针刺鬼穴对广泛性焦虑障碍注意偏向影响的事件相关电位研究

Effect of Needling Ghost Points on Attentional Bias in Treatment of GAD Based on ERP Study

目的:采用事件相关电位(ERP)中的点探测范式观察针刺鬼穴对广泛性焦虑障碍(GAD)的注意偏向影响,探讨针刺“鬼穴”治疗GAD的认知神经学机制。方法:选取60例符合标准的GAD患者,随机分为鬼穴针刺观察组和普通针刺对照组,在针刺前后分别行HAMA评分,检测对靶刺激的反应时、正确率及N2成分的潜伏期和波幅,再随机选取30例正常人作为健康组,不行干预措施,在入组前行HAMA评分,入组后检测对靶刺激的反应时、正确率、N2的潜伏期和波幅。结果:针刺前,观察组和对照组的负性反应时较健康组缩短,注意偏向分数增大,差异具有统计学意义(P<0.05),N2波幅显著下降,差异具有统计学意义(P<0.01);针刺后,两组的负性反应时延长,注意偏向分数降低,HAMA评分降低,差异具有统计学意义(P<0.05),N2波幅显著升高,差异具有统计学意义(P<0.01),且观察组针刺后的负性反应时、前后差值和HAMA评分、前后差值与对照组相比,差异具有统计学意义(P<0.05),N2波幅的前后差值差异显著,差异具有统计学意义(P<0.01)。结论:针刺鬼穴治疗GAD疗效显著,能够改善GAD患者的负性注意偏向,其机制可能是通过平衡大脑偏侧化来达到改善GAD患者认知功能、减轻症状的效果。

Objective:To explore the cognitive neurologic mechanism of needling ghost points in the treatment of generalized anxiety disorder(GAD)by observing its effect on attentional bias using the point detection paradigm of event-related potential(ERP).Methods:60 patients with GAD were randomly divided into the observation group and the control group.The control group was treated with conventional acupuncture,and the observation group was treated with needling ghost points.Another 30 normal people were taken as the blank control.HAMA score,reaction time of target stimuli,accuracy,N2 latency and amplitude were detected in the groups.Results:Before needling,the negative reaction time was shortened(P<0.05),the score of attentional bias was increased(P<0.05),and N2 amplitude was decreased significantly in the observation group and the control group compared with those in the blank control group(P<0.01).After needling,the negative reaction time was prolonged,the score of attentional bias and HAMA score were decreased(P<0.05),and N2 amplitude was increased significantly compared with those before needling in the two groups(P<0.01);the negative reaction time and the difference,as well as HAMA score and the difference were more significant in the observation group than those in the control group(P<0.05),the difference of N2 amplitude was significant in the observation group than that in the control group(P<0.01).Conclusion:Needling ghost acupoints has a significant effect in the treatment of GAD,which can improve the negative attentional bias in GAD patients,and the mechanism may be related to improving the cognitive function and alleviating the symptoms of GAD patients by balancing brain lateralization.