逍遥丸调控海马功能连接改善肝气郁结型aMCI认知功能的神经影像机制研究  

Resting State Functional Magnetic Resonance Study on the Mechanism of Treating aMCI of Liver Qi Stagnation with Xiaoyao Pills

作　　者：刘紫阳[1,3] 侯俊林 刘永[2,3] 张振强 詹向红[1,3] Liu Ziyang;Hou Junlin;Liu Yong;Zhang Zhenqiang;Zhan Xianghong(Traditional Chinese medicine School,Henan University of Chinese Medicine,Zhengzhou 450046,China;Medical School,Henan University of Chinese Medicine,Zhengzhou 450046,China;Henan province engineering technology research center for Chinese and western integrative prevention and treatment of brain cognitive disease、Zhengzhou Key laboratory for Chinese&western integrative prevention and treatment of brain cognitive disease,Zhengzhou 450046;ChinaAcademy of Chinese Medical Sciences,Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学中医学院,郑州450046 [2]河南中医药大学医学院,郑州450046 [3]河南省中西医结合防治脑认知疾病工程技术研究中心、郑州市中西医结合防治脑认知疾病重点实验室,郑州450046 [4]河南中医药大学中医药科学院,郑州450046

出　　处：《世界科学技术-中医药现代化》2022年第6期2210-2216,共7页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委员会面上项目(81473556):疏肝法对情绪调节不良MCI患者工作记忆影响的机制研究,负责人:詹向红;河南省教育厅高等学校青年骨干教师培养计划(2020GGJS109):基于列线图可视化技术建立糖尿病相关认知功能障碍的风险预测模型及应用,负责人:王瑾瑾;河南中医药大学优秀博士科研启动项目(RSBSJJ2019-18):基于肝失疏泄理论探讨氧化应激影响细胞脂膜EGFR受体微环境的作用机制研究,负责人:刘紫阳。

摘　　要：目的探讨逍遥丸辨证干预长期肝气郁结(肝郁)遗忘型轻度认知功能障碍(aMCI)的神经作用机制。方法筛选出正常志愿者及6个月以上肝郁aMCI,以年龄(前后差异小于2.5岁)、性别及受教育年限三项为匹配条件,将所有补试分为正常对照组、肝郁aMCI治疗组与非治疗组。非治疗组正常组不予药物干预处理,治疗组给予逍遥丸服用3个月。分别在3个月前后对各组开展行为学MoCA认知功能检测、中医肝郁症状积分及基于体素的全脑功能连接神经脑影像测评分析。结果行为学方面:3个月后,治疗组的MoCA总体认知功能比非治疗组显著提升(P<0.05),治疗组MoCA总分与视空间/执行功能恢复至正常水平;非治疗组3个月前未受损的命名功能在3个月后出现了下降,明显低于治疗组(P<0.05),且非治疗组命名与语言功能均低于正常组(P<0.05)。功能磁共振方面:3个月后,治疗组左海马与右舌状回、右距状裂周围皮层功能连接显著强于未治疗组(P<0.05,FWE团块校正),且功能连接改变与延迟回忆功能呈正相关(r=0.3014,P<0.05)。结论逍遥丸能够提升肝气郁结型aMCI大脑总体认知功能,其机制可能与增强海马、舌回及距状裂周围皮层间的功能连接,调节大脑负责抑制干扰信息及注意动机启动功能并进一步改善aMCI延迟回忆有关。Objective To explore the neurological mechanism of Xiaoyao pills for the treatment of amnestic mild cognitive impairment(aMCI)of long-term liver qi stagnation on syndrome differentiation.Methods Normal volunteers and aMCI of liver Qi stagnation which lasts more than 6 months were selected.According to the matching principle of age stages(up and down 2.5 years),sex and years of education,normal control group,non-treatment group(without any treatment)and aMCI treatment group(treated with Xiaoyao pills for 3 months)were divided.MoCA cognitive function,liver stagnation symptoms and voxel-based whole brain function connection assessment were analyzed in each group before and after 3 months.Results For behavioral aspects,after 3 months,compared with the non-treatment group,the overall cognitive function of MoCA in the treatment group showed a significant increase(P<0.05).Total MoCA score and visual space/executive function of the treatment group returned to normal levels.Meanwhile,the unimpaired naming function of the untreated group decreased and as well as significantly lower than the treatment group(P<0.05);both naming and language function of non-treatment group were lower than that of the normal group(P<0.05).For fMRI aspects,after 3 months,functional connection between the left hippocampus and the right lingual gyrus as well as right occipital lobe of the intervened group was enhanced compared with blank controller(P<0.05,FWE clusters correction).Meanwhile,the change of FC was positively correlated with delayed memory(r=0.3014,P<0.05).Conclusion Xiaoyao Pills can improve the overall cognitive function of aMCI with long term of liver qi stagnation,and the mechanism may be related to the enhancement of the functional connection among the hippocampus and tongue gyrus,the cortex around the talus regulation which lead regulation of restraining interference information and motivation priming and at last improving the function of delayed memory.

关 键 词：遗忘型轻度认知功能障碍 肝气郁结 逍遥丸 神经影像 功能连接 

分 类 号：R285.5[医药卫生—中药学]