电针“调神醒脑法干预创伤后应激障碍的大脑局部一致性研究.pdfVIP

中文摘要 目的：观察创伤后应激障碍( posttraumatic stress disorder，PTSD) 患者与健康志 愿者之间以及 PTSD 患者经过电针治疗前后在静息状态下大脑局部一致性的差 异变化。 方法： 采用静息功能磁共振成像（fMRI ）技术，纳入 10 例PTSD 患者及 12 例 健康志愿者,两组纳入后即进行静息态功能磁共振成像扫描。患者用电针治疗12 周，对创伤后应激障碍患者治疗前、治疗 12 周后分别使用临床监测量表、抑郁 自评量表、焦虑自评量表进行评定。在电针治疗前后利用局部一致性方法检测静 息状态下 10 例 PTSD 患者的大脑局部一致性及其与 12 例健康志愿者间的差异, 评价治疗方案的临床疗效。 结果：①PTSD组治疗前后ReHo显著增加的脑区包括右侧额中回、右侧小脑、左 侧枕上回、左侧楔前叶、左侧中央回；ReHo 显著降低的脑区包括左侧颞上回、 左侧扣带回、左侧梭状脑回、右侧背外侧上回。②PTSD组治疗前与健康志愿者组 ReHo有差异的脑区为颞上回、额中回、小脑,治疗后上述差异脑区未见明显差异。 结论：1、PTSD患者与健康志愿者ReHo的差异体现了PTSD的发病机制与颞回、额 回及小脑有一定联系。 2 、PTSD 患者治疗前后的大脑局部一致性有所差异，电针治疗PTSD 的中枢整合 效应与枕叶、颞叶、脑岛及边缘系统等脑区相关。 关键词：创伤后应激障碍 电针 功能核磁共振 局部一致性 1 ABSTRACT Objective: To explore the changes of the regional homogeneity of brain activity in patients with posttraumatic stress disorder (PTSD)by puncturing at the acupoints on the involved meridian. Methods: Functional magnetic resonance imaging (fMRI) was performed in 10 PTSD patients ( PTSD group) and 12 healthy volunteers ( normal control group).Each patient received electric acupuncture for 12 weeks.The regional homogeneity ( ReHo) values of resting- state brain activity in all the subjects were calculated by software ．One and two sample t- test was used to observe the changes of the ReHo values between the two groups ． Results: Compared to the before treatment, increased ReHo was found in PTSD patients in the right middle frontal gyrus, right cerebellum, left occipital gyrus, left precuneus, left central back;and decreased ReHo was found in the left superior temporal gyrus, left cingulate gyrus, left fusiform gyrus, right dorsal lateral gyrus and so on.(p0.05, corrected). Conclusion: The changes of the regional homogeneity of