不同中医证型FD患者静息态脑功能局部一致性研究  

Study on Regional Consistency of Resting State Brain Function in Functional Dyspepsia patients with Different TCM syndrome

作　　者：邢文文 闫颖 王相东[1] 段海峰 于楠 刘奇[1] XING Wenwen;YAN Ying;WANG Xiangdong(Shaanxi University of Chinese Medicine,Xi'an Shanxi 712046,China)

机构地区：[1]陕西中医药大学,陕西西安712046 [2]陕西中医药大学附属医院,陕西咸阳712000

出　　处：《四川中医》2023年第9期85-89,共5页Journal of Sichuan of Traditional Chinese Medicine

基　　金：陕西省自然科学基础研究计划(编号:2019JQ-011);陕西省重点研发计划(编号:2022SF-034)。

摘　　要：目的:对比肝胃不和证与脾胃虚弱证功能性消化不良(FD)患者的一般病情资料和不同脑区局部一致性差异,探讨不同中医证型的中枢差异客观证据。方法:纳入FD患者38例(肝胃不和证20例,脾胃虚弱证18例),采用消化不良症状积分、NDI、情绪状态评价相关量表对受试者病情进行评价,各组受试者分别进行一次静息态功能磁共振成像扫描,采用ReHo分析方法对数据进行分析处理,比较两种证型FD患者静息态脑功能活动差异。结果:与脾胃虚弱证相比,肝胃不和证FD患者焦虑自评量表评分、抑郁自评量表评分、状态焦虑量表评分显著升高(P<0.05),特质焦虑量表评分无统计学差异(P>0.05);双侧丘脑、ACC、PCC、海马、额上回,右侧脑干、尾状核、补充运动区,左侧直回、中央后回等脑区功能活动局部一致性增高(P<0.05);双侧楔叶、小脑、MCC、中央前回,右侧中央后回,左侧脑岛、补充运动区等脑区功能活动局部一致性降低(P<0.05)。结论:以边缘系统为主的脑区是肝胃不和证与脾胃虚弱证FD患者静息状态脑功能活动的主要差异脑区,提示肝所主的“情志脑区”是FD肝胃不和证与脾胃虚弱证的中枢差异所在。Objective:To compared the general medical information and the regional consistency differences in different brain of FD patients with liver-stomach disharmony syndrome and deficiency of spleen and stomach,and to discuss the objective evidence of central differences in different TCM syndrome.Methods:38FD patients were included(20patients with liver-stomach disharmony syndrome and 18patients with deficiency of spleen and stomach).The dyspepsia symptom score,NDI and emotion scale were used to evaluate the patient's condition.The patients in each group underwent a resting-state functional magnetic resonance imaging scan,and the data were analyzed and processed by ReHo analysis method to compare the differences of resting-state brain functional activities between the two types of FD patients.Results:Compared with deficiency of spleen and stomach,the scores of SAS,SDS and emotion scale were significantly higher in FD patients with liver-stomach disharmony syndrome(P<0.05),and there was no statistically significant difference in the trait anxiety scale score(P<0.05).Bilateral thalamus,ACC,PCC,hippocampus,superior frontal gyrus;right brainstem,caudatenucleus,supplemental motor area,left straight gyrus,central posterior gyrus and other brain regions of local coherence increased(P<0.005);Bilateral wedges,cerebellum,MCC,centralanterior gyrus,right central posterior gyrus,left insula,supplementary motor area and other brain regions decreased(P<0.005).Conclusion:The brain region dominated by the limbic system is the main cerebral functional activity difference between two group of FD patients,suggesting that the“emotional brain region”dominated by the liver is the central difference between liver-stomach disharmony syndrome and deficiency of spleen and stomach.

关 键 词：功能性消化不良 证型 脑功能 静息态 

分 类 号：R57[医药卫生—消化系统]