胃俞募配穴针刺对功能性消化不良患者静息态脑功能局部一致性和胃电图的影响

目的 观察胃俞募配穴与非经非穴针刺对功能性消化不良(FD)患者静息态脑功能局部一致性(ReHo)和胃电图(EGG)的影响，探讨胃俞募配穴针刺调节FD患者胃运动效应的中枢作用机制。方法 将37例FD患者随机分为配穴组（19例）和非穴组（18例），分别予以双侧胃俞+中脘、同节段非经非穴针刺治疗，同时选取19名健康人作为对照组。治疗前后分别对2组患者进行静息态脑功能磁共振成像( rs-fMRI)扫描和EGG检测，观察2组患者针刺治疗前后各脑区ReHo及EGG变化情况，并对差异脑区ReHo变化与胃运动变化进行相关性分析。结果 治疗后，①配穴组EGG振幅、频次均增高（P＜0.05~0.01）。非穴组EGG振幅增高（P＜0.01），频次较治疗前未见明显差异（P>0.05）。②与对照组相比，FD患者小脑、额叶、扣带回、脑岛、颞叶等脑区内不同区域ReHo值异常。配穴组针刺后FD患者梭状回、后扣带回等脑区ReHo值增高（P＜0.05），海马、额中回等脑区ReHo值降低（P＜0.05）。非穴组针刺后FD患者小脑、额上回、额中回、楔前叶、角回等脑区ReHo值发生变化。③相关性分析可见:配穴组颞上回、颞极颞中回、后扣带回、额中回、海马与EGG变化相关。非穴组各差异脑区ReHo值变化与EGG变化无显著相关。结论 胃俞募配穴针刺可引起FD患者多个脑区ReHo值变化且其对胃运动调节效应优于非穴，海马、后扣带回等脑区可能参与了针刺对胃运动的调节。胃俞募配穴针刺可能通过对边缘系统、胃肠感觉矩阵相关脑区的良性调控而发挥对FD患者胃运动功能的调节作用。 

Effect of Acupuncture at Weishu Combined with Zhongwan on the Regional Homogenity of Resting-State Brain Function and Electrogastrogram for Patients with Functional Dyspepsia

OBJECTIVE To observe the effect of acupuncture at Weishu (BL21) combined with Zhongwan (RN12) and acupuncture at non-combined acupoints on regional homogeneity (ReHo) of resting-state brain function and the electrogastrogram (EGG) in patients with functional dyspepsia (FD)， and to explore the central mechanism of regulating the gastric motility of FD patients by acupuncture at BL21 and RN12. METHODS 37 FD patients were randomly divided into combined acupoints group (19 cases) and non-combined acupoints group (18 cases). The two groups were treated with bilateral BL21+RN21 acupuncture therapy and non-acupoints acupuncture therapy of the same segment separately. At the same time， 19 healthy people were enrolled as the control group. The resting-state functional magnetic resonance imaging scan (rs-fMRI) and EGG test were performed before and after treatment. The changes of ReHo and EGG were observed before and after treatment. Additionally， the correlation analysis between the changes of ReHo and gastric motility was conducted. RESULTS ① After treatment， the amplitude and frequency of EGG in the combined acupoints group increased (P<0.05，P<0.01). In the non-combined acupoints group， the amplitude of EGG increased (P<0.01)， and the frequency was not significantly different from that before treatment (P>0.05). ② Compared with the control group， the ReHo values of FD patients in different regions of the brain such as cerebellum， frontal lobe， cingulate gyrus， insula and temporal lobe were abnormal. In the combined acupoints group， the ReHo values of fusiform gyrus， posterior cingulate gyrus and other brain areas increased in FD patients after treatment (P<0.05)， and that of hippocampus and middle frontal gyrus decreased (P<0.05). In the non-combined acupoints group， the ReHo values of cerebellum， superior frontal gyrus， middle frontal gyrus， anterior cuneiform lobe， angular gyrus and other brain regions of FD patients changed after acupuncture. ③ Correlation analysis showed that the changes of EGG were correlated with the changes of superior temporal gyrus， middle temporal gyrus， posterior cingulate gyrus， middle frontal gyrus and hippocampus in the combined acupoints group. There was no significant correlation between the changes of ReHo values in different brain regions and the change of EGG amplitude in the non-combined acupoints group. CONCLUSION Acupuncture at BL21 combined with RN21 can cause the changes of ReHo values in multiple brain regions of FD patients and its effect on gastric motility is better than that of non-combined acupoints group. Hippocampus， posterior cingulate gyrus， cerebellum and other brain regions may be involved in the regulation of gastric motility. The effect of regulating gastric motility in FD patients by acupuncture at BL21 combined with RN21 may be achieved by the benign regulation of brain regions which is related to limbic system and gastrointestinal sensory matrix.