针刺百会穴前后血管性痴呆患者不同脑区的脑葡萄糖代谢

Glucose metabolism in different brain areas of vascular dementia patients after acupuncture at Baihui

目的:运用正电子发射型计算机断层显像技术,观察百会穴针刺前后血管性痴呆患者对不同脑区葡萄糖代谢的变化。方法:收治2004-05/10广州星光老人之家二院和广州千禧颐老院的血管性痴呆患者10例。男4例,女6例;病程1～9年;均为右利手。随机分为常规体针治疗组5例和百会治疗组5例。5次/周,共治疗4周。10例中缺血性脑血管病8例,出血性脑血管病2例;有1次脑卒中史9例,有2次脑卒中史1例;右侧偏瘫7例,左侧偏瘫3例。所有患者均接受正电子发射型计算机断层显像法观察脑区感兴趣区[分别设为双侧额叶(眶回)、双侧顶叶、双侧颞叶(海马及海马旁回)、双侧枕叶、双侧丘脑、双侧扣带回、双侧尾状核、双侧豆状核和双侧小脑]的葡萄糖代谢水平,并进行治疗前后的比较。结果:10例患者均进入结果分析。①常规针刺组治疗前后脑部感兴趣区葡萄糖代谢变化:患脑豆状核治疗后明显高于治疗前[(2.49±0.99,1.85±0.53),t=2.90,P<0.05]。健脑治疗后颞叶明显高于治疗前[(1.59±0.63,1.28±0.36),t=2.88,P<0.05]。②百会组治疗前后脑部感兴趣区葡萄糖代谢变化:患脑额叶、豆状核治疗后显著高于治疗前[(2.78±0.27,2.80±0.40;2.21±0.34,2.25±0.35),t=3.01,3.25,P<0.05]。健脑颞叶、豆状核治疗后显著高于治疗前[(1.69±0.43,2.79±0.38;1.32±0.36,2.22±0.47),t=2.93,3.16,P<0.05]。结论:①常规针刺组能显著提高患脑豆状核和健脑颞叶的葡萄糖代谢水平。②百会穴治疗组对血管性痴呆患者的患脑额叶、健脑颞叶及双侧豆状核区的葡萄糖代谢有显著增高。

AIM： To observe the effect of acupuncture at Baihui （DU20） on cerebral glucose metabolism in vascular dementia patients with positron emission tomography （PET）. METHODS： Ten patients suffering from vascular dementia were collected in Guangzhou Xingguang Senile Home （ Ⅱ ） and Guangzhou Qianxi Senile Center between May and October 2004. Among them, 4 cases were male, and 6 were female with the disease course of 1-9 years. All the 10 patients were right-hand dominated and were divided into 2 groups randomly. Patients （n=5） in the control group received the treatment of needling in the routine acupoints for hemiplcgia, while patients （n=5） in the treatment group received the above normal treatment plus Baihui （DU20） five times a week and totally for four weeks. Of the ten patients, 8 patients had ischemic cerebrovascular disease and 2 had hemorrhagic cerebrovascular disease; stroke occurred once in 9 cases, and twice in 1 case; there were 7 cases of right bemiplegia and 3 of left bemiplegia. All the patients were examined by positron emission tomography （PET） in order to detect the cerebral glucose metabolism before and after treatment [bilateral frontal lobe（orbital gyri）, bilateral parietal lobe, bilateral temporal lobe （hippocampi and subiculum hippocampi）, bilateral occipital lobe, bilateral thalamus, bilateral cingulated gyrus, bilateral eaudate nucleus, bilateral lentiform nucleus, and bilater cerebellum]. Then the results were compared in＇statistics way. RESULTS：All the 10 cases came into the re.suit analysis. ①Routineacupuncture could improve the glucose metabolism of lentiform nucleus of the affected side [（ 2.49±0.99,1.85±0.53 ）,t=2.90,P 〈 0.05] and temporal lobe of the healthy side[（ 1.59±0.63,1.28±0.36 ）, t=2.88,P 〈 0.05] of brain in VD patients （both P 〈 0.05）. ②Routine acupuncture plus DU20 could improve the glucose metabolism of frontal lobe and lentiform nucleus in the affected side of brain [（2.78±0.27,2.80±0.40;2.21±0,34,2.25±0.35）,t=3.01, 3.25,P 〈 0.05], temporal lobe and lentiform nucleus in the healthy side of brain [（1.69 ±03.43,1.32 ±3.36;2.79 ±0.38,2.22 ±0.47）,t =2.93,3.16,P 〈 0.05]. CONCLUSION：Routine acupuncture can improve the glucose metabolism of lentiform nucleus in the affected side and temporal lobe in the healthy side,and routine acupuncture plus DU20 can have an obvious improvement in the glucose metabolism of bilateral lentiform nucleus, frontal lobe in the affected side and temporal lobe in the healthy side.