针灸对偏头痛伴抑郁/焦虑障碍患者认知功能影响临床研究  

Effect of acupuncture on the cognitive function of migraine patients with depression/anxiety disorder

作　　者：王京京[1] 王晓宇[1] 张晓宁[1] 王广军[1] 蒲荣 陈李圳 陈仲杰[1] 周劲草[1] 张易 王文艳[1] WANG Jing-jing;WANG Xiao-yu;ZHANG Xiao-ning;WANG Guang-jun;PU Rong;CHEN Li-zhen;CHEN Zhong-jie;ZHOU Jin-cao;ZHANG Yi;WANG Wen-yan(Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences,Beijing 100700,China;Eighth Medical Center,Chinese PLA General Hospital)

机构地区：[1]中国中医科学院针灸研究所,北京100700 [2]中国人民解放军总医院第八医学中心

出　　处：《中国针灸》2021年第6期615-620,共6页Chinese Acupuncture & Moxibustion

基　　金：国家重点研发计划资助项目:2019YFC1712200;国家自然科学基金资助项目:81574088。

摘　　要：目的:观察五行针灸对偏头痛伴抑郁/焦虑障碍患者认知功能修复的影响。方法:观察组为偏头痛伴抑郁/焦虑障碍患者(19例,脱落5例),接受五行针灸治疗,每周2次,共治疗8周;同时以人口学资料匹配的健康受试者(19例)为对照组。采用事件相关电位(ERP)技术评定认知功能,观察指标为视觉诱发电位P300潜伏期和波幅。以头痛天数(每4周)、头痛强度[视觉模拟量表(VAS)评分]、头痛影响测定量表(HIT-6)评分、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分作为疗效观察指标。结果:治疗前,观察组患者额中线(Fz)位点靶刺激潜伏期[(417.5±34.3)ms]长于对照组健康受试者[(388.6±42.1)ms,P<0.05],观察组患者治疗后各位点靶刺激潜伏期[Fz:(376.1±36.2)ms,F3:(374.8±37.6)ms,F4:(372.0±37.6)ms]均较治疗前[Fz:(417.5±34.3)ms,F3:(417.4±33.8)ms,F4:(416.0±36.6)ms]缩短(P<0.05)。治疗前后,观察组患者各位点波幅与对照组比较差异无统计学意义(P>0.05)。观察组患者治疗后头痛天数较治疗前减少(P<0.01),VAS评分、HIT-6评分、HAMD评分、HAMA评分均较治疗前降低(P<0.01)。结论:偏头痛伴抑郁/焦虑障碍患者出现一定程度的认知功能损害。五行针灸在有效改善头痛、缓解焦虑及抑郁情绪的同时,提高了额叶的激活水平,对患者受损的认知功能起到明显的修复作用。Objective To observe the effect of five-element acupuncture on the cognitive function repair of migraine patients with depression/anxiety disorder.Methods The migraine patients with depression/anxiety disorder(19 cases,5 cases dropped off)were taken as the observation group,and received five-element acupuncture twice a week for 8 weeks.Healthy subjects(19 cases)were selected by demographic data matching as the control group.The cognitive function was evaluated with the event related potential(ERP)technique,and the latency and amplitude of visual evoked potential P300 were adopted as the observation indexes.The headache days(every 4 weeks),headache intensity[visual analogue scale(VAS)score],and headache impact test-6(HIT-6)score,Hamilton depression scale(HAMD)score and Hamilton anxiety scale(HAMA)score were used as the observation indexes for curative effect.Results Before the treatment,latency of target stimulus at Fz[(417.5±34.3)ms]in the observation group was extended compared with the healthy subjects of the control group[(388.6±42.1)ms,P<0.05].In the observation group,the latency of each point target stimulus[Fz:(376.1±36.2)ms,F3:(374.8±37.6)ms,F4:(372.0±37.6)ms]after treatment were shorter than those[Fz:(417.5±34.3)ms,F3:(417.4±33.8)ms,F4:(416.0±36.6)ms]before treatment(P<0.05).Before and after treatment,there was no significant difference in the amplitude of each point between the observation group and the control group(P>0.05).In the observation group,the headache days was shorter than that before treatment(P<0.01),and the VAS score,HIT-6 score,HAMD score and HAMA score were all lower than before treatment(P<0.01).Conclusion There are some cognitive impairments in migraine patients with depression/anxiety disorder.Five-element acupuncture not only relieves headache,anxiety and depression effectively,but also improves the activation level of the frontal lobe.It significantly repairs the impaired cognitive function.

关 键 词：偏头痛 抑郁/焦虑障碍 五行针灸 认知功能 事件相关电位 P300 

分 类 号：R246.6[医药卫生—针灸推拿学]