基于事件相关电位P300探讨针刺鬼穴对广泛性焦虑患者认知功能的影响

Effect of Needling Ghost Points on Cognitive Function of Patients with Generalized Anxiety Disorder Based on Event-Related Potential P300

目的:基于事件相关电位P300研究针刺鬼穴对广泛性焦虑障碍(GAD)患者认知功能的即刻效应与远期效应,并结合针刺鬼穴对健康人群P300电位的影响,探讨其认知神经学机制。方法:将60例GAD患者随机分为观察组和对照组,分别予以2周共8次的针刺鬼穴和假针刺干预,同时随机纳入30例健康受试者作为健康组,采取点探测实验范式,选取事件相关电位P300的波幅和潜伏期、汉密尔顿焦虑量表(HAMA)评分以及对靶刺激的反应时和正确率作为观察指标。结果:与健康组相比,观察组和对照组针刺前的负性反应时缩短,差异具有统计学意义(P<0.05),注意偏向分数显著增大,差异具有统计学意义(P<0.01),在探测点与负性图片位置一致(负性一致)时P300波幅升高,差异具有统计学意义(P<0.05),在探测点与中性图片位置一致(中性一致)时P300波幅降低,差异具有统计学意义(P<0.05);观察组接受单次针刺鬼穴治疗后即出现负性一致时P300波幅降低,中性一致时P300波幅升高,差异具有统计学意义(P<0.05);在接受2周的鬼穴针刺治疗后,出现负性反应时延长,注意偏向分数、HAMA评分降低,差异具有统计学意义(P<0.05),且与单次针刺相比,负性一致时的P300波幅显著降低,差异具有统计学意义(P<0.01),中性一致时P300波幅升高,差异具有统计学意义(P<0.05);对照组在接受2周的假针刺干预后,负性反应时延长,HAMA评分、注意偏向分数降低,差异具有统计学意义(P<0.05),与观察组对比差异具有统计学差异(P<0.05);健康组在接受单次的鬼穴针刺后,负性一致时的P300波幅较以前下降,差异具有统计学意义(P<0.05)。结论:针刺鬼穴能改善GAD患者及健康人群的P300波幅,且对GAD患者的远期效应要优于即刻效应,能降低其对负性刺激的注意警觉,提升注意控制能力,优化认知资源的分配,从而改善认知功能,缓解焦虑症状。

Objective:To study the immediate effect and the long-term effect of needling ghost points on cognitive function in patients with generalized anxiety disorder(GAD)based on event-related potential P300,and to explore its cognitive neurological mechanism by referring to the effect of needling ghost points on P300 of healthy people.Methods:60 patients with GAD were randomly divided into the observation group and the control group.The observation group was treated with needling ghost points,and the control group was treated with sham acupuncture.Both groups were treated for 8 times within 2 weeks.At the same time,30 healthy people were randomly selected into the healthy group,and the dot probe paradigm was adopted.The amplitude and latency of P300,the score of Hamilton Anxiety Scale(HAMA),and the response time and accuracy to target stimulation were selected as observed indexes.Results:Compared with those in the healthy group,the negative reaction time was shorter(P<0.05),and the score of attention bias increased significantly in the observation group and the control group before the treatment(P<0.01).The amplitude of P300 increased when the position of the detection point was consistent with that of the negative picture(P<0.05),and decreased when the position of the detection point was consistent with that of the neutral picture(P<0.05).In the observation group,the amplitude of P300 changed immediately after single needling ghost points,which showed that the amplitude of P300 decreased in negative consistency,and increased in neutral consistency.After 2 weeks of needling ghost points,the negative reaction time was prolonged,attention bias score and HAMA score were decreased(P<0.05);compared with single acupuncture,the amplitude of P300 decreased significantly in negative consistency(P<0.01),and increased in neutral consistency(P<0.05).In the control group,the HAMA score and the attention bias score were decreased,and the negative reaction time was prolonged after receiving sham acupuncture for 2 weeks(P<0.05);in which there were significant differences between the control group and the observation group(P<0.05).In the healthy group,the amplitude of P300 decreased in negative consistency after receiving single acupuncture(P<0.05).Conclusion:Needling ghost points can affect the P300 potential of GAD patients and healthy people,and the long-term effect on GAD patients is better than immediate effect.It can reduce their attention vigilance to negative stimuli,improve the ability of attention control,optimize the allocation of cognitive resources,improve cognitive function and alleviate anxiety symptoms.