文献类型：期刊文献

中文题名：基于静息态功能磁共振成像低频振幅算法探讨针刺治疗儿童屈光参差性弱视的机制

英文题名：Mechanism of acupuncture in the treatment of children with anisometropic amblyopia based on amplitude of low frequency fluctuation analysis by rs-fMRI

作者：贾静[1];孙燕[1];马重兵[1];王觉[1];朱田田[1];严兴科[1]

第一作者：贾静

机构：[1]甘肃中医药大学针灸推拿学院,兰州730000

第一机构：甘肃中医药大学针灸推拿学院

年份：2022

卷号：37

期号：5

起止页码：2734

中文期刊名：中华中医药杂志

外文期刊名：China Journal of Traditional Chinese Medicine and Pharmacy

收录：CSTPCD;;北大核心:【北大核心2020】；CSCD:【CSCD2021_2022】；

基金：国家自然科学基金(No.82160935,No.81860879);甘肃省高等学校创新基金项目(No.2021A-087);甘肃省科技厅重点研发计划(No.20YF8FA111)。

语种：中文

中文关键词：屈光参差性弱视;针刺;静息态功能磁共振成像;低频振幅;边缘叶;扣带回;顶叶;额叶

外文关键词：Anisometropic amblyopia;Acupuncture;Resting state-functional magnetic resonance imaging(rs-f MRI);Amplitude of low frequency fluctuation(ALFF);Limbic lobe;Cingulate gyrus;Parietal lobe;Frontal lobe

摘要：目的:利用静息态功能磁共振成像(rs-fMRI)技术的低频振幅(ALFF)算法探讨针刺治疗儿童屈光参差性弱视的脑功能机制。方法:将80例屈光层参差性单眼弱视儿童分为常规组(40例,脱落1例)和针刺组(40例,脱落1例)。常规组予以配镜、红闪光栅和视刺激治疗,每项5 min/次;针刺组在常规治疗的基础上给予“调气通经明目”针法治疗,取双侧睛明、攒竹、光明、风池,每次留针30 m in;两组均隔日治疗1次,3次/周,共4周。治疗结束后,检测两组患者视力和视觉诱发电位(P-VEP)P100波潜伏期和振幅改变。同时从两组中各随机选取9例左眼弱视患儿,于治疗前后分别予以rs-fMRI扫描,比较分析两组患儿脑区ALFF差异。结果:①治疗后两组患儿矫正视力均较治疗前提高(P<0.05);与治疗前比较,治疗后两组患儿P-VEP P100波潜伏期缩短、振幅升高(P<0.05),针刺组改善程度显著优于常规组(P<0.05)。②治疗后,常规组右侧豆状核ALFF值增高;针刺组右侧颞叶ALFF值增高(P<0.05);针刺组与常规组比较,右侧边缘叶/扣带回左侧胼胝体/扣带回、左侧额叶/双侧辅助运动区的ALFF值降低(P<0.05),右侧顶叶/顶下小叶增高(P<0.05)。结论:针刺联合常规治疗可改善屈光参差性弱视儿童的矫正视力,增强视神经传导功能;两种疗法的效应机制与有效调节不同脑区自发功能活动和响应有关,但二者脑功能响应区域存在明显差异。与常规疗法相比,边缘系统、额叶、顶叶可能是针刺治疗屈光参差性弱视重点调控的脑区。
Objective:To explore the brain mechanism of acupuncture in the treatment of children with anisometropic amblyopia using rs-f MRI based on amplitude of low frequency fluctuation(ALFF)analysis.Methods:Eighty children with monocular anisometropic amblyopia were divided into routine-treatment group(40 cases with one dropout)and acupuncture group(40 cases with one dropout).The routine-treatment group was treated with glasses,red flash grating and visual stimulation,each for 5 min/time.Acupuncture group was treated with the acupuncture for regulating qi,unblocking meridians and improving vision on the basis of routione treatment,taking four bilatral acupoints Jingming(BL 1),Cuanzhu(BL 2),Guangming(GB 20),Fengchi(GB 37),and the needles were retained for 30 min.Once every other day,3 times/week,for a total of 4 weeks for both group.After the treatment,the visual acuity and visual evoked potential(P-VEP)P100 wave latency and amplitude changes were measured in the two groups.Nine children from each group were scanned with rs-fMRI before and after treatment to compare and analyze the difference of ALFF between the two groups.Results:①The corrected visual acuity of children in both groups was improved after treatment compared with that before treatment(P<0.05);the latency of P-VEP P100 wave was shortened and the amplitude was increased in children in both groups after treatment compared with that before treatment(P<0.05),and the improvement in the acupuncture group was better than that in the routine-treatment group(P<0.05).②After treatment,the ALFF values of the right side of the lenticular nucleus were increased in the routine-treatment group,the right side of the temporal lobe ALFF were increased in the acupuncture group(P<0.05).The ALFF of right bilateral limbic lobe/cingulate gyrus left corpus callosum/cigulat gyrus,and left frontal lobe/SMA were decreased after treatment in the acupuncture group compared with the routine-treatment group(P<0.05),and were increased in the right parietal/subparietal lobule(P<0.05).Conclusion:Acupuncture combined with routine therapy can improve corrected visual acuity and increase optic nerve conduction in children with anisometropic amblyopia.The effect mechanism of both therapies is related to effective modulation of spontaneous functional activity from different brain regions,however,the specific responding brain areas of the two group are significantly different.Compared with the routine-treatment group,the limbic system,frontal lobe,and parietal lobe may be the key brain regions targeted by acupuncture for the treatment of anisometropic amblyopia.