电针对抑郁症患者不同脑区的影响：磁共振研究

目的:探讨电针治疗前后抑郁症患者脑内代谢物质变化的特点.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),每组25例.A组:口服百优解胶囊,20 mg/d;B组:主穴取百会、印堂,随症配穴,电针30～40 min,留针1 h,每日1次;C组采用A组与B组方法相结合治疗.共观察6周.采用磁共振系统,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(对照组)与3组患者治疗前后氮-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3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3组患者双侧额叶的Cho/Cr值较对照组增高(P＜0.01),治疗后A组、B组及C组双侧额叶的Cho/Cr值较治疗前均明显减低(P＜0.05,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;电针可通过多途径改善抑郁,而百优解的作用途径单一.

Study on electroacupuncture treatment of depression by magnetic resonance imaging

Objective To explore the changes of metabolites in brain after treatment by analysis on ' H-MRS examination of the hippocampus and prefrontal lobe in the healthy volunteers and the depression patients. Methods Seventy-five cases of mild and moderate depression were randomly divided into groups A, B and C, 25 cases in each group. The group A was treated with oral administration of Prozac capsule, 20 mg/d; the group B by electroacu-puncture for 30 — 40 min and the needle was retained for 1 h, once each day, with main points Baihui (GV 20), Yin-tang (GV 29) and adjuvant acupoints selected; the group C by combination of the treatment methods in the groups A and B. They were treated for 6 weeks. Use PROBE-J sequence at the MRI system on Single Voxel of ROI of each lateral of hippocampus and frontal lobe in the depression patients of the 3 groups. Compare the differences of N-acetylasp artate/creatine (NAA/Cr) and choline/creatine (Cho/Cr) between the healthy volunteers and the patients before and after treatment. Results Before treatment, NAA/Cr in the bilateral hippocampus decreased in the 3 groups as compared with the control group, and after treatment, NAA/Cr in the bilateral hippocampus of the group Band in the right hippocampus of the group C increased compared with that before treatment (P<0. 05), and NAA/Cr in the left hippocampus of the group C significantly increased as compared with that before treatment (P<0. 01). Before treatment, Cho/Cr in the bilateral prefrontal lobe in the 3 groups increased as compared with that in the control group (P<0. 05), after treatment, Cho/Cr in the bilateral prefrontal lobes of the groups A, B and C significantly decreased as compared with that before treatment (P<0. 05, P<0. 01). Conclusion There are differences in contents of metabolites in corresponding parts in bilateral frontal lobes and hippocampus between the depression patient and healthy person.