针刺治疗偏头痛疗效差异的单核苷酸多态性相关脑功能网络研究

Acupuncture analgesia mechanism has been obtained much attention in acupuncture area. Based on our previous research, it has been considered that genetic factor can play a remarkable role in acupuncture analgesia. Thus, this study centered the hypothesis "interindividual variation of acupuncture efficacy has specific functional network in the brain based on genetic variation" on basis of the interindividual efficacy variation of acupuncture for menstrual migraine. Through the integration of multidisciplinary methods e.g. molecular biology, computer science and acupuncture, the aim of this study is to explore the genetic effect on acupuncture analgesia for menstrual migraine in real-time, noninvasive and visual way of functional central networks in the brain using functional magnetic resonance imaging technology and single nucleotide polymorphisms analysis, to elucidate the meaning of acupuncture analgesia further and provide more sufficient scientific evidence for clinical use of acupuncture analgesia.

针刺镇痛机制一直是针刺研究的热点与难点。基于前期一系列科学研究基础上，研究发现遗传因素可能是影响针刺镇痛疗效的关键因素之一。因此，本课题拟从针刺个体疗效差异入手，以针刺优势病种经期偏头痛为载体，提出并围绕“不同针刺疗效在基于遗传标记的脑内神经通路有迹可寻”的研究假说，整合分子生物学、计算机科学、针灸学等多学科方法技术，基于遗传标记分析结果，应用功能性磁共振成像技术，从中枢响应网络的视角，实时、无创、可视化的呈现偏头痛患者遗传因素对针刺镇痛效用的影响，进一步揭示针刺镇痛机制，以期为针刺镇痛的临床运用提供更为充分的科学依据。

本项目围绕“不同针刺疗效在基于遗传标记的脑内神经通路有迹可寻”的工作假说，从针刺个体疗效差异入手，联合应用单核苷酸多态性分析与fMRI技术的脑功能分析技术，首次从中枢功能调节的视角，实时、无创、可视化的进行偏头痛患者遗传因素对针刺镇痛效用影响的探索研究。研究结果显示：（1）采用“头痛天数缓解程度”对经期偏头痛患者的针刺疗效评价具有良好的区分度；（2）经期偏头痛患者与健康受试者、不同疗效经期偏头痛患者的ESR1基因(rs2228480、rs1801132)在基因型的分布频率、等位基因A与G的分布频率均未发现统计学差异；（3）与健康受试者相比，经期偏头痛患者在旁海马、边缘叶、脑岛、后扣带回、双侧额眶回的局域一致性出现异常；针刺干预对“有效”经期偏头痛患者原先局域一致性异常的边缘叶、双侧额眶回、脑岛进行了靶向性调节，而对 “无效”经期偏头痛患者的中枢功能活动调节呈现广泛性皮层调节特点，未发现对皮质下结构的功能影响。