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岭南林氏正骨手法对枕大神经痛患者静息态功能磁共振低频振幅作用研究 被引量:6

Effect of Lingnan LIN’s Bone-setting Manipulations on the Amplitude of Low Frequency Fluctuation in Whole-brain Resting-state fMRI in Patients with Greater Occipital Neuralgia
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摘要 【目的】采用静息态功能磁共振成像(rs-fMRI)探究岭南林氏正骨手法对枕大神经痛镇痛效应与脑功能活动的相关性。【方法】选取广东省中医院门诊收治的7例枕大神经痛患者为观察组,同期招募8例健康志愿者为对照组。观察组给予岭南林氏正骨手法颈椎定点旋转扳法治疗,每周治疗1次,疗程为4周。采集患者治疗前后的脑功能磁共振(fMRI)数据,运用基于低频振幅算法(ALFF)分析患者脑区相关参数变化情况,并与对照组比较;同时,观察枕大神经痛患者治疗前后疼痛视觉模拟量表(VAS)评分及贝克抑郁自评量表(BDI)评分的变化情况。【结果】(1)与对照组比较,观察组ALFF增高的脑区为右侧小脑皮质,ALFF降低的脑区为左侧枕中回、右侧距状裂周围皮层、左侧楔叶;与治疗前比较,观察组患者治疗后的ALFF增高的脑区为双侧枕中回、右侧颞中回,差异有统计学意义(P<0.05)。(2)经推拿手法治疗后,观察组患者的VAS评分和BDI评分均较治疗前明显降低,差异均有统计学意义(P<0.001)。【结论】枕大神经痛患者的rs-fMRI显示其ALFF存在异常,岭南林氏正骨手法治疗枕大神经痛疗效显著,可通过部分脑区活动度的改变实现其镇痛效果。 Objective To study the correlation between the analgesic effect of Lingnan LIN’s bone-setting manipulations and the activity of brain function of greater occipital neuralgia patients detected by resting-state functional magnetic resonance imaging(rs-fMRI).Methods Seven patients with greater occipital neuralgia treated in the outpatient department of Guangdong Provincial Hospital of Traditional Chinese Medicine served as the observation group,and 8 healthy volunteers enrolled at the same period served as the control group.The observation group was treated with Lingnan LIN’s bone-setting manipulations of rotation and pulling manipulation on the fixed point of cervical vertebra,once a week,and the treatment lasted for 4 weeks.Before and after treatment,the functional magnetic resonance imaging(fMRI)data in the observation group were collected and were analyzed with reference to the amplitude of low frequency fluctuation(ALFF)for the investigation of the changes in relevant parameters of the patients’brain regions,and then were compared with those of the control group.The visual analogue scale(VAS)pain scores and Beck depression rating scale(BDI)scores in the observation group were also observed before and after treatment.Results(1)Compared with the control group,the brain region with the increased ALFF in the observation group was the right cerebellar cortex,while the brain areas with the decreased ALFF were the left middle occipital gyrus,the peripheral cortex of the right calar fissure,and the left cuneus.In the observation group,ALFF in the bilateral middle occipital gyrus and right middle temporal gyrus was increased in comparison with that before treatment,and the difference was statistically significant(P<0.05).(2)After treatment with manipulative techniques of massage,the VAS scores and BDI scores in the observation group were decreased in comparison with those before treatment,and the differences were statistically significant(P<0.001).Conclusion The rs-fMRI of the patients with greater occipital neura
作者 郭汝松 黄帆 黄楚渝 朱碧锋 赵思怡 刘国清 范志勇 田强 吴山 GUO Ru-Song;HUANG Fan;HUANG Chu-Yu;ZHU Bi-Feng;ZHAO Si-Yi;LIU Guo-Qing;FAN Zhi-Yong;TIAN Qiang;WU Shan(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China;Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)
出处 《广州中医药大学学报》 CAS 2021年第1期109-115,共7页 Journal of Guangzhou University of Traditional Chinese Medicine
基金 广东省科技计划项目(编号:2017A020215078) 广东省财政厅项目(编号:粤财教[2016]387号)。
关键词 枕大神经痛 岭南林氏正骨手法 镇痛 静息态功能磁共振成像(rs-fMRI) 低频振幅 greater occipital neuralgia Lingnan LIN’s bone-setting manipulations analgesia resting-state functional magnetic resonance imaging(rs-fMRI) amplitude of low frequency fluctuation
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