基于静息态功能磁共振探讨火针点刺颅底穴位配合体针治疗对帕金森病伴抑郁患者的中枢影响  

Discussion on the central influence of fire acupuncture at skull base combined with body acupuncture on patients with Parkinson’s disease accompanied with depression based on resting state functional magnetic resonance imaging(fMRI)

作　　者：陈鹏[1] 王忠艳[2] 刘璐[1] 孙敬青[1] 王少松[1] 张涛[1] 夏秋玉 侯学思 王一战 王鑫 霍健伟 CHEN Peng;WANG Zhong-yan;LIU Lu;SUN Jing-qing;WANG Shao-song;ZHANG Tao;XIA Qiu-yu;HOU Xue-si;WANG Yi-zhan;WANG Xin;HUO Jian-wei(Acupuncture Department,Beijing Hospital of TCM Affiliated to the Capital Medical University,Beijing,100010,China;Department of Radiology,Beijing Hospital of TCM Affiliated to the Capital Medical University,Beijing,100010)

机构地区：[1]首都医科大学附属北京中医医院针灸科,北京100010 [2]首都医科大学附属北京中医医院放射科,北京100010

出　　处：《北京中医药》2021年第12期1325-1329,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：北京市属医院科研培育计划项目(PZ2022013)。

摘　　要：目的从静息态功能磁共振脑功能(fMRI)低频振幅的角度探讨火针点刺颅底穴位配合体针治疗帕金森病伴抑郁(DPD)的中枢机制。方法采用火针点刺颅底穴位配合体针治疗27例DPD患者,治疗前后采用帕金森病(PD)综合评分量表(UPDRS 3.0版第三部分)及PD患者生活质量问卷(PDQ-39)作为临床结局评估主要量表;汉密尔顿抑郁评分量表17项(HAMD-17)及抑郁自评量表(SDS)对DPD患者的抑郁症状严重程度进行评估,同时采集fMRI数据。结果与治疗前比较,针刺治疗后DPD患者PD相关量表及抑郁相关量表评分均降低,差异有统计学意义(P<0.05)。DPD患者ALFF值增高的脑区有双侧顶叶、左侧枕叶;ALFF值降低的脑区包括右侧额叶、颞叶、小脑及边缘叶。结论火针点刺颅底穴位配合体针改善DPD患者抑郁症状的中枢机制可能是通过额叶、顶叶、颞叶、小脑等多个脑区共同实现的。Objective To explore the central mechanism of fire acupuncture at acupoints at the skull base in the treatment of depression in Parkinson’s disease(DPD)from the perspective of low-frequency amplitude of brain function of resting fMRI.Methods 27 patients with DPD were treated with fire acupuncture at skull base acupoints combined with body acupuncture.Before and after treatment,the third part of Parkinson’s disease comprehensive score scale UPDRS version 3.0 and Parkinson’s disease patient quality of life questionnaire(PDQ-39)were used as the main scale for evaluating the clinical outcome of PD symptoms;Hamilton Depression Rating Scale 17 items(HAMD-17)and Self-rating Depression Scale(SDS)were used to evaluate the severity of depressive symptoms in patients with DPD.At the same time,fMRI data were collected and analyzed.Results After acupuncture treatment,there were significant differences in Parkinson’s disease related scale and depression related scale in DPD patients compared with those before treatment(P<0.05),suggesting that the symptoms of DPD patients were improved after fire acupuncture at skull base acupoints combined with body acupuncture.The brain areas with increased ALFF in DPD patients were bilateral parietal lobe and left occipital lobe;the brain areas with decreased ALFF value include the right frontal lobe,temporal lobe,cerebellum and marginal lobe.Conclusion The central mechanism of fire acupuncture at skull base to improve depressive symptoms in patients with DPD may be realized through multiple brain regions such as frontal lobe,parietal lobe,temporal lobe and cerebellum.

关 键 词：帕金森病 抑郁 火针 颅底穴位 功能磁共振 

分 类 号：R246.6[医药卫生—针灸推拿学]