基于fNIRS技术的通督安神针刺法治疗中度抑郁障碍的脑机制研究

Study on brain mechanism of Tongdu Anshen acupuncture in the treatment of moderate depression based on fNIRS

目的 基于功能性近红外光谱成像技术(fNIRS)观察通督安神针刺法对中度抑郁障碍患者的前额叶调节机制。方法 将60例中度抑郁障碍患者随机分为观察组和对照组,每组30例。观察组采用针刺联合艾司西酞普兰治疗,对照组予以单纯艾司西酞普兰治疗。比较两组治疗前后任务态下各脑区激活程度以及24项汉密尔顿抑郁量表(HAMD-24)评分改变。结果 治疗后两组HAMD评分均较治疗前降低(P<0.05),且治疗后观察组HAMD评分低于对照组(P<0.05)。观察组治疗后双侧额极、左背外侧前额叶、右腹外侧前额叶对应的β值和治疗前比较,差异有统计学意义(P<0.05)。对照组治疗后双侧额极、右腹外侧前额叶对应的β值和治疗前比较,差异有统计学意义(P<0.05)。治疗后两组左侧额极、左背外侧前额叶、右腹外侧前额叶对应的β值比较,差异有统计学意义(P<0.05)。两组治疗后的双侧额极β值与HAMD-24评分均呈负相关(P<0.05)。结论 通督安神针刺联合艾司西酞普兰可改善抑郁患者抑郁症状,其机制可能与激活双侧额极、左侧背外侧前额叶、右腹外侧前额叶有关。

Objective To explore the regulatory effect of Tongdu Anshen acupuncture on prefrontal lobe in patients with moderate depression based on fNIRS. Methods A total of 60 patients with moderate depression were randomly divided into observation group(n=30) and control group(n=30). The observation group was treated with acupuncture combined with escitalopram, while the control group was treated with escitalopram alone. The activation degree of each brain region and the change of HAMD-24 score in the task state were compared between the two groups before and after treatment. Results After treatment, the HAMD-24 score of both groups decreased significantly compared with those before treatment(P<0.05), and the HAMD-24 score of observation group was lower than that of control group(P<0.05). There existed significant differences in β values of bilateral frontal poles, left dorsolateral prefrontal lobe, and right ventrolateral prefrontal lobe in observation group before and after treatment(P<0.05). There existed significant differences in β values of bilateral frontal poles and right ventrolateral prefrontal lobe in control group before and after treatment(P<0.05). After treatment, the β values of the left frontal pole, left dorsolateral prefrontal lobe, and right ventrolateral prefrontal lobe were significantly different between two groups(P<0.05). The bilateral frontal β values after treatment in both groups were negatively correlated with the HAMD-24 scores(P<0.05).Conclusion Tongdu Anshen acupuncture combined with escitalopram can improve the depressive symptoms of depressive patients, and its mechanism may be related to the activation of bilateral frontal poles, left dorsolateral frontal lobe and right ventrolateral prefrontal lobe.