| Objective:To combine functional magnetic resonance imaging(fMRI)(a modern technique)with acupuncture theory(a traditional medical theory)to investigate the distribution characteristics and activation of the brain effect area of the Taixi acupoint in patients with knee osteoarthritis(KOA)pain by acupuncture versus sham acupuncture,to corroborate the acupoint specificity of the Taixi acupoint,and to provide a modern theoretical basis for clinical application in the treatment of KOA.Methods:Forty patients with KOA(right-sided)pain were selected according to strict diagnostic and nadir criteria,and they were randomly divided into two groups,namely,the acupuncture group and the sham acupuncture group,with 20 subjects in each group filling in the VAS pain scale,receiving acupuncture at the Taixi point and sham acupuncture,respectively,using fMRI to scan the changes in brain areas before and after(sham)acupuncture,and filling in the qi gain scale after the operation was completed,and the data and image information collected were processed and analyzed by DPABI,SPSS 23 0 and other software.The data and image information collected were processed and analyzed by DPABI,SPSS 23.0 and other software to obtain information on the pain level of KOA patients,qi gain from acupuncture,voxel values of brain regions before and after(sham)acupuncture at the Taixi point,the degree of low-frequency amplitude activation,and regional consistency.Results:1.compared with before acupuncture,the brain regions with elevated ALFF values after acupuncture of the Taixi acupoint were: the right inferior temporal gyrus,and no significantly lower brain regions were seen;the brain regions with decreased fALFF values were the left cuneate lobe and the left superior occipital gyrus,and no significantly elevated brain regions were seen;the brain regions with elevated ReHo values were mainly: the bilateral superior frontal gyrus,the right middle frontal gyrus of the orbit,and the left anterior cingulate and paracingulate brain gyrus,and no significantly lower brain regions were seen.2.Compared with before sham acupuncture,no significant increase or decrease in ALFF and fALFF values were found in the p-value <0.01 range after sham acupuncture of the Taixi acupoint;ReHo values decreased in the right ducal shell nucleus and the right insula.3.The brain regions with differences in ALFF values after acupuncture of the Taixi point compared with sham acupuncture of the Taixi point were: bilateral middle occipital gyrus,bilateral inferior occipital gyrus,bilateral dorsolateral superior frontal gyrus,right perirhinal cortex of the talar fissure,right cuneus,right lingual gyrus,right middle frontal gyrus,left angular gyrus,left middle temporal gyrus,left medial and paracuneus gyrus,left precentral gyrus,left posterior cuneus gyrus,left inferior parietal marginal angular gyrus,left posterior central gyrus left precuneus,left supplementary motor area,and left paracentral lobule.4.The brain regions with differences in fALFF after acupuncture of the Taixi point compared with sham acupuncture of the Taixi point were mainly: the left inferior occipital gyrus,the left medial superior frontal gyrus,the right anterior cingulate and paracingulate gyrus,and the perirhinal cortex of the talar fissure.5.The brain regions with differences in ReHo values after acupuncture of the Taixi point compared with sham acupuncture of the Taixi point were mainly: bilateral precuneus,bilateral middle frontal gyrus,bilateral precentral gyrus,bilateral superior parietal gyrus,right lingual gyrus,right syrinx gyrus,right perirhinal cortex of the talar fissure,right middle occipital gyrus,right postcentral gyrus,right inferior parietal marginal angular gyrus,and right superior marginal gyrus.6.Before(sham)acupuncture,there was no statistical difference in the VAS pain scale scores between the two groups of subjects(P > 0.05);after(sham)acupuncture,there was a significant difference in the needle sensation between the 2 groups of subjects,and the incidence of each needle sensation was significantly higher in the acupuncture group than in the sham acupuncture group,and there was soreness,distension,and numbness,etc.The difference in the common needle sensation scores between the 2 groups of subjects was not statistically significant(P > 0.05).Conclusion:1.Acupuncture at the Taixi point can have a modulating effect on several brain areas,regulating neuronal activity in brain areas related to sensation,movement,emotion,cognition,etc.2.The brain areas activated by acupuncture or sham acupuncture at Taixi point were different,and acupuncture affected a wider range of brain areas.3.Compared with the sham acupuncture group,the acupuncture group got qi significantly,which is guessed to be related to its having the sense of getting qi such as soreness,swelling and numbness. |
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