疏肝法对肝郁型轻度认知功能障碍影响的静息态功能磁共振成像研究  

Resting State fMRI Study on Effect of Soothing Liver and Relieving Depression on MCI Patients with Stagnation of Liver Qi

作　　者：詹向红[1,2,3] 曲金荣 侯俊林 刘永[1,2,3] 闫国立 孙前明[1,2,3] 关徐涛 ZHAN Xianghong;QU Jinrong;HOU Junlin;LIU Yong;YAN Guoli;SUN Qianming;GUAN Xutao(Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China;Henan Province Engineering Technology Research Center for Chinese and Western Integrative Prevention and Treatment of Brain Cognitive Disease,Zhengzhou 450046,Henan,China;Zhengzhou Key Laboratory for Chinese&Western Integrative Prevention and Treatment of Brain Cognitive Disease,Zhengzhou 450046,Henan,China;Affiliated Oncology Hospital of Zhengzhou University,Zhengzhou 450008,Henan,China)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南省中西医结合防治脑认知疾病工程技术研究中心,河南郑州450046 [3]郑州市中西医结合防治脑认知疾病重点实验室,河南郑州450046 [4]郑州大学附属肿瘤医院,河南郑州450008

出　　处：《中华中医药学刊》2022年第6期10-13,I0014,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81173148,81473556)。

摘　　要：目的采用基于低频振幅(amplitude of low frequency fluctuation,ALFF)算法的静息态功能磁共振成像(function-al magnetic resonance imaging,fMRI)技术探讨轻度认知功能障碍(mild cognitive impairment,MCI)的客观诊断指标及疏肝法改善肝郁型MCI患者认知功能的机制。方法以肝郁型MCI患者10例为病例组,年龄、性别、文化程度与之匹配的正常人10例被视为对照组,采集病例组用药前后及对照组静息态fMRI的血氧水平依赖(blood oxygenation level dependent,BOLD)信号,分析ALFF值的差异。结果与对照组相比,病例组ALFF值降低的区域主要位于左侧枕中回和岛盖部额下回(P<0.01,AlphaSim校正),ALFF值增高的区域为右内侧前额叶(P<0.01,AlphaSim校正)。与用药前相比,病例组用药后ALFF值降低的区域主要位于右侧枕中回(P<0.01,AlphaSim校正),ALFF值增高的区域主要集中在左侧颞上回和左侧颞中回(P<0.01,AlphaSim校正)。结论ALFF值有望成为诊断MCI的客观指标,左侧颞上回和左侧颞中回兴奋性增高是疏肝法改善肝郁型MCI患者认知功能的可能机制。Objective To investigate the objective indicator for diagnosis of mild cognitive impairment(MCI)and mechanism of improving cognitive function of soothing liver and relieving depression on mild cognitive impairment(MCI)patients with stagna-tion of liver Qi by means of resting functional magnetic resonance(fMRI)based on amplitude of low frequency fluctuation(ALFF)algorithm.Methods MCI patients with stagnation of liver Qi were taken as the case group,and the normal subjects with age,sex and education level matched with them were taken as the control group.The BLOD signals were measured from control group and before and after medication of the case group.Results Compared with that of the control group,the area where the ALFF value decreased was mainly located in the left medial occipital gyrus and the lower frontal gyrus of the island cover in the case group(P<0.01,Alphasim correction).The area where the ALFF value increased was the right medial prefrontal lobe in the case group(P<0.01,Alphasim correction).Compared with MCI patients before medication,the area where the ALFF value de-creased was mainly located in the right occipital gyrus after medication(P<0.01,Alphasim correction).The area where the ALFF value increased was mainly concentrated in the left superior temporal gyrus and the left middle temporal gyrus after medica-tio(P<0.01,Alphasim correction).Conclusion ALFF is expected to be an objective indicator of diagnostic MCI.The increased excitability of left superior temporal gyrus and left middle temporal gyrus is a possible mechanism of soothing liver and relieving depression to improve the cognitive function of MCI patients with stagnation of liver Qi.

关 键 词：疏肝解郁 轻度认知功能障碍 认知评估 功能磁共振成像 低频振幅 

分 类 号：R277.749.16[医药卫生—中医学]