目的观察针刺预防性治疗偏头痛患者的脑代谢变化特征,探讨针刺预防性治疗偏头痛的中枢神经取效机制。方法选取凤池、百会、行间作为预防性治疗穴位,对15例偏头痛患者和15例头痛患者进行连续5天的针刺治疗,应用磁共振波谱技术进行检测,观察分析针刺前后受试者左侧丘脑及中央旁小叶后部的脑代谢变化。结果针刺预防性治疗后偏头痛组左侧丘脑的NAA/Cr、Cho/Cr水平升高,头痛组减低,差值大于0.1,两组之间有显著性差异。偏头痛组中央旁小叶后部NAA/Cr水平升高,头痛组减低,差值小于0.1,两组之间有统计学差异。中央旁小叶后部Cho/Cr针刺前后无明显变化,两组之间无差异。结论针刺预防性治疗偏头痛的镇痛作用可能靶点是左侧丘脑及中央旁小叶,针刺治疗可对局部大脑神经元能量及代谢重新分配、平衡协调,从而起到良性的治疗效果。
Objective To observe cerebral metabolism response mode of acupuncture for migraine prophylaxis and to discuss the cerebral mechanism of acupuncture therapy for migraine. Methods We selected Fengchi, BaiHui, XingJian as stimulating points to treat 15 migraine patients and 15 headache patients for continuous 5 days acupuncture prophylaxis treatment. Magnetic resonance spectroscopy had been operated before and after course of acupuncture treatment. Metabo- lism changes of left thalamus and posterior part of paracentral gyrus were acquired and compared in two groups. Results After acupuncture prophylaxis treatment, NAA/Cr and Cho/Cr of left thalamus in migraine group increased and decreased in headache group. The different data are larger than 0.1. There is a significant difference between migraine and headache group. NAA/Cr of posterior part of paracentral gyrus in migraine group increased and decreased in headache group. The different data is less than O. 1. There is a significant difference between migraine and headache group. There is no significant difference on Cho/Cr in posterior part of paracentral gyrus. Conclusion The possible targets of acupuncture prophy- laxis treatment may be thalamus and paracentral gyrus. Acupuncture treatment can reassign and coordinate metabolism of local cerebral neuron.