摘要：
OBJECTIVE: The aim of this systematic review and meta-analysis is to improve the understanding of the pathophysiology of tension-type headache (TTH), as well as propose avenues for future neuroimaging studies of TTH. METHODS: From the inception dates to May 1, 2020, a systematic literature will search in Medline (Ovid SP), Embase (Ovid SP), Cochrane Central Register of Controlled Trials, Web of Science, and 4 Chinese databases without limitation on language or publication. Additionally, International Clinical Trials Registry Platform , reference lists, and relevant gray literatures will be searched. After screening of eligible references, included studies will be determined according to included criteria, and then data extraction and a methodological quality assessment with a customized checklist will be conducted. Each process will be independently implemented by 2 reviewers, any disagreement will be resolved by consensus to the third researcher. If the extracted data is feasible, anisotropic effect-size version of signed differential mapping will be conducted to perform the meta-analysis of the structural and functional brain alterations in TTH patients.
摘要：
OBJECTIVE: To explore how baseline resting-state cerebral function predicts clinical outcomes of acupuncture treatment for migraine. METHODS: One hundred migraine patients and 46 healthy subjects were recruited. Patients were randomized into the acupuncture, sham acupuncture, and waiting list groups. Resting-state functional magnetic resonance imaging data were collected at baseline and after 1 month of longitudinal acupuncture treatments. Fractional amplitude of low-frequency fluctuations (fALFF) calculations were applied to explore the associations between baseline fALFF and changes in clinical variables in the acupuncture treatment group and the waiting list group. RESULTS: Compared with healthy subjects, migraine patients had lower fALFF in the left rostral ventromedial medulla, right thalamus, left amygdala, and right angular gyrus. Regression analyses revealed that baseline fALFF values in the left middle frontal gyrus, left superior temporal gyrus, and middle temporal gyrus were positively associated with headache intensity changes in the acupuncture treatment group, while baseline fALFF values in the bilateral lingual gyrus and cuneus were negatively associated with headache intensity changes in this group. CONCLUSION: The baseline fALFF values of brain regions associated with cognitive pain modulation, but not migraine severity, may predict future headache intensity improvement levels in migraine patients receiving acupuncture treatment. (C) 2020 JTCM. All rights reserved.
作者机构：
[Tu, Yiheng; Maleki, Nasim; Lang, Courtney; Kong, Jian; Park, Joel] Massachusetts Gen Hosp, Dept Psychiat, Charlestown, MA 02129 USA.;[Tu, Yiheng; Maleki, Nasim; Lang, Courtney; Kong, Jian; Park, Joel] Harvard Med Sch, Charlestown, MA 02129 USA.;[Zeng, Fang; Lan, Lei; Liang, Fanrong; Li, Zhengjie] Chengdu Univ Tradit Chinese Med, Teaching Hosp 3, Chengdu, Sichuan, Peoples R China.;[Chen, Jun; Liu, Bo] Guangdong Prov Hosp Chinese Med, Dept Radiol, Guangzhou, Peoples R China.;[Wang, Chenchen] Tufts Med Ctr, Ctr Complementary & Integrat Med, Div Rheumatol, Boston, MA 02111 USA.
通讯机构：
[Kong, Jian] M;[Kong, Jian] H;[Liang, Fanrong] C;Massachusetts Gen Hosp, Dept Psychiat, Charlestown, MA 02129 USA.;Harvard Med Sch, Charlestown, MA 02129 USA.
摘要：
OBJECTIVE: To identify and validate an fMRI-based neural marker for migraine without aura (MwoA) and to examine its association with treatment response. METHODS: We conducted cross-sectional studies with resting-state fMRI data from 230 participants and machine learning analyses. In studies 1 through 3, we identified, cross-validated, independently validated, and cross-sectionally validated an fMRI-based neural marker for MwoA. In study 4, we assessed the relationship between the neural marker and treatment responses in migraineurs who received a 4-week real or sham acupuncture treatment, or were waitlisted, in a registered clinical trial. RESULTS: In study 1 (n = 116), we identified a neural marker with abnormal functional connectivity within the visual, default mode, sensorimotor, and frontal-parietal networks that could discriminate migraineurs from healthy controls (HCs) with 93% sensitivity and 89% specificity. In study 2 (n = 38), we investigated the generalizability of the marker by applying it to an independent cohort of migraineurs and HCs and achieved 84% sensitivity and specificity. In study 3 (n = 76), we verified the specificity of the marker with new datasets of migraineurs and patients with other chronic pain disorders (chronic low back pain and fibromyalgia) and demonstrated 78% sensitivity and 76% specificity for discriminating migraineurs from nonmigraineurs. In study 4 (n = 116), we found that the changes in the marker responses showed significant correlation with the changes in headache frequency in response to real acupuncture. CONCLUSION: We identified an fMRI-based neural marker that captures distinct characteristics of MwoA and can link disease pattern changes to brain changes.
作者机构：
[Hong-hua Liu; Guo-shan Zhang; Hui-juan Liu; Duo-duo Li; Mi Liu; Xiao-rong Chang; Mai-lan Liu] Hunan University of Chinese Medicine, Changsha, China
通讯机构：
[Xiao-rong Chang; Mai-lan Liu] H;Hunan University of Chinese Medicine, Changsha, China
关键词：
Acupuncture Therapy;Point Selection, Meridian;Point Selection Based on Syndrome Differentiation;Dyspepsia;Randomized Controlled Trial
摘要：
Objective: To observe the difference in clinical efficacy between acupuncture with point selection based on syndrome differentiation along the meridians and acupuncture at non-meridian and non-acupoint points for functional dyspepsia (FD). Methods: A total of 74 FD patients were randomized into an observation group and a control group, with 37 cases in each group. Both groups received acupuncture treatment. Zusanli (ST 36) and Neiguan (PC 6) were selected in the observation group, with Taichong (LR 3) and Neiting (ST 44) added for excess syndrome, and Gongsun (SP 4) and Yinlingquan (SP 9) added for deficiency syndrome. Four non-meridian and non-acupoint points were selected in the control group. The treatments in both groups were performed once a day with a 2-day break after 5 consecutive treatments, which constituted one treatment course. A total of 4 courses were performed. The scores of Nepean dyspepsia index (NDI) and Leeds dyspepsia questionnaire (LDQ) were recorded before and after treatment, and during follow-up (8, 12, 16, 20 and 24 weeks after recruitment) to assess the clinical efficacy. Results: The NDI scores in the two groups after treatment and at each time point during follow-up were higher than those before treatment (all P<0.05), and the LDQ scores were lower than those before treatment (all P<0.05). The NDI scores after treatment and at each time point during follow-up in the observation group were higher than those in the control group (all P<0.01); the total LDQ score and scores of upper abdominal pain, postprandial satiety and upper abdominal burning sensation after treatment and at each time point during follow-up in the observation group were significantly lower than those in the control group (P<0.01 or P<0.05).. Conclusion: Acupuncture with point selection based on syndrome differentiation along the meridians has a better curative effect than acupuncture at non meridian and non-acupoint points in the treatment of FD.
作者机构：
[刘红华] Nursing School, Hunan University of CM, Changsha 410208, China;[葛君芸; 刘迈兰; 欧阳里知; 刘琼; 常小荣] School of Acupuncture-Moxibustion and Tuina, Hunan University of CM, Changsha 410208, China;[胡辉] First Affiliated Hospital of Hunan University of CM
作者机构：
[葛君芸; 刘迈兰; 沈菁; 刘涛; 刘霞; 常小荣] College of Acupuncture-Moxibustion and Tuina, Hunan University of CM, Changsha 410208, China;[汪厚莲] Hunan Junior College of TCM;[Guo, An-Lin] Changsha Civil Vocational Technical School
作者机构：
[Tu, Yiheng; Maleki, Nasim; Wilson, Georgia; Kong, Jian; Park, Joel] Massachusetts Gen Hosp, Dept Psychiat, Charlestown, MA 02129 USA.;[Tu, Yiheng; Maleki, Nasim; Wilson, Georgia; Kong, Jian; Park, Joel] Harvard Med Sch, Charlestown, MA 02129 USA.;[Fu, Zening; Calhoun, Vince] Mind Res Network, Albuquerque, NM USA.;[Zeng, Fang; Lan, Lei; Liang, Fanrong; Li, Zhengjie] Chengdu Univ Tradit Chinese Med, Teaching Hosp 3, Acupuncture & Tuina Sch, Chengdu, Sichuan, Peoples R China.;[Gao, Yujie] Ningxia Med Univ, Tradit Chinese Med Sch, Yinchuan, Peoples R China.
通讯机构：
[Kong, Jian] M;[Kong, Jian] H;[Liang, Fanrong] C;Massachusetts Gen Hosp, Dept Psychiat, Charlestown, MA 02129 USA.;Harvard Med Sch, Charlestown, MA 02129 USA.
作者机构：
[Yu-lan Tang; Mai-lan Liu; Qian-yun Yang; Jie Yu; Zeng-hui Yue; Xiao-rong Chang] School of Acupuncture, Moxibustion & Tuina, Hunan University of Chinese Medicine, Changsha, China
通讯机构：
[Mai-lan Liu] S;School of Acupuncture, Moxibustion & Tuina, Hunan University of Chinese Medicine, Changsha, China
摘要：
Objective: To observe the clinical efficacy of treating infantile diarrhea due to spleen deficiency with five-step pediatric tuina of Huxiang school. Methods: Using a randomized controlled trial design, sixty eligible kids with diarrhea due to spleen deficiency were randomized into an observation group and a control group, with 30 cases in each group. The observation group was intervened by the five-step pediatric tuina method of Huxiang school, and the control group received conventional tuina treatment. The intervention was conducted once a day, consecutive 5-day treatment as 1 course, at a 2-day interval between courses, successively for a total of 4 courses. Changes in the primary and secondary symptoms of diarrhea due to spleen deficiency were observed, and the clinical efficacy was evaluated. Results: After treatment, the scores of primary and secondary symptoms and the general score of diarrhea due to spleen deficiency were improved; the improvements in fecal form and frequency, decreased appetite, bloating after meals and fatigue and sluggishness were more significant in the observation group than in the control group. Conclusion: The five-step pediatric tuina method of Huxiang school and conventional tuina both can improve the primary and secondary symptoms in infantile diarrhea due to spleen deficiency, while the former one can produce more significant efficacy.
