原发性痛经（PD）是妇科临床的常见病，针灸治疗PD疗效显著，但其中枢作用机制有待深入阐述。本项目前期研究发现，奖赏系统神经环路的功能异常与PD发生密切相关。而PD作为典型的月经周期性疾病，从神经环路水平阐明针刺在月经周期不同阶段的神经调控机制目前尚无报道。基于此，我们提出“针刺通过调控月经周期不同阶段的大脑奖赏系统神经环路发挥镇痛作用”的假说。本研究拟以针刺治疗三阴交为研究对象，采用弥散张量成像和静息态功能磁共振结合的多模态成像技术，以奖赏网络神经环路为切入点，采集针刺前后PD患者在月经周期中不同阶段（月经期与排卵期）的影像数据，同时引入先进的脑连接组学图论分析技术，通过多模态影像数据与效应指标、血生化指标的多维度相关分析，探讨针刺治疗对月经周期不同阶段下PD患者中枢奖赏神经网络的调控机制。以期更深入揭示针刺治疗PD的作用机制，对促进针灸治疗PD临床推广有着重要的科学意义和实用价值。

Primary dysmenorrhea (PD) is common gynecological disease. Though acupuncture is significantly effective for the treatment of PD, its central mechanism requires further elucidation. Our previous study found that the functional abnormalities of the reward neural circuit are closely related to PD. As a typical menstrual periodic disease, there is hardly research on the neuromodulation mechanism of acupuncture at different stages of the menstrual cycle from the reward neural circuit. Based on this, we propose the hypothesis that acupuncture exerts an analgesic effect by regulating the reward neural circuit at different stages of the menstrual cycle. We plan to combine diffusion tensor imaging and resting state functional magnetic resonance imaging technology, use the reward network as the point to explore the mechanism of acupuncture stimulation at Sanyinjiao (SP6). We plan to collect the image data of PD subjects before and after acupuncture at different stages of the menstrual cycle (menstrual period and ovulation period), as well as the corresponding hormone levels and biochemical parameters’ changes. Based on the brain-connected graph theory, we try to explore the neuromodulation mechanism of acupuncture at different stages of the menstrual cycle from the reward neural circuit by multi-dimensional correlation analysis of multimodal image data and effect indicators and blood biochemical indicators. This program will further reveal the mechanism of acupuncture treatment of PD and has important scientific significance and practical value for clinical promotion of acupuncture.