基于影像学特征的针刺治疗功能性消化不良疗效预测研究

As one of the most common clinical functional gastrointestinal diseases, functional dyspepsia (FD) has a negative impact on quality of the life of patients and yields high medical costs. The underlying pathogenesis of FD remains unclear, and there are not unsatisfactory treatment options. Ample clinical reports studies have demonstrated that the acupuncture, an efficient therapeutic modality in Traditional Chinese Medicine (TCM), shows great treatment effect on FD to some extent, but the effective rate is only around 70%. This raised the question: how to select the functional dyspepsia patients suitable for acupuncture treatment, which may improve clinical effective rate and promote the development of acupuncture. Based on the critical role of dysfunctions of the brain-gut interaction involved in FD and the neural mechanisms of acupuncture treatment, we tried our best to investigate characteristic neural mechanisms of FD which might predict the curative effect of acupuncture based on multimodal medical imaging technologies and a series of radiomics-related approaches. Finally, Comprehensive medical imaging feature models were constructed for radiomics-driven detection of FD patients who were better fit for acupuncture treatment. We hope that this study may provide clinical and theoretical support to the improvement of appropriate acupuncture treatment related to FD and may improve a new view of acupuncture-related precise treatment.

功能性消化不良（FD）是一种常见的功能性胃肠疾病，其致病原因不明，目前尚缺乏真正有效的治疗方式。临床研究发现：针刺治疗FD有相对明显的疗效。然而，其疗效显著的患者仅在约70%。治疗前如何筛选适合针刺治疗的患者，最大限度的发挥针刺疗法的价值是一个值得探究、迫需解决的临床问题。根据现代医学观点，脑-肠轴互动异常理论，即中枢神经系统在内脏感觉处理功能异常可能是导致FD发病的主要原因。中枢神经系统在针刺效应的发挥中处于至关重要的地位也被得以证实。基于以上的理论和我们以往工作报道，本项目提出假设：功能性消化不良患者的影像学中枢表征可提示针刺疗效。本项目拟采用多模态神经影像技术为主要研究手段并结合放射组学技术中的一系列分析方法，基于代谢、结构、功能的中枢表征，建立FD患者影像学特征与针刺临床疗效的关系。为针刺精准治疗FD提供有价值的影像学依据和循证基础，进而更好地指导临床，提高诊断与治疗水平。

功能性消化不良（FD）是一种常见的功能性胃肠疾病，其致病原因不明，目前尚缺乏真正有效的治疗方式。临床研究发现：针刺治疗FD有相对明显的疗效，然而其治疗机制尚不明确。有研究表明：针刺的作用机理与中枢神经系统功能改变有关。本项目基于脑-肠轴互动异常理论，探究了FD患者的影像学中枢表征，主要含有：前额叶、运动感觉区、脑岛、颞极、扣带回、楔叶/楔前叶、舌回、基地神经节、海马、杏仁核和小脑。这些脑区涉及运动感觉、情绪处理、疼痛处理。并在神经影像的研究结果上，提出了FD患者影像学特征与针刺临床疗效的关系模型，为针刺治疗FD提供了更好地指导证据。同时为后续的针刺治疗FD的设备研发提供了初步理论支撑。. 此外，基于此项目，我们还开展了针对克罗恩疾、经前期综合征、早泄、精神疾病的中枢神经机制以及相关的治疗做了评估,为胃肠病相关的共病研究提供了初步的研究。