<p style="text-align: center;">王振宇¹，孙忠人²</p><p style="text-align: center;">（1、重庆医科大学附属永川医院，重庆市，402160；2、黑龙江中医药大学，黑龙江哈尔滨，150001，通讯作者）</p><p style="text-align: justify;">摘要：神经病理性疼痛是由躯体感觉系统的损害或疾病导致的疼痛。神经病理性疼痛的可能机制涉及初级感觉神经元超敏、中枢敏感和中枢去抑制，虽然关于神经病理性痛的研究取得了很多进展，但其细胞和分子机制仍不清楚。药物治疗、神经调控技术、脊髓刺激和微创治疗常常收效不明显，我们认为应该更加关注神经病理性疼痛患者的管理，因而课题组提出“基于S.M.A.R.T原理神经病理性疼痛患者的管理理念”。课题组从2016年起对针刺治疗脑卒中后神经病理性疼痛的核磁影像功能学和结构学展开研究，本文将汇报部分静息态功能核磁研究结果。研究招募患者30例，其中包括健康志愿者10例（健康对照组）。符合纳入标准的脑梗死后神经病理性疼痛患者20例，随机分为针刺处理组和假针刺组，针刺处理组采用于氏头穴丛刺长留针（颞区）。课题组以双侧丘脑为感兴趣区，计算丘脑与全脑的功能连接。发现与健康者对比脑梗死后患者区的中央前回、中央后回、前扣带回、胼胝体、尾状核、左侧角回、右侧缘上回等的功能连接显著性减弱（P&lt;0.05）； 患者治疗前后比较，2周治疗后丘脑与全脑的功能连接显著性增强（P&lt;0.05）；治疗后，针刺组较假针刺组全脑的功能连接显著性增强（P&lt;0.05）。结果提示针刺对脑梗死后神经病理性疼痛的治疗作用可能与其调整丘脑-皮层网络结构有关。</p><p style="text-align: justify;">关键词：针刺；S.M.A.R.T原理神经病理性疼痛；功能核磁</p><p style="text-align: justify;"><strong>Abstract</strong>:Neuropathic pain is defined as pain resulting from injury to, or dysfunction of the somatosensory system. The mechanisms of neuropathic pain include peripheral sensitization, central Sensitization and central disinhibition. In the past decade, several reviews have been written on the mechanisms of neuropathic pain, the contribution of neuropathy to pain presenting in primary care may be unrecognized. Unfortunately, neuropathic pain often responds poorly to standard pain treatments. Yet it is essential that clinicians understand the Neuropathic Pain S.M.A.R.T Management,because such an understanding can steer future research and guide clinical practice.The paper is to introduce our clinical study that is use functional magnetic resonance imaging to investigate the acupuncture inhibition of neuropathic pain.30 volunteers participated in the experiment that include 10 healthy volunteers. 20 cases of neuropathic pain after ischemic stroke Participants were randomly assigned to receive acupuncture group or sham acupuncture group followed by at least 2 weeks. Functional and structural images were acquired on a 3T Siemens Trio scanner and we were specifically interested in the effect of acupuncture on the thalamus. Functional connectivity between the thalamus and the whole brain was calculated to determine changes in pain-related functional. We observed significantly decreased BOLD responses in several areas typically. These areas included the precentral gyrus, insular cortex, amygdala, and anterior cingulate cortex (ACC). Under acupuncture, the thalamus showed enhanced functional coupling with the precentral gyrus, insular cortex, amygdala, and anterior cingulate cortex (ACC) （P&lt;0.05），when compared to sham acupuncture. This suggests that the effect of acupuncture inhibition of neuropathic pain is how the presence of changes functional connectivity between the thalamus and other brain areas of the somatosensory.</p><p style="text-align: justify;"><strong>Keywords</strong>：Acupuncture; Neuropathic Pain S.M.A.R.T Management；Functional Magnetic Resonance Imaging;</p><p><br/></p>