头部电针对帕金森病患者脑多巴胺转运体的影响  

Effects on Electro-scalp Acupuncture on Cerebral Dopamine Transporter in Patients with Parkinson’s Disease

作　　者：黄泳[1] 姜雪梅[1] 李东江[2] 唐安戊[2] 卓鹰[1] 陈静[1] 李求实[1] 高彦平[1] 王升旭[1] 

机构地区：[1]南方医科大学中医药学院,广州510515 [2]广东省人民医院伟伦PET中心

出　　处：《中国中西医结合杂志》2006年第4期303-307,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：广东省自然科学基金资助课题(No.04020389);广东省中医药管理局资助课题(No.1050131)

摘　　要：目的运用单光子发射计算机断层扫描(SPECT)技术观察头部电针对帕金森病(PD)患者基底节区多巴胺转运体(DAT)的影响。方法10例原发性PD患者随机分为治疗组和对照组,治疗组5例接受顶颞前斜线(MS6),额旁3线(MS4),顶旁1线(MS8),顶旁2线(MS9),枕下旁线(MS14)的电针治疗,单侧病变针刺对侧,双侧病变针刺双侧,深度达到帽状腱膜,每日1次,每周5次;对照组5例口服美多巴,轻度患者:125mg每日3次;中度患者:250mg每日3次;重度患者:250mg每日4次口服;所有患者治疗前及治疗6周后分别行99mTcTRODAT1SPECT脑断层显像,利用感兴趣区(ROI)技术测定基底节区/枕叶(BG/OC)的比值,分析基底节区的DAT活性。结果所有患者治疗后99mTcTRODAT1摄取均较治疗前有所增加,治疗组发病肢体同侧治疗前后BG/OC分别为1.1883±0.1471和1.2416±0.3146,对侧分别为0.9019±0.1210和0.9496±0.2522;对照组发病肢体同侧治疗前后BG/OC分别为1.1597±0.0568和1.2053±0.1153,对侧分别为1.0436±0.1393和1.2972±0.2612。对照组发病肢体对侧BG/OC治疗前后差异有显著性(P<0.05),其余脑区差异均无显著性(P>0.05)。两组之间对于DAT的改善效应无差异。结论头部电针可以减少PD患者基底节区DAT的丢失,改善基底节区DAT的活性,达到对于多巴胺神经元的保护作用,从而延缓PD患者的病程并且减轻临床症状。Objective To investigate the effect of electro-scalp acupuncture （ESA） on dopamine transporter （DAT） in basal ganglia （BG） of patients with Parkinson＇s disease （PD） by single photon emission computed tomography （SPECT）. Methods Ten patients with primary PD were divided equally into two groups randomly. Patients in the treated group received ESA at points of MS6, MS4, MS8, MS9 and MS14, for patients with u- nilateral lesions, ESA was applied on contralateral points, while for those with bilateral lesions, points of both sides were stimulated, the depth of puncturing was made to arrive at the galea aponeurotica. Patients in the control group took medopa orally in the dosage of 125 mg, 3 times per day for mild, 250 mg, 3 times per day for moderate and 250 mg, 4 times per day for severe cases. All the patients were examined with ^99m Tc-TRODAT- 1 SPECT before and after 6 weeks＇ treatment to analyze the activity of DAT by ratio of basal ganglia/occipital （BG/OC） using regional of interesting （ROI） technique. Results The uptake of ^99m Tc-TRODAT-1 increased after treatment in both groups. In the treated group, the homolateral （of the affected limbs, the same below） BG/OC ratios before and after treatment were 1. 1883 ± 0. 1471 and 1. 2416 ± 0. 3146 respectively, and those in the control group 1. 1597 ±-0. 0568, 1. 2053 ± 0.1153, showing no significant difference between them （ P 〉 0.05）; while the contralateral BG/OC ratios before and after treatment were 0. 9019 ± 0. 1210 and 0.9496 ± 0.2522 respectively in the treated group, and 1. 0436 ± 0. 1393 and 1. 2972 ± 0. 2612 respectively in the control group. The difference value of contralateral BG/OC before and after treatment in the control groups was significantly different （P 〈 0.05）. But at other cerebral regions, ^99m Tc-TRODAT-1 SPECT showed no difference between the two groups in changes before and after treatment, therefore, showed no difference in effect of improving DAT between the two groups （P �

关 键 词：帕金森病 头部电针 多巴胺转运体 关多巴 功能显像 

分 类 号：R246[医药卫生—针灸推拿学]