed that, compared with the image before the intervention, ReHo values increased brain regions of the image after after 4 weeks include lingual gyrus on the right, precuneus, anterior cingulate, pillow back on the left; ReHo values decreased brain regions of the image include ventral posterolateral nucleus on the left.Conclusion1. Based on the outcome, it was initially confirmed that balance acupuncture therapy for migraine without aura has analgesic effects. In terms of quality of life, the study suggests balance acupuncture therapy may improve the patient’s functional limitations in the treatment period and 4-week follow-up period. Balance acupuncture therapy may improve functional disorders in the treatment period, but cannot in the follow-up period. The therapy may not improve emotional state in the treatment period and follow-up period.2. During in treating migraine without aura in balanced acupuncture the lateral and inside conduction system of alegesia participate in the whole process and multiple brain functional region given priority to with the limbic system interacted with each other. In the same time, the abirritation of balanced acupuncture had a cumulative effect. Due to the limitation of the study and the complexity of the central nervous system, only can speculated the possible central modulating mechanism of abirritation in balanced acupuncture. |
PDF Full Text Request