经皮耳迷走神经刺激对功能性消化不良患者大脑局部一致性的影响  

Effect of auricular acupoint continuous stimulation on brain regional homogeneity in patients with functional dyspepsia

作　　者：陈维翠[1] 叶泳松[1] 侯小燕[1] 周思繁 吴珊珊[1] 严兆贤[1] 刘波[1] CHEN Weicui;YE Yongsong;HOU Xiaoyan;ZHOU Sifan;WU Shanshan;YAN Zhaoxian;LIU Bo(Department of Radiology,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China.)

机构地区：[1]广东省中医院广州中医院大学第二附属医院放射科,广东广州510120

出　　处：《中国中西医结合影像学杂志》2021年第1期6-10,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：广东省中医药管理局基金项目(20191160)。

摘　　要：目的:观察经皮耳迷走神经刺激(taVNS)对功能性消化不良(FD)患者的临床疗效及对大脑局部一致性(ReHo)的影响。方法:将54例FD患者随机分为迷走刺激组(26例)及非迷走刺激组(28例),对2组进行治疗前后总体症状、尼平消化不良指数(NDI)、Hamilton焦虑(HAMA)及Hamilton抑郁(HAMD)量表评分,并行静息态下BOLD-fMRI扫描,利用DPABI软件预处理图像数据并获取ReHo值进行统计分析。结果:迷走刺激组治疗前后总体症状评分、NDI、HAMA及HAMD评分差异均有统计学意义(均P<0.05);非迷走刺激组治疗前后总体症状评分差异有统计学意义(P<0.05),NDI、HAMA及HAMD评分差异均无统计学意义(均P>0.05)。2组治疗前后,左侧颞中回、左侧枕中回及左侧中央前回的ReHo值差异均有统计学意义(均P<0.05);其中迷走刺激组治疗后,左侧颞中回、左侧中央前回ReHo值均较治疗前升高(均P<0.05);非迷走刺激组治疗后,左侧枕上回ReHo值升高(P<0.05)。结论:taVNS可有效改善FD患者的消化不良及精神症状,利用fMRI可初步揭示taVNS治疗FD的脑中枢机制。Objective:To explore the clinic effect of transcutaneous auricular vagus nerve stimulation(taVNS)and changes of neuron activity with functional dyspepsia using regional homogeneity(ReHo).Methods:Participants with functional dyspepsia were randomly assigned to receive treatment of auricular acupoints with vagus nerve(Group A)or auricular acupoints with non-vagus nerve(Group B).The total effect scores,Nepean dyspepsia index(NDI),Hamilton anxiety(HAMA)and Hamilton depressive(HAMD)scores,and mental state were compared before and after treatment.BOLD-MRI was performed with data processing assistant for DPABI software package.ReHo were used for statistical analysis.Results:Significant differences were found in the total effect,NDI,HAMA and HAMD scores in Group A before and after treatment(all P<0.05).No significant differences were found in NDI,HAMA and HAMD scores in Group B,except the total effect.Significant differences were found in left middle temporal gyrus,left middle occipital gyrus and left precentral gyrus before and after treatment in two groups.The ReHo were significantly higher in the left middle temporal gyrus,left precentral gyrus in Group A after treatment(P<0.05).The ReHo was significantly higher in the left superior occipital gyrus in group B after therapy(P<0.05).Conclusions:TaVNS may improve dyspeptic symptoms and mental symptoms of functional dyspepsia.FMRI can be used to assess the central mechanisms of taVNS.

关 键 词：耳疗法 针刺穴位 局部一致性 消化不良 磁共振成像 经皮耳迷走神经刺激 

分 类 号：R246.1[医药卫生—针灸推拿学]