调肝运脾方对腹泻型肠易激综合征患者脑内兴奋区域活动的影响

Influence of "Tiaogan Yunpi Decoction" on Regional Encephalic Activation in Irritable Bowel Syndrome Patients

目的探讨中药调肝运脾方对腹泻型肠易激综合征(IBS)患者脑内各兴奋区域活动的影响。方法采用自身配对对照方法,运用功能磁共振成像(fMRI)技术,分别观察18例腹泻型IBS患者治疗前、治疗后及对照用药后在不同容量直肠气囊刺激时脑内扣带回前皮层(ACC)、脑岛皮层(IC)、前额叶皮层(PFC)、丘脑(THAL)兴奋区域面积和MR信号强度-时间变化曲线。结果①注气量为120ml时,治疗后IC、PFC和THAL兴奋区域面积较治疗前有统计学意义(P<0.05);PFC和THAL兴奋区域面积治疗后较对照后有统计学意义(P<0.05)。②注气量为90ml时,治疗后IC兴奋区域MR信号强度变化幅度较治疗前显著降低(P<0.05);注气量为120ml时,IC、PFC和THAL兴奋区域MR信号强度变化幅度均较治疗前显著降低(P<0.05);IC兴奋区域MR信号强度变化幅度较对照后显著降低(P<0.05)。结论调肝运脾方对IBS患者脑-肠轴及其调节机制功能紊乱的干预,与其抑制IBS患者脑内IC,PFC和THAL兴奋区域激活程度有关。

Objective To investigate the effects of ＂Tiaogan Yunpi Decoction＂ on regional encephalic activation in irritable bowel syndrome patients. Methods Using self-paired controlled method, we conducted functional fMRI to observe the regional area of interest and the change of MR signal intensity-time variation curve of anterior cingulate cortex（ACC）, island cortex （IC）, prefrontal cortex（PFC）, hypothalamus （THAL） before and after treatment, as well as after the control treatment using placebo in 18 diarrhea-predominant IBS patients when they were recally stimulated. Results After treatment, when the injection of gas reached 120 ml, the regional areas of interest IC, PFC and THAL were of significant difference compared with those before the treatment （P 〈 0.05）respectively. After treatment, when the injected gas reached 90 ml, the change of MR signal intensity-time variation curve of IC was significantly decreased compared with that before treatment, P 〈 0.05. When the injected gas reached 120 ml, the change of MR signal intensity-time variation curve of IC, PFC and THAL were significantly decreased compared with those before the treatment （P 〈 0.05）respectively. And after treatment, the change of MR signal intensity-time variation curve of IC was significantly decreased compared with the control, P 〈 0.05. Conclusion The interference of ＂Tiaogan Yunpi Decoction＂ on the real-regulation of brain-gut axis is related to its inhibiting effect on the activation of IC, PFC and THAL.