基于fNIRS观察针药并用治疗首发轻中度抑郁障碍的脑效应

Brain effects of acupuncture and medication in the treatment of first-episode mild-to-moderate depressive disorder observed based on fNIRS

目的观察针药并用治疗首发轻中度抑郁症的抑郁症状及脑神经活动的影响。方法将60例首发轻中度抑郁症患者随机分为观察组和对照组,每组30例。观察组予以针刺联合艾司西酞普兰治疗,对照组予以假针刺联合艾司西酞普兰治疗。比较两组治疗前后HAMD评分变化,并采用功能性近红外光谱技术(functional near-infrared spectroscopy,fNIRS)比较两组任务态下各脑区激活程度(β值)。结果两组治疗后HAMD评分均较治疗前降低(P<0.05),且观察组均低于对照组(P<0.05)。两组治疗后双侧额极前额叶区的β值均较治疗前升高(P<0.05);观察组治疗后双侧额极前额叶、左背外侧前额叶β值高于对照组(P<0.05)。两组治疗后右侧额叶β值与HAMD评分呈负相关(P<0.05)。结论针刺联合艾司西酞普兰可改善首发抑郁患者抑郁症状,其机制可能与激活双侧额极前额叶、左侧背外侧前额叶有关。

Objective To observe the effects of acupuncture and medication on depressive symptoms and cerebral nerve activity in the treatment of first-episode mild-to-moderate depression.Method A total of 60 patients with first-episode mild-to-moderate depression were randomly divided into observation group and control group,with 30 cases in each group.The observation group was treated with acupuncture combined with escitalopram,and the control group was treated with sham acupuncture combined with escitalopram.The Hamilton depression scale(HAMD)scores of the two groups were compared before and after the treatment,and the activation level of each brain region under the task state(bvalue)was compared between the two groups using functional near-infrared spectroscopy(fNIRS).Result The HAMD scores of both groups were lower than those before treatment(P<0.05),and those in the observation group was lower than those in the control group(P<0.05).Thebvalues of bilateral frontal pole prefrontal area were higher than before treatment in both groups(P<0.05);thebvalues of bilateral frontal pole prefrontal and left dorsolateral prefrontal were higher than those of the control group in the observation group after treatment(P<0.05).The right frontal lobebvalue was negatively correlated with HAMD score after treatment in both groups(P<0.05).Conclusion Acupuncture combined with escitalopram can improve depressive symptoms in patients with first-episode depression,and its mechanism may be related to the activation of bilateral frontal pole prefrontal lobe and left dorsolateral prefrontal lobe.