针药治疗抑郁症过程中患者海马、额叶代谢的变化

目的：对正常志愿者、抑郁症患者脑海马、前额叶进行1H-MRS分析，探讨治疗前后脑内代谢物质的变化特点。方法：将75例轻、中度抑郁症患者随机分为西药组（A组）、电针组（B组）、针药组（C组），采用GE EXCITE II Signa 3.0T磁共振系统，PROBE-J序列进行单体素采集，感兴趣区分别置于左、右两侧海马和额叶。比较正常志愿者与3组患者治疗前后N－乙酰天门冬氨酸/胆碱（NAA/Cho）、N－乙酰天门冬氨酸/肌酸（NAA/Cr）和胆碱/肌酸（Cho/ Cr）值的差异。结果：治疗前三组患者双侧海马的NAA/Cr值较对照组减低，治疗后B组双侧海马、C组右侧海马的NAA/Cr值较治疗前增高（P<0.05），C组左侧海马的NAA/Cr值较治疗前明显增高（P<0.01）。治疗前三组患者双侧额叶的Cho/ Cr值较对照组增高（P<0.05），治疗后A组、B组双侧额叶的Cho/ Cr值较治疗前减低（P<0.05），C组双侧额叶的Cho/ Cr值较治疗前明显减低（P<0.01）。结论：抑郁症患者双侧额叶、海马与正常成人相应部位的代谢物浓度存在差异,三种方案干预前后抑郁症患者脑功能活动各项指标的改变表明电针可通过多途径改善抑郁，而百优解的作用途径单一。

Combined effects of electroacupuncture and anti-depression drugs on the hippocampus and frontal lobe

Electroacupuncture (EA) has been clinically used to treat depression and has resulted in favorable effects in China. However, results from animal studies and pathology do not reflect the influence of electroacupuncture treatment on in vivo physiological functions. To thoroughly and dynamically observe pathological changes during depression, the present study established EA + fluoxetine and fluoxetine groups to observe depression in patients. 1H-magnetic resonance spectroscopy was utilized to determine the correlation between hippocampal frontal lobe metabolite changes and mental disorder scale. Results revealed significantly increased N-acetylaspartate (NAA)/creatine (Cr) in the bilateral hippocampus and right frontal lobe of depression patients treated with EA compared with fluoxetine. Changes in NAA/Cr in bilateral hippocampus and right frontal lobe in both groups, before and after treatment, negatively correlated with severity and curative effects. Choline/Cr changes in the bilateral frontal lobes of both groups were significant before and after treatment, but negatively correlated with curative effects. Choline/Cr changes in the bilateral hippocampus were significant in the EA + fluoxetine group before and after treatment, but negatively correlated with severity and the curative effects of depression. These results demonstrate abnormal biochemical metabolism in bilateral frontal lobes and hippocampus of depression patients, and show that EA significantly altered biochemical indices in the frontal lobes and hippocampus compared with fluoxetine.