逍遥丸对肝气郁结型轻度认知功能障碍患者磁共振波谱的影响  

Effects of Xiaoyao Pill(逍遥丸) on Magnetic Resonance Spectroscopy of Mild Cognitive Impairment Patients with Liver Qi Stagnation Syndrome

作　　者：刘紫阳 詹向红[2] 刘永[2] 孙前明[2] 赵紫薇 刘秀灵 LIU Ziyang;ZHAN Xianghong;LIU Yong;SUN Qianming;ZHAO Ziwei;LIU Xiuling(College of Basic Medicine,Shandong University of Traditional Chinese Medicine,Jinan,250355;Henan University of Chinese Medicine)

机构地区：[1]山东中医药大学中医学院 [2]河南中医药大学

出　　处：《中医杂志》2018年第17期1489-1493,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81173148;81473556)

摘　　要：目的探讨肝气郁结型轻度认知功能障碍(MCI)患者的磁共振波谱(MRS)特征及用逍遥丸治疗的可能机制。方法收集肝气郁结型MCI患者10例设为治疗组,另外按照同性别、同年龄段、同文化程度匹配体检健康受试者10例设为对照组。治疗组给予逍遥丸每次8粒口服,每日3次,连续服用12周,对照组不进行干预。治疗组于干预前后及对照组入组时采用蒙特利尔认知评估量表(Mo CA)进行评分,用GE 3.0T超导型MR成像系统检测左右海马及左右后扣带回皮质N-乙酰天冬氨酸(NAA)、胆碱(Ch)、肌醇(m I)曲线下面积,并分别计算其与肌酸(Cr)的比值。结果治疗组治疗前Mo CA量表中命名、抽象、定向评分与对照组比较差异无统计学意义(P>0.05),其他各项评分均明显低于对照组(P<0.05),左海马区NAA/Cr低于对照组(P<0.05)。治疗组治疗后Mo CA量表中命名、定向评分与治疗前比较差异无统计学意义(P>0.05),其余各评分均显著上升(P<0.05),右扣带回区的Ch/Cr低于对照组(P<0.05)。结论左海马区NAA/Cr下降可作为肝气郁结型MCI患者的神经损伤标记特征,降低海马环路中后扣带回区域胆碱化合物水平可能是逍遥丸纠正认知功能下降的神经机制之一。Objective To explore the characteristics of magnetic resonance spectroscopy（MRS） of mild cognitive impairment（MCI） patients with liver-qi stagnation syndrome and the possible mechanism of treatment with Xiaoyao Pill（逍遥丸）. Methods Ten MCI patients with liver-qi stagnation syndrome formed treatment group,and another 10 healthy subjects with corresponding genders,ages,educational degree formed control group. The treatment group was given Xiaoyao Pill by oral administration,8 pills once,3 times a day in continuous 12 weeks,and no intervention in control group. Montreal cognitive assessment scale（MoCA） was used to evaluate before and after the intervention of the treatment group and since inclusion starting for the control group. GE 3. 0 T super imaging system was used to detect the area under the curve of N-acetyla spartate（NAA）,choline（Ch）,myinositol（mI） of hippocampus,cingulate gyrus of left and right sides,and calculate the ratio to creatine（Cr）. Results Compared with the control group,the numerical value of nomenclature,abstraction,orientation in MoCA of treatment group before intervention had no statistical significance（P〉0. 05）,and the scores of other items were significantly lower（P〈0. 05）.NAA/Cr in the left hippocampus was lower than the control group（P〈0. 05）. The numerical value of nomenclature,orientation in MoCA of treatment group after intervention had no statistical significance when compare with before treatment（P〈0. 05）,and the scores of other items were significantly increased（P〈0. 05）. Ch/Cr in the right cingulate gyrus of MRS was lower than the control group（P〈0. 05）. Conclusion The decrease of NAA/Cr in the left hippocampus can be used as a marker of nerve injury in MCI patients with liver qi stagnation syndrome,and the decrease of the level of choline compound in the posterior cingulate gyrus of hippocampal loop may be one of the neurological mechanisms of Xiaoyao Pill to correct cognitive decline.

关 键 词：轻度认知功能障碍 逍遥丸 肝气郁结型 磁共振波谱 蒙特利尔认知评估量表 

分 类 号：R277.7[医药卫生—中医学]