基于“任主胞胎”理论的针刺治疗原发性痛经的中枢-靶器官响应特征研究

“REN meridian connecting with the uterus and pregnancy” is an important theory for TCM diagnosis and treatment of gynecological diseases in clinical practice. However, its scientific connotation remains to be elucidated. Previous studies showed salient brain function abnormities and uterus malperfusion as main pathological features of primary dysmenorrhea. We therefore hypothesized that “there’s a correlation between central integration and target organ response in the efficacy of acupuncture treatment for primary dysmenorrhea ”. We designed the present project based on our previous finding, to characterize responsive traits of central nervous system and target organ that are regulated by acupuncture treatment for primary dysmenorrhea. Primary dysmenorrhea patients will be recruited to receive acupuncture reatment. The acupoint applied in this study is Guanyuan (Ren 4) in Ren-conception vessel. Classical Bold-fMRI and ASL technologies will be integrated together to acquire data of brain pain matrix and uterus perfusion. By combining with clinical and biochemical parameters’ changes, imaging data will be analyzed simultaneously to demonstrate the correlation of central integration and target organ response. This program will provide in-depth evidence to illustrate the biological mechanism of acupuncture for primary dysmenorrhea. The finding of this study will shed light on the scientific connotation of the “REN meridian connecting with the uterus and pregnancy” theory, and will further promote the improvement of acupuncture clinical effect and development of TCM theories.

“任主胞胎”是指导中医妇科临床诊疗的重要理论，但其科学内涵有待深入阐释。本项目在前期研究的基础上，提出“针刺治疗原发性痛经（PD）镇痛效应的中枢整合与靶器官响应之间存在联动性”的研究假说，以任脉穴针刺治疗的优势病种PD为研究载体，以关元穴为刺激点，针对PD脑功能紊乱和子宫血流灌注异常的重要病理变化，采用经典的功能磁共振成像技术和先进的动脉自旋标记技术，采集针刺治疗前、后PD患者大脑疼痛矩阵和子宫血流灌注数据，以及血管舒缩相关生化指标，通过影像数据之间的同步采集与实时融合分析、影像数据与效应指标的相关分析，从影响血管功能的角度，探讨针刺治疗PD中枢和靶器官响应特征及联动机制，以期更深入揭示针刺治疗PD的作用机制，为阐释“任主胞胎”理论的科学内涵提供依据。

“任主胞胎”是指导中医妇科临床诊疗的重要理论，但其科学内涵有待深入阐释。本研究以原发性痛经（PD）为研究载体，以任脉关元穴为刺激点，在评价针刺治疗PD临床疗效的基础上，通过BOLD-fMRI、ASL-MRI和3D-CDU数据的融合分析，发现相对于等待治疗，PD受试者在接受关元穴针刺后，其左侧后扣带回、距状回、右侧背外侧前额叶、双侧眶额叶、顶下小叶等脑区功能连接密度增加，双侧额叶腮盖部、前岛叶、辅助运动区等脑区功能连接密度降低；而在脑血流方面，左侧辅助运动区、前扣带回，右侧杏仁核、海马，双侧伏隔核、尾状核等脑区的脑血流量增加，左侧缘上回、距状回，双侧顶上叶等脑区的脑血流量降低；同时，子宫动脉的舒张末期血流速度明显增加，阻力指数均有显著降低；大脑左侧辅助运动区的脑血流变化值与子宫动脉阻力指数的变化值之间具有显著的正相关关系，这说明了PD受试者在接受关元穴针刺后大脑和子宫的血流灌注出现了联动同步的改善，从中枢-靶器官角度为阐释“任主胞胎”理论的科学内涵提供了一定依据。