基于“膝为筋之府”理论针刺治疗KOA疼痛认知控制网络整合机制研究

“Knee is the house of tendon” is an important reference for traditional acupuncture treatment of knee joint diseases, which is also critical for its theory and clinic value. This study will be based on our previous acupuncture neuroimaging studies. Clinical common disease knee osteoarthritis (KOA) will be the research carrier in this study, with the key acupoint of acupuncture treating for KOA --“tendon converge” yanglingquan as the main stimulation point, with brain pain-cognitive control network as the emphasis, with functional magnetic resonance imaging (fMRI), laser speckle imaging and brian functional network analysis method as the technique or method. This study will compare acupuncture treatment with postive control drugs, placebo treatment and waiting-list treatment to determine the specific effect of acupuncture treatment on KOA brain function network. This study will further combine fMRI data with local knee microcirculation changes and clinical outcome changes to determine the central mechanism of acupuncture treatment for KOA based on “Knee is the house of tendon” theory, providing scientific evidence for acupuncture treatment for KOA, promoting the heritage and development of traditional Chinese medicine theory.

“膝为筋之府”是传统中医针灸治疗膝关节疾病的重要依据，具有重要的理论价值和临床意义。本研究在前期深入开展针刺神经影像研究的基础上，拟以临床常见的膝骨性关节炎（KOA）为研究载体，以针刺治疗KOA要穴“筋会”阳陵泉为主要刺激点，以大脑疼痛认知控制网络为重点，综合运用经典的功能磁共振技术、激光散斑技术和脑功能网络分析方法，对比观察针刺治疗相对于阳性药物治疗、安慰剂治疗和等待治疗对KOA患者局部脑功能网络的影响，并通过膝关节局部微循环变化、效应指标与脑网络功能变化的融合分析，深入探讨基于“膝为筋之府”理论针刺治疗KOA的部分中枢机制，为针刺治疗KOA的临床运用提供科学的试验依据，促进传统中医理论的传承与发展。

本研究以膝骨关节炎膝痛患者为研究载体，以传统中医针灸理论“膝为筋之府”为针刺选穴指导理论，运用大脑磁共振、激光散斑等技术手段，以大脑疼痛认知控制网络为重点结合膝关节局部微循环变化、血液代谢指标变化，通过“局部-外周-中枢”多维度验证了“大脑疼痛认知控制网络功能的调控是针刺治疗膝骨性关节炎的重要中枢整合机制”的研究假说。其研究成果系统揭示了针刺治疗膝骨性关节炎的中枢整合作用机制，为针刺治疗膝骨性关节炎的临床应用提供了科学实验依据，同时也促进了中医针灸学的国际化进程。