改良易筋经对卒中后轻度抑郁患者的临床疗效及脑网络机制研究

Clinical efficacy and brain network mechanism research of modified Yijinjing in patients with mild depression after stroke

目的:卒中后抑郁是卒中后躯体障碍合并情绪障碍的身心疾患,严重影响卒中的恢复。改良易筋经根据其调身、调息、调神的特点,可以有效干预卒中后抑郁状态。本研究通过HAMD-24评估、脑电信号观察改良易筋经功法的临床疗效,探析大脑网络功能连接、局部及全局信息处理效率特征性的改变。方法:选取符合纳入标准的卒中后轻度抑郁患者60例,随机分为对照组和试验组,每组30例。对照组给予常规康复训练;试验组在对照组基础上予以改良易筋经练习,每次40min,两组均干预3周。于治疗前后及30天随访时采用HAMD-24评估患者抑郁情绪,并于治疗前后对试验组患者进行脑电信号检测,评估大脑网络功能连接变化。结果:试验组HAMD-24评分较治疗前明显下降(P<0.05),且下降程度多于对照组(P<0.05);与治疗前相比,试验组β、δ、θ波的全局效率及α、δ、θ波的局部效率明显提高(P<0.05),脑功能网络连接性增强。结论:改良易筋经能够有效缓解卒中后抑郁患者的抑郁情绪,提高不同脑区间信息传播效率及信息整合能力,为传统功法改善情绪障碍提供一定理论基础。

Objective:To explore and analyze the characteristic changes in brain network functional connections and local and global information processing efficiency of modified Yijinjing in patients with mild depression after stroke.Method:Sixty patients with mild poststroke depression(PSD)who met the inclusion criteria were randomly divided into control group and experimental group,30 patients in each group.The control group was given routine rehabilitation training.On the basis of the control group,the experimental group was given modified Yijinjing exercises,40min each time,and both groups were intervened for 3 weeks.The Hamilton Depression Scale(HAMD)was used to assess patients'depression before and after treatment and at the 30-day follow-up,and EEG signals were detected before and after treatment in the experimental group to assess changes in brain network functional connections.Result:After treatment,the HAMD-24 score of the experimental group was significantly lower than that of the control group(P<0.05)and before treatment.The global efficiency ofβ、δ、θwaves and the local efficiency ofα、δ、θwaves in the experimental group were significantly increased(P<0.05),which means that the brain functional network connectivity was enhanced.Conclusion:Yijinjing exercises can effectively alleviate depression in PSD patients,improve information transmission efficiency and information integration ability in different brain regions,and provide a certain theoretical basis for Yijinjing exercises to improve mood disorders.