头部电针对抑郁症患者脑功能区葡萄糖代谢的影响

背景有研究认为抑郁症患者额叶、扣带回、尾核等脑功能区葡萄糖代谢水平低下,小脑内血流量降低.目的运用正电子发射型计算机断层显像技术观察头电针对抑郁症患者脑部功能区葡萄糖代谢的影响.设计随机对照的验证性实验.单位南方医院针灸科,广东省人民医院伟伦PET中心.对象选择2002-10/2003-10在南方医院、珠江医院门诊确诊的原发性抑郁症患者12例,男3例,女9例;年龄36～66岁,平均48岁.方法头电针取穴为顶中线、额中线和双侧额旁1线.电针前和治疗6周后分别接受正电子发射型计算机断层显像技术检测.框取双侧额叶、尾核、扣带回和小脑作为感兴趣脑区,将各脑区所得葡萄糖代谢放射性计数采用半定量方式进行治疗前后比较.主要观察指标双侧额叶、尾核、扣带回和小脑葡萄糖代谢显像的半定量分析.结果12例原发性抑郁症患者均进入结果分析.①头电针治疗后右侧额叶、左侧额叶、右侧扣带回、右侧尾核、左侧小脑葡萄糖代谢放射计数半定量结果明显高于治疗前(2 91±0.34,2.96±0.26,2.68±0.20,2.61±0 39,2.55±0.18,2.53±0.31,2.53±0.36,2.34±0.31,2.40±0.33,2.35±0.25),(P＜0.05～0.01)],而治疗后左侧扣带回、左侧尾核、右侧小脑葡萄糖代谢放射计数半定量结果与治疗前基本相似(2.69±0.38,2.66±0.01,2.50±0.27;2.43±0.38,2 45±0 21,2.30±0.34),(P＞0.05)].结论电针抑郁症患者顶中线、额中线和双侧额旁1线能提高部分脑区的葡萄糖代谢,头电针治疗抑郁症的机制可能与提高额叶、尾核、扣带回、小脑等部分脑区葡萄糖代谢有关.

Effect of electro-scalp acupuncture on metabolism of glucose in brain functional region of patients with depression

BACKGROUND:It is suggested that glucose metabolism of frontal lobes,cingulate gyri and caudate nuclei in cerebral functional area of patients with depression is low,and the blood flow in cerebellum decreases.OBJECTIVE:To observe the effect of scalp acupuncture on cerebral glucose metabolism in depression by positron emission tomography.DESIGN:Randomly controlled and verifying experiment.SETTING:Department of Acupuncture and Aoxibustion in Nanfang Hospital and Center of Positron Emission Tomography in a Guangdong People's hospital.PARTICIPANTS:Twelve patients of primary depression,from Nanfang Hospital,Zhujiang Hospital and Center of Positron Emission Tomography in Guangdong People's Hospital from October 2002 to October 2003,were selected randomly with the diagnostic criteria of F32] in the Third Edition of the Chinese Classification and Diagnostic Criteria of Mental Disease.Among them,3 were male and 9 were female.Their ages were from 36 to 66 years,with the average of 48.METHODS:Giving scalp acupuncture in middle line of vertex(MS5),middle line of forehead(MS1) and bilateral lateral line 1 of forehead(MS2).All the patients received positron emission tomography examination before and after acupuncture treatment for 6 weeks.Then cerebral Regions of Interest,bilateral frontal lobes,bilateral caudate nuclei,bilateral cingulate gyri and bilateral cerebella,were chosen and their average glucose metabolisms were counted by half-quantifying analysis.MAIN OUTCOME MEASURES:Glucose metabolism of bilateral frontal lobes,bilateral caudate nuclei,bilateral cingulate gyri and bilateral cerebella.RESULTS:According to intension,all 12 patients with primary depression sults of right frontal lobes(2.91 ±0.34),left frontal lobes(2.96±0.26),right cingulate gyri(2.68±0.20),right caudate nuclei (2.61±0.39) and left cerebellum(2.55±0.18)were obviously higher than those of right frontal lobes(2.53±0.31),left frontal lobes(2.53±0.36),right cingulate gyri(2.34±0.31),right caudate nuclei(2.40±0.33) and left cerebellum(2.35±0.25)before treatment(P＜ 0.05-0.01).However, the results of left cingulate gyri (2.69 ±0.38),left caudate nuclei(2.66±0.01) and right cerebellum(2.50±0.27) were similar to those of left cingulate gyri(2.43±0.38),left caudate nuclei(2.45±0.21) and right cerebellum(2.30±0.34) before treatment(P ＞ 0.05).CONCLUSION:Scalp acupuncture on middle line of vertex,middle line of forehead and bilateral lateral line 1 of forehead could improve the glucose metabolism in depressive patients of certain cerebral regions,and it might be a mechanism related to improvement of frontal lobes,caudate nuclei,cingulate gyri and cerebellum.