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基于功能磁共振探讨调神法电针治疗慢性疲劳综合征伴焦虑抑郁共病的中枢机制 被引量:2

Exploring the central mechanism of mind-regulation electroacupuncture in treatment of chronic fatigue syndrome with anxiety and depression comorbidity based on functional magnetic resonance imaging
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摘要 目的:基于静息态功能磁共振成像(rs-fMRI),观察调神法电针治疗慢性疲劳综合征(CFS)伴焦虑抑郁共病的局部一致性(ReHo)及功能脑网络的变化。方法:纳入医护人员群体中30例CFS伴焦虑抑郁共病患者作为观察组;招募性别、年龄、受教育年限相匹配的医学高校学生群体中30例健康受试者作为对照组,不进行任何针刺干预。观察组予调神法电针治疗,选取主穴孙氏头部情感区、腹针一区、腹针八区,配穴百会、关元,双侧足三里、三阴交,分别连接G6805-Ⅱ型电针治疗仪,予连续波,频率2 Hz,强度为患者最大耐受度,每次电针30 min,每天1次,连续治疗6 d,休息1 d,共2周(12次)。比较观察组治疗前后与对照组多维疲劳量表(MFI-20)、抑郁自评量表(SDS)、焦虑自评量表(SAS)、匹兹堡睡眠质量指数量表(PSQI)评分。采集观察组治疗前后及对照组基线期的rs-fMRI数据,分析调神法电针治疗对CFS伴焦虑抑郁共病患者ReHo及功能脑网络的影响及与临床量表的相关性。结果:观察组治疗前MFI-20综合性疲劳、躯体疲劳、精神疲劳、动力下降、活动下降5个维度评分及总分与SDS、SAS、PSQI评分均较对照组升高(P<0.05)。除MFI-20动力下降维度外,观察组治疗后MFI-20各维度评分及总分与SDS、SAS、PSQI评分均较治疗前降低(P<0.05)。与治疗前比较,观察组治疗后ReHo值增大的脑区为右侧楔前叶,ReHo值减少的脑区有左侧颞下回、左侧角回。与对照组比较,观察组治疗前ReHo值增大的脑区有左侧大脑下叶、半球间、右侧枕叶、丘脑,ReHo值减小的脑区有左侧颞中回、右侧中央后回、右侧颞中回、右侧眶部额中回、中央旁小叶、右侧梭状回。观察组治疗前右侧丘脑与左侧中央后回、右侧海马、右侧梭状回之间的功能连接减少,治疗后右侧丘脑与左侧中央后回、右侧梭状回之间的功能连接重新建立。与对照组比较,观察组治疗前� Objective To observe the changes in the regional homogeneity(ReHo)and functional brain network in treatment of chronic fatigue syndrome(CFS)with anxiety and depression comorbidity with the mind-regulation electroacupuncture(EA),using resting-state functional magnetic resonance imaging(rs-fMRI).Methods Thirty CFS patients with anxiety and depression comorbidity were enrolled from medical staffs as the observation group.The other 30 healthy subjects were recruited from medical university students as the control group,matching gender,age and education years with the observation group.No any acupuncture intervention was delivered in the control group,and EA for regulating the mind was operated in the observation group.Main points were the emotional area of Sun's scalp acupuncture,the regions 1 and 8 of Sun's abdominal acupuncture.Supplementary acupoints included Baihui(GV 20),Guanyuan(CV 4)and bilateral Zusanli(ST 36)and Sanyinjiao(SP 6).The needles at the above points were attached to G6805-Ⅱelectric acupuncture apparatus,with continuous wave,2 Hz in frequency and the maximal tolerable intensity depending on patients.Each EA took 30 min,once daily and lasted for consecutively 6 days.The duration of intervention was 2 weeks(12 treatments)at the interval of 1 day.The scores of multidimensional fatigue inventory-20(MFI-20),self-rating depression scale(SDS),self-rating anxiety scale(SAS),and Pittsburgh sleep quality index(PSQI)were compared before and after treatment in the two groups.The rs-fMRI data were collected before and after treatment in the observation group,as well as at the baseline in the control group separately.The effects of the mind-regulation EA therapy was analyzed on ReHo and functional brain network in CFS patients with anxiety and depression comorbidity,as well as the correlation between differential brain region and clinical scales.Results The scores of the five domains in MFI-20(i.e.general fatigue,physical fatigue,mental fatigue,reduced motivation and reduced activity),the total score of MFI-20
作者 曾祥新 冯楚文 张沐华 程为平 孙忠人 杨添淞 ZENG Xiangxin;FENG Chuwen;ZHANG Muhua;CHENG Weiping;SUN Zhongren;YANG Tiansong(Clinical Medical School of Chinese and Western Medicine,Heilongjiang University of CM,Harbin 150006,China;Department of Acupuncture and Moxibustion,Second Affiliated Hospital of Heilongjiang University of CM,Harbin 150001;Department of Acupuncture and Moxibustion,First Affiliated Hospital of Heilongjiang University of CM,Harbin 150040)
出处 《中国针灸》 CAS CSCD 北大核心 2024年第1期3-11,共9页 Chinese Acupuncture & Moxibustion
基金 黑龙江省中医药科研项目:ZHY2022-167 黑龙江中医药大学科研基金面上项目:201814 孙申田青年人才基金项目:ky-201809 黑龙江省自然科学基金项目:LH2020H092 黑龙江省自然科学基金项目优秀青年项目:YQ2023H019 国家自然科学基金面上项目:82074539 黑龙江省中医药科研课题项目:ZHY2022-136 黑龙江省中医药学会2022-2024年度青年人才托举工程项目:2022-QNRC1-05。
关键词 慢性疲劳综合征 焦虑抑郁共病 调神法针刺 电针 功能磁共振 chronic fatigue syndrome(CFS) anxiety and depression comorbidity acupuncture for regulating the mind electroacupuncture functional magnetic resonance imaging(fMRI)
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