开心解郁方治疗血管性抑郁症脑机制fMRI初步研究  

The preliminary study of brain function mechanism of Kai Xin Jie Yu Fang treating vascular depression by using fMRI

作　　者：谭赛[1] 方继良[2] 黄世敬[1] 洪洋[2] 包岩[2] 张勇[3] 裴静[4] 吴巍[1] 韩铭[2] 张磊[2] 孙梦云[1] 

机构地区：[1]中国中医科学院广安门医院中药研发中心,北京100875 [2]中国中医科学院广安门医院放射科,北京10053 [3]北京理工大学生命科学院,北京100081 [4]北京师范大学认知神经科学与学习国家重点实验室暨脑与认知科学研究院,北京100875

出　　处：《中国中西医结合影像学杂志》2017年第3期261-266,273,共7页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金(81072801;81273674);北京市科技计划(Z141100002214014);中央级公益性科研院所基本科研业务费专项(ZZ0708076)

摘　　要：目的:通过静息态f MRI观察中药开心解郁方治疗血管性抑郁症(VD)前后患者脑功能的变化,从神经元自发活动初步探究其疗效的脑机制。方法:从临床试验研究中随机选取中药开心解郁方组和西药盐酸氟西汀组各7例行f MRI扫描,采用脑功能成像软件REST处理数据,比较2组在治疗前后全脑低频振幅(ALFF)值、局部一致性(Re Ho)值的变化。结果:与基线比较,中药组和西药组在治疗8周后量表汉密尔顿抑郁量表(HAMD)积分均显著下降(P<0.01);2组HAMD量表积分组间比较差异无统计学意义(P>0.05)。与治疗前相比,2组ALFF值变化的共同脑区主要在左侧前额叶下回,2组Re Ho值变化的共同脑区主要在顶叶小叶、颞下回。治疗8周后,与西药组相比,中药组ALFF值降低的脑区有右侧前额叶下回三角部、右侧背外侧前额叶上回、双侧中央前回,ALFF值升高的脑区有右侧颞下回、右侧前楔叶;Re Ho值降低的脑区有右侧额中回、左侧中央前回,Re Ho值升高的脑区有左侧颞上回、左侧小脑。结论:开心解郁方具有抗抑郁作用,其临床疗效与盐酸氟西汀相当。随着症状的改善,部分抑郁症相关脑区的脑功能也随之改变,这可能是药物抗抑郁疗效脑机制之一;中西药2组治疗前后脑功能发生改变的脑区不一致,推测可能与开心解郁方和盐酸氟西汀治疗VD作用脑机制不同有关。Objectives：To investigate the changes of brain function on vascular depression and explore the brain mechanism of curative effect from neurons spontaneous activity before and after Chinese Medicine Kai Xin Jie Yu Fang treatment by using fMRI. Methods：Fourteen patients with vascular depression from the clinical trial were randomly selected to participate fMRI experiment,7 cases from Chinese Medicine （Kai Xin Jie Yu Fang） group and Western Medicine （Fluoxetine） group separately. The data acquired by fMRI were processed by brain imaging software （REST）. The whole brain ALFF value and ReHo value were compared between two groups before and after treatment. Result：Compared with baseline,the scores of HAMD scale decreased significantly （P〈0.01） in both of Chinese and Western Medicine group after 8Ws treatment,and the difference of the reduced scores between two groups was not significant （P〉0.05）. Compared with pre-treatment,the common brain region in which the ALFF value changed in two groups were mainly concentrated in left inferior frontal gyrus,the common brain region in which the ReHo value changed were mainly concentrated in inferior parietal lobule,inferior temporal gyrus. Compared with Western Medicine group after 8Ws treatment,the brain region that ALFF value decreased in Chinese Medicine group included right dorsal lateral prefrontal cortex,right inferior frontal gyrus and bilateral precentral gyrns;the ALFF value increased regions were right inferior temporal gyrns,right precuneus ;the ReHo value decreased regions included right middle frontal gyrns and left precentral gyrns;the ReHo value increased regions included left superior temporal cortex and left cerebellum. Conclusions：Our preliminary study showed Kai Xin Jie Yu Fang had similar effect of antidepressant as Fluoxetine. As the symptoms improved, the brain function in which some brain regions relate to depression was also changed after antidepressant treatment. It was possible that the changes of brain function in these r

关 键 词：开心解郁方 抑郁症 脑机理 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.4[医药卫生—诊断学]