电针治疗抑郁症临床观察及其机理的fMRI脑网络成像研究

目的观察醒脑开窍法电针治疗抑郁症的临床疗效及f MRI脑网络改变。方法采用随机数字表法将广州市惠爱医院门诊80例中重度抑郁症患者分为电针治疗组和假针对照组各40例,均治疗14天,对其进行治疗前后静息态f MRI检查,并于治疗前后评定汉密尔顿抑郁量表24项版(HAMD-24)、抑郁自评量表(SDS)及检验血浆ACTH、血清CORT水平的变化情况。结果 1临床疗效比较:治疗后,两组HAMD-24、SDS评分均较治疗前低,差异有统计学意义(P0.05),两组组间比较差异有统计学意义(P0.05),电针治疗组减分差值大于假针对照组;2血生化比较:治疗后两组血浆ACTH、血清CORT水平较治疗前低,同组治疗前后及组间比较差异均有统计学意义(P0.05);3脑功能活动比较:两组对抑郁症患者脑功能活动的影响存在差异。结论醒脑开窍法电针能有效调控中重度抑郁症患者的脑网络活动信号,调节内分泌功能,改善临床症状,提升机体的代偿功能及生存质量。

Clinical observation of electroacupuncture for depression and its brain response monitored by fMRI

Objective To observe the clinical curative effect of electroacupuncture in treating major depression and its brain response monitored by fMRI. Methods Patients diagnosed with major depression from Guangahou Huiai Hospital were randomly divided into electroacupuncture treatment(ET)group(n = 40)and fake acupuncture control(FC)group(n = 40). After 2 - week treatment,Hamilton Depression Scale - 24 item(HAMD - 24),Self - rating Depression Scale(SDS),modified plasm ACTH,serum CORT levels and fMRI were observed and compared. Results Comparison of clinical efficacy:after treatment,two groups of HAMD -24 and SDS were lower than that before,the difference was statistically significant(P <0. 05). There was a significant difference between the two groups(P < 0. 05),the difference of score in electroacupuncture treatment group was greater than that in the sham acupuncture control group. The blood biochemical comparison:after treatment,the serum CORT level and plasma ACTH in two groups were lower than before,the difference before and after treatment in both groups and the difference between two groups were statistically significant (P < 0. 05). Comparison of brain functional activities:there were significant differences between the two groups of functional activities in brain of patients with depression. Conclusion Electroacupuncture can effectively regulate the endocrine function of major depression patients,improve symptoms,and thus enhance the compensatory function and the quality of life.