PET-CT对肝气郁型经前期综合征患者郁怒症脑功能成像研究  

Study on Brain Functional Image of Depression and Anger Symptom for PMS Patients with Liver-qi Obstacle by PET-CT

作　　者：王德敬[1,2] 郭晓艳[3] 林乐军[4] 李善春[4] 乔明琦[2] 张慧云[2] 

机构地区：[1]山东中医药高等专科学校,山东烟台265200 [2]山东中医药大学,山东济南250355 [3]天津中医药大学,天津300193 [4]烟台毓璜顶医院,山东烟台264000

出　　处：《辽宁中医杂志》2014年第2期232-236,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：中国博士后科学基金(20090461263)

摘　　要：目的:揭示经前期妇女、肝气郁型PMS(经前期综合征)郁怒症者脑发病机制,为两者脑功能变化的提供可视性实验依据,为情绪的脑定位提供科学依据。方法:运用无创性PET-CT,采用成组t检验的统计方法与测定双侧脑区视觉分析放射性分布不对称指数(AI),研究经前期妇女、肝气郁型PMS的郁怒者,观察到脑组织中哪些区域与经前期、PMS患者郁怒症有关。结果:(1)与正常妇女经前期比较,经前期综合征肝气郁结郁怒者组相关脑区多呈现葡萄糖代谢减低,葡萄糖代谢减低脑区P<0.01有:右侧额中回,有非常显著性差异;P<0.05有:中脑、左侧额下回、右侧额下回等有显著性差异。(2)正常妇女经前期与PMS肝气郁结郁怒者组相关脑区不对称指数(AI)双侧脑区视觉分析异常区勾画感兴趣区(ROI),测定放射性分布不对称指数(AI)。正常妇女经前期未见明显有规律性差异。PMS肝气郁结郁怒组有差别的:葡萄糖代谢明显有规律性差异的是右侧额中回代谢明显低于左侧额中回,提示右前额皮层与消极感情有关,左前额皮层与积极感情有关。结论:(1)经前期妇女脑葡萄糖代谢未见明显有规律性差异。(2)肝气郁型PMS郁怒者的实质是与脑功能异常有关的情绪失常,即情志致病。(3)肝与脑密切相关,是进行肝气郁型PMS郁怒者脑功能成像的基础。(4)右前额皮层与肝气郁型PMS郁怒症患者的消极感情有关,右前额皮层支配身体的左侧,这与中医的肝胆之气行于身体的左侧是一致的。(5)探讨郁怒的脑定位,为有效的药物和心理疗法进行干预提供科学依据,据此制订系列的治疗方案。Objective：This paper aims to explore the pathogenesis in the brain functional imaging of normal premenstrual woman and depression- anger- symptom patients with premenstrual syndrome（PMS） and stagnation of liver- Qi syndrome, so as to provide the experimental basis for the visibility of brain functional changes and to provide a scientific basis for emotional brain positioning. Methods ： The research is done by sense of vision induction such as images or video, in accordance with the recognized diagnostic criteria for depression and anger symptom for PMS patients with liver - Qi obstacle, and by using non - invasive PET - CT to Set the standard for integration, elimination, rejection and falling off. The results of brain imaging were analyzed and the sta- tistics of data was performed according to the standardization value （SUV） of relevant region, and the asymmetric index （AI） was determined of radioactive distribution in bilateral brain regions visual analysis by using statistical methods of group t test. This was different from the previous research. The patients brain was scanned by PET - CT to observe the brain areas relatived to the de- pression - anger - symptom of premenstrual woman and PMS patients. Results ： （ 1 ） The relative brain region of the subjects presen- ted more glucose metabolism, compared with that of normal premenstrual woman. There were some brain areas in which glucose metabolism reduced, P 〈 0. 01. The area was middle frontal gyrus, which was of significant difference. The area included midbrain, left inferior frontal gyrus, right inferior frontal gyrus,left middle frontal gyrus,left superior temporal gyrus, right superior temporal gyrus, left middle temporal gyrus, right middle temporal gyrus, left precentral gyrus,left hippocampus, right hippocampns, right cer- ebellum, right Sphenophyllum, left amygdala and right amygdala,which were of significant difference as well ,P 〈 0. 05.2. The in- dex（AI） of related brain regions was asymmetric between the normM prem

关 键 词：经前期 经前期综合征(PMS) 肝气郁结型 郁怒者症 PET脑功能成像 

分 类 号：R271.115[医药卫生—中医妇科学]