针刺百会水沟神门对血管性痴呆患者大脑皮层葡萄糖代谢的影响

A Study on Cerebral Lobes' Glucose Metabolism in Vascular Dementia Patients Treated by DU20,DU26 and HT7

目的:运用正电子发射型计算机断层显像(PET)技术,研究百会、水沟、神门针刺前后,血管性痴呆(VD)患者大脑皮层葡萄糖代谢的变化,从该穴组对脑功能成像的影响,分析其作用机制。方法:10例VD病人随机分为两组。A组治以针对偏瘫的常规穴位(手足三阳经为主),B组加用百会、水沟、神门,治疗前后所有病人均接受PET检测。划定VD患者双侧额叶(眶回)、双侧顶叶、双侧颞叶(海马及海马旁回)、双侧枕叶为感兴趣区。分析各区葡萄糖代谢水平,并进行治疗前后的比较。结果:治疗组患者针刺治疗后,双侧额叶、健脑颞叶的葡萄糖代谢升高具有统计学意义;常规针刺组患者治疗后,健脑颞叶的代谢升高具有统计学意义。结论:初步表明,百会、水沟、神门治疗VD的机理,与其改善额叶、颞叶的葡萄糖代谢有关。

Objective Observe the effect of needling in Baihui（DU20）, Shuigou（DU26） and Shenmen （HTT） on cerebral lobes＇ glucose metabolism in vascular dementia patients. Method Ten patients suffering from vascular dementia were divided into 2 groups randomly. Patients in the control group received the treatment of needling in the routine Acu-points for hemiplegia （Acu-points were chose from 6 Yang meridians of hand and foot）, while patients in the treatment group received the treatment of 3 added Acu-points, Baihui （DU20）, Shuigou（DU26） and Shenmen（HTT）, which were specifically meant for dementia. All the patients were examined by positron emission tomography （PET） in order to detect the cerebral glucose metabolism before and after treatment. The regions of interesting were bilateral frontal lobes, temporal lobes, parietal lobes and occipital lobes. Then the results were compared in statistics way. Result Routine acupuncture could improve the glucose metabolism of temporal lobe of the healthy side of brain in VD patients （ P 〈 0.05）. Routine acupuncture plus DU20, DU26 and HT7 could improve the glucose metabolism of bilateral frontal lobes and temporal lobe in the healthy side of brain （all P 〈 0.05）. Conclusion The effect of treating VD by needling in Baihui （ DU20 ）, Shuigou （ DU26 ） and Shenmen （ HT7 ） has close relationship with producing improvement in the cerebral glucose metabolism of frontal and temporaI lobes.