针刺治疗儿童孤独症单光子发射计算机断层成像术可视化研究

Visualized Study on Acupuncture Treatment of Children Autism Using Single Photon Emission Computed Tomography

目的为针刺治疗儿童孤独症提供分子影像学的依据。方法34例儿童孤独症患儿,ABC行为量表测试>57分。电针穴位为双侧合谷、曲池、足三里和三阴交穴。采用SIEMENS ECAM/ICON双探头单光子发射计算机断层成像术(single photon emission computed tomography,SPECT)系统,进行针前和电针中2次SPECT脑灌注显像;显像剂为99m锝双半胱乙酯(99mTc-ECD);对SPECT影像进行视觉和定量分析。结果视觉分析显示,34例患儿针刺前可见114处局灶性脑血流灌注和功能低下区,其中28例同时显现左侧(或者双侧)额叶前部、左侧语言运动区(Broca)和左侧颞叶听语言区(Wernicke)异常,占患儿总数的82.35%。电针时上述病灶区皆有不同程度的增高。定量分析显示,针刺前病灶Ff和镜侧Ff差异显著(P<0.01);针刺前病灶Ff和电针时病灶Fe差异显著(P<0.01);病灶BFCR%和镜侧BFCR%差异非常显著(P<0.01)。脑血流灌注和脑功能改善情况显示,电针显效为78.95%。结论初步证明针刺治疗儿童孤独症有疗效。

Objective To provide the molecular iconographic evidence for acupuncture treatment of children autism （CA）. Methods Hegu （LI4）, Quchi （LI11）, ZuElectric acupuncture （EA） was applied on acupoints of bilateral sanli （ST36） and Sanyinjiao （SP6） in 34 CA patients＇ with ABC scale 〉 57 scores. Using SIEMENS ECAM / ICON double head system, single photon emission computed tomography （SPECT） brain perfusion imaging were performed before and during EA with ^99mTc-ECD. Then SPECT images were analyzed visually and quanti- tatively. Results Visual analysis showed that 114 loci of low cerebral perfusion and function were found in 34 CA patients before EA, 28 cases （82.35%） of them with abnormalities in left （or both） front lobes, left Broca area and left Wernicke area. During EA, the affected areas improved to different extent. Quantitative analysis showed that significant difference existed between pre-EA focal Ff and mirror-side Ff, pre-EA Ff and mid-EA Fe, foeal BFCR% and mirror-side BFCR% （all P 〈 0.01 ）. The improving analysis of cerebral perfusion and function showed that the efficacy of EA was 78.95%. Conclusion Acupuncture was proved preliminarily effective in treating children autism.