针刺百会穴前后血管性痴呆患者不同脑区的脑葡萄糖代谢

目的:运用正电子发射型计算机断层显像技术,观察百会穴针刺前后血管性痴呆患者对不同脑区葡萄糖代谢的变化。方法:收治2004-05/10广州星光老人之家二院和广州千禧颐老院的血管性痴呆患者10例。男4例,女6例;病程1～9年;均为右利手。随机分为常规体针治疗组5例和百会治疗组5例。5次/周,共治疗4周。10例中缺血性脑血管病8例,出血性脑血管病2例;有1次脑卒中史9例,有2次脑卒中史1例;右侧偏瘫7例,左侧偏瘫3例。所有患者均接受正电子发射型计算机断层显像法观察脑区感兴趣区[分别设为双侧额叶(眶回)、双侧顶叶、双侧颞叶(海马及海马旁回)、双侧枕叶、双侧丘脑、双侧扣带回、双侧尾状核、双侧豆状核和双侧小脑]的葡萄糖代谢水平,并进行治疗前后的比较。结果:10例患者均进入结果分析。①常规针刺组治疗前后脑部感兴趣区葡萄糖代谢变化:患脑豆状核治疗后明显高于治疗前[(2.49±0.99,1.85±0.53),t=2.90,P<0.05]。健脑治疗后颞叶明显高于治疗前[(1.59±0.63,1.28±0.36),t=2.88,P<0.05]。②百会组治疗前后脑部感兴趣区葡萄糖代谢变化:患脑额叶、豆状核治疗后显著高于治疗前[(2.78±0.27,2.80±0.40;2.21±0.34,2.25±0.35),t=3.01,3.25,P<0.05]。健脑颞叶、豆状核治疗后显著高于治疗前[(1.69±0.43,2.79±0.38;1.32±0.36,2.22±0.47),t=2.93,3.16,P<0.05]。结论:①常规针刺组能显著提高患脑豆状核和健脑颞叶的葡萄糖代谢水平。②百会穴治疗组对血管性痴呆患者的患脑额叶、健脑颞叶及双侧豆状核区的葡萄糖代谢有显著增高。

百会、人中、神门治疗血管性痴呆的比较研究

目的:探讨百会、人中、神门治疗血管性痴呆(VD)的相对特异性。方法:50例VD患者随机分为常规穴位针刺组、常规穴位加用百会穴组、常规穴位加用人中穴组、常规穴位加用神门穴组、常规穴位加用百会、人中和神门组。治疗前后运用临床痴呆评定表(CDR)、简易智能量表(MMSE)、Blessed行为量表(BBS)、神经功能缺损评分(CNFD)等量表进行测评,评分结果纳入统计学处理。结果:百会、人中、神门对VD患者流体智力方面有显著改变,3穴联合运用,可较全面地改善VD患者的认知功能和非认知功能。单用其中任何一穴进行治疗,VD患者的时间定向、空间定向和图形描记能力都有显著提高。百会还长于改善注意计算、短程记忆和其个性改变,人中穴还长于改善语言命名和短程记忆。结论:百会、人中、神门对改善VD患者智力有一定疗效,百会和人中的作用优于神门,3穴联用效果最佳。

头部电针对抑郁症患者脑功能区葡萄糖代谢的影响(英文)

背景:有研究认为抑郁症患者额叶、扣带回、尾核等脑功能区葡萄糖代谢水平低下,小脑内血流量降低。目的:运用正电子发射型计算机断层显像技术观察头电针对抑郁症患者脑部功能区葡萄糖代谢的影响。设计:随机对照的验证性实验。单位:南方医院针灸科,广东省人民医院伟伦PET中心。对象:选择2002-10/2003-10在南方医院、珠江医院门诊确诊的原发性抑郁症患者12例,男3例,女9例;年龄36～66岁,平均48岁。方法:头电针取穴为顶中线、额中线和双侧额旁1线。电针前和治疗6周后分别接受正电子发射型计算机断层显像技术检测。框取双侧额叶、尾核、扣带回和小脑作为感兴趣脑区,将各脑区所得葡萄糖代谢放射性计数采用半定量方式进行治疗前后比较。主要观察指标:双侧额叶、尾核、扣带回和小脑葡萄糖代谢显像的半定量分析。结果:12例原发性抑郁症患者均进入结果分析。①头电针治疗后右侧额叶、左侧额叶、右侧扣带回、右侧尾核、左侧小脑葡萄糖代谢放射计数半定量结果明显高于治疗前犤(2.91±0.34,2.96±0.26,2.68±0.20,2.61±0.39,2.55±0.18,2.53±0.31,2.53±0.36,2.34±0.31,2.40±0.33,2.35±0.25),(P<0.05～0.01)犦,而治疗后左侧扣带回、左侧尾核、右侧小脑葡萄糖代谢放射计数半定量结果与治疗前基本相似犤(2.69±0.38,2.66±0.01,2.50±0.27;2.43±0.38,2.45±0.21,2.30±0.34),(P>0.05)犦。结论:电针抑郁症患者顶中线、额中线和双侧额旁1线能提高部分脑区的葡萄糖代谢,头电针治疗抑郁症的机制可能与提高额叶、尾核、扣带回、小脑等部分脑区葡萄糖代谢有关。

针刺百会人中神门治疗血管性痴呆的临床比较研究

目的:比较百会、人中、神门治疗血管性痴呆(VD)的相对特异性。方法:50例血管性痴呆患者,随机分为5组,分别治以常规穴位针刺、常规穴位加用百会穴、加用人中穴、加用神门穴、加用百会、人中和神门3穴。治疗前后均观察临床症状的变化,并运用修订长谷川痴呆量表(HDS-R)、日常生活活动量表(ADL)、社会功能活动调查(FAQ)等量表进行测评,评分结果进行统计学处理。结果:百会、神门能够改善VD患者记忆、定向、反应、固执、恍惚等方面的症状,百会长于帮助患者理解、计算、适应社会;人中则偏重于针对VD患者喜睡嗜卧、反应迟钝、神思恍惚、记忆等症状的改善;百会、人中、神门3穴联合运用,对于VD患者的智力水平、社会适应能力有着较为全面的改善。结论:百会、人中、神门3穴在改善VD患者临床症状和智力水平方面各有其相对特异性,3穴联合运用疗效最佳。

A COMPARATIVE STUDY ON THE TREATMENT OF VASCULAR DEMENTIA BY PUNCTURING BAIHUI (GV20), SHUIGOU (GV26) AND SHENMEN (HT7)

Objective: To observe the relative specialty of the therapeutic effect of acupuncture of Baihui (百会 GV 20), Shuigou (水沟 GV 26) a nd Shenmen (神门 HT 7) in the treatment of vascular dementia (VD) patients. Methods: F ifty VD patients were randomly divided into routine treatment group (control gro up), Baihui (GV 20) group (GV 20 group), Shuigou (GV 26) group (GV 26 gr oup), Shenmen (HT 7) group (HT 7 group) a nd GV 20+GV 26+HT 7 group (joint treatment group), with 10 cases in ea ch group. In control group, acupoints used were Jianyu (肩NFDA1 LI 15), Quchi (曲池 L I 11), Waiguan (外关 TE 5), etc. (which were also used in the other four groups) on the paralyzed side. The treatment was conducted once a day except weekends, 20 session s all together. Clinical Dementia Rating Scale (CDR), Mini-Mental State Examin at ion (MMSE) test, Blessed Dementia Rating Scale (BDR) and Clinical Neurological D eficit Rating (CNDR) were used to assess the patients’ intelligence state befor e and after acupuncture treatment. Results: After acupuncture tr eatment, the VD patients’ intelligence in all the five groups was improved at different degrees . Additional acupuncture of each of GV 20, GV 26 and HT 7 had a remarkable e ffec t in improving the VD patients’ fluid intelligence, and could obviously promote their abilities of temporal orientation, spatial orientation and figure drawing ; and additional joint acupuncture of the three acupoints could improve their co gnitive and non-cognitive functions, such as reducing the severity of dementia , raising the temporal orientation, spatial orientation, calculation, short-term m emory and figure drawing abilities, and improving their activities of daily livi ng and personality. Besides, acupuncture of GV 20 could improve the abilities of calculation and short term memory, and correct the personality change of VD pat ients, while acupuncture of GV 26 could improve the abilities of naming and sh or t-term memory. Conclusion: Acupuncture of GV 20, GV 26 and HT 7 all had a certai n therapeutic effect in improving VD; the therapeutic effects of acupuncture of GV 20 and GV 26 were better than that of acupuncture of HT 7; and the effica cy of the three points used in combination was the best.

EFFECT OF ELECTRO-SCALP ACUPUNCTURE ON GLUCOSE METABOLISM OF THE CEREBRAL REGIONS INVOLVING MENTAL ACTIVITY IN HEALTHY PEOPLE

Objective: To observe the effect of electro-scalp acupuncture on glucose metabolism of cerebral regions involving mental activity in healthy people. Methods: A total of 6 cases of volunteer healthy subjects (3 males and 3 females) ranging in age from 22 to 36 years were subjected to this study. Changes of cerebral glucose metabolism before and after electro-scalp acupuncture were observed by using positron emission tomography (PET) and semi-quantifying analysis method. Electro-scalp acupuncture stimulation (50 Hz, 2 mA) of Middle Line of Vertex (Ding zhongxian,顶中线,MS5), Middle Line of Forehead (Ezhongxian, 额中线,MS1) and bilateral Lateral Line 1 of Forehead (Epangyixian,额旁一线,MS2) was administered for 30 minutes. Then cerebral regions of interest (ROIs) were chosen and their average glucose metabolism levels (radioactivity of 18 fluorine deoxyglucose) were analyzed. Results: After administration of electro-scalp acupuncture, the glucose metabolism levels in bilateral frontal lobes and bilateral caudate nuclei, left cingulate gyrus and right cerebellum increased significantly in comparison with those of pre stimulation (P<0.05). Conclusion: Electro-scalp acupuncture of MSI, MS2 and MS5 can increase the glucose metabolism of certain cerebral regions involving mental activity in healthy subjects.