Deqi is taken as an indispensable requirement to achieve acupuncture efficacy. This study aimed to explore the central influence of deqi on the efficacy of acupuncture for functional dyspepsia (FD). 70 FD patients were randomized to receive 20 sessions' acupuncture treatment with (n = 35) and without deqi (n = 35). In each group, 25 FD patients randomly selected underwent functional magnetic resonance imaging (fMRI) scans before and after treatment. After group re-division according to deqi response, changes of amygdala subregions-based resting-state functional connectivity (rsFC) were compared between the acupuncture with and without obvious deqi group. The clinical changes of the Nepean Dyspepsia Symptom Index (NDSI) measuring FD symptoms were also used to further assess the correlation with amygdala subregions rsFC in FD patients. The decrease in the NDSI scores (pre-pos) in the obvious deqi group was significantly greater than that in the acupuncture without obvious deqi group (p < 0.05). Compared to the without obvious deqi group, the obvious deqi group showed significantly decreased the left basolateral amygdala (BLA) rsFC with bilateral insular (INS), putamen and middle/posterior cingulate cortex (MCC/PCC), right pallidum and hippocampus (HIPP) after treatment. The changed NDSI scores(pre-post) of all 41 FD patients was significantly positively correlated with their Fisher's transformed z value of the left BLA rsFC with left INS (r = 0.376, FDR corrected p = 0.015), and rsFC with right HIPP (r = 0.394, FDR corrected p = 0.015). The changed NDSI scores(pre-post) of the obvious deqi group was significantly negatively correlated with their Fisher's transformed z value of the right centromedial amygdala (CMA) rsFC with left medial prefrontal cortex (mPFC) (r = -0.463, p = 0.035). The results tested the hypothesis that the advantage of deqi on efficacy is related to affecting the BLA and CMA rsFC. It suggested that deqi might influence the abnormal rsFC within the salience network (SN), and participate in the adaptive modulation of disrupted relationship between the SN and default mode network (DMN).

中文翻译：

---

基底外侧杏仁核参与针刺结合地气治疗功能性消化不良的疗效。

德气是达到针灸疗效必不可少的条件。本研究旨在探讨德气对针灸治疗功能性消化不良（FD）的影响。70名FD患者被随机分配接受20疗程的针灸治疗，其中（n = 35），无针刺（n = 35）。在每组中，随机选择25名FD患者在治疗前后进行功能磁共振成像（fMRI）扫描。根据deqi反应对组进行重新划分后，比较有明显deqi组和没有明显deqi组的针刺之间基于杏仁核亚区的静止状态功能连接性（rsFC）的变化。测量FD症状的尼泊尔消化不良症状指数（NDSI）的临床变化也用于进一步评估FD患者与杏仁核亚区rsFC的相关性。明显地气组的NDSI评分（正位）下降明显大于没有明显地气组的针灸下降（p <0.05）。与无明显德奇组相比，明显德奇组显示左基底外侧杏仁核（BLA）rsFC显着降低，双侧岛突（INS），壳状核和中/后扣带回皮层（MCC / PCC），右苍白球和海马（HIPP）治疗后。所有41例FD患者的NDSI评分变化（事后）与左INS左BLA rsFC的Fisher变换z值（r = 0.376，FDR校正后的p = 0.015）和rsFC右HIPP的Fisher变换z值显着正相关（ r = 0.394，FDR校正后的p = 0.015）。明显的deqi组的NDSI评分变化（事前）与他们的Fisher's显着负相关。右中央杏仁核（CMA）rsFC与左内侧前额叶皮层（mPFC）的变换后的z值（r = -0.463，p = 0.035）。结果检验了这样的假设，即德气在功效上的优势与影响BLA和CMA rsFC有关。这表明deqi可能会影响显着网络（SN）中的异常rsFC，并参与SN与默认模式网络（DMN）之间的中断关系的自适应调制。