舒肝解郁胶囊对轻中度抑郁症疗效的静息态功能磁共振低频振幅研究  

Alterations of amplitude of low frequency fluctuation in patients with mild to moderate depression treated with Shugan Jieyu capsules:a resting-state functional magnetic resonance imaging study

作　　者：李婧[1] 姚冠群 李曜均 刘莎[1] 李忻蓉[1] 徐勇[3] Li Jing;Yao Guanqun;Li Yaojun;Liu Sha;Li Xinrong;Xu Yong(Department of Psychiatry,First Hospital/First Clinical Medical College of Shanxi Medical University,Taiyuan 030001,China;School of Clinical Medicine,Tsinghua University,Beijing 100091,China;Department of Clinical Psychology,The Eighth Affiliated Hospital,Sun Yat-Sen University,Shenzhen 518033,China)

机构地区：[1]山西医科大学第一医院/第一临床医学院精神卫生科,太原030001 [2]清华大学临床医学院,北京100091 [3]中山大学附属第八医院临床心理科,深圳518033

出　　处：《中华行为医学与脑科学杂志》2024年第4期303-309,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金(81971601,82371511,82271546);山西省基础研究计划项目(202203021211018);山西省科技创新人才团队(202304051001049);山西医科大学第一医院院基金项目(YQ2204);山西省"136兴医工程"。

摘　　要：目的:采用静息态功能磁共振低频振幅(amplitude of low-frequency fluctuation,ALFF)探讨舒肝解郁胶囊对轻中度抑郁症(mild to moderate depression,MMD)的疗效及其机制。方法:2017年6月至2019年12月,选取45例MMD患者(患者组)和45例健康对照者(对照组),患者组服用舒肝解郁胶囊8周,对照组8周内不服用任何精神类药物。在基线和8周后分别收集所有被试的汉密尔顿抑郁量表24项(Hamilton depression scale 24 items,HAMD-24)和功能磁共振成像数据。使用SPSS 19.0软件和DPABI工具包进行统计分析,采用两因素重复测量方差分析和广义估计方程比较患者组和对照组的量表分数和ALFF值的变化。结果:(1)两组治疗前后HAMD-24评分交互效应显著(χ^(2)=96.446,P<0.001);经过8周治疗后,患者组HAMD-24分数较基线降低[5.00(6.50)分,(15.44±5.87)分](χ^(2)=120.657,P<0.001)。(2)两组治疗前后右侧颞中回和右侧额上回ALFF值交互效应显著(F=36.445,36.122,19.015,22.713,均P<0.05);简单效应分析显示,患者组右侧颞中回和右侧额上回的ALFF值在基线期显著高于对照组(均P<0.05),服药8周后较基线期显著降低(均P<0.05)。(3)两组治疗前后左侧顶上回ALFF值交互效应显著(F=36.193,P<0.001);简单效应分析显示,患者组左侧顶上回的ALFF值在基线期显著低于对照组(0.352±0.366,0.556±0.443),服药8周后较基线期显著升高(P<0.05)。(4)两组治疗前后左侧颞上回ALFF值交互效应显著(F=18.059,P<0.001);简单效应分析显示,患者组左侧颞上回ALFF值在基线期低于对照组(0.514±0.887,0.930±1.049)(P<0.05),服药8周后患者组与对照组相比差异无统计学意义(P>0.05)。(5)两组治疗前后右侧内侧扣带回ALFF值交互效应显著(F=20.152,P<0.001),患者组右侧内侧扣带回ALFF值服药8周后较基线期显著降低(-0.549±0.238,0.089±0.320)(P<0.05)。结论:舒肝解郁胶囊可能通过改变MMD患者右侧额上回、右侧颞中回、左侧颞上回、右侧内侧Objective To explore the therapeutic efficacy and underlying mechanism of Shugan Jieyu capsules on mild to moderate depression(MMD)by the amplitude of low-frequency fluctuations(ALFF)of resting-state functional magnetic resonance imaging(fMRI).Methods From June 2017 to December 2019,a total of 45 MMD patients(the patient group)and 45 healthy individuals(the control group)were recruited.The patients in patient group underwent an 8-week treatment regimen with Shugan Jieyu capsules,and the patients in control group did not take any psychotropic medication for the same duration.All participants underwent assessment by 24-item Hamilton depression scale(HAMD-24)and fMRI scans at baseline and 8 weeks later.Statistical analysis was conducted by SPSS 19.0 and DPABI softwares.Two-way repeated measurement analysis of variance and generalized estimating equations were used to compare the changes in HAMD-24 scores and ALFF values between the patient group and control group.Results(1)A significant interaction effect was found in the HAMD-24 scores between the two groups before and after treatment(χ^(2)=96.446,P<0.001).Simple effect analysis showed that after 8 weeks of treatment,HAMD-24 scores were lower in the patient group than at baseline(5.00(6.50),(15.44±5.87))(χ^(2)=120.657,P<0.001).(2)Significant interaction effects were found in the ALFF values of the right middle temporal gyrus and right superior frontal gyrus between the two groups before and after treatment(F=36.445,36.122,19.015,22.713,all P<0.05).Simple effect analysis showed that the ALFF values of the right middle temporal gyrus and right superior frontal gyrus in the patient group were significantly higher than those in the control group at baseline(both P<0.05),and significantly decreased after 8 weeks of treatment in both groups(both P<0.05).(3)A significant interaction effect was found in the ALFF values of the left superior parietal gyrus between the two groups before and after treatment(F=36.193,P<0.05).Simple effect analysis showed that the ALFF value

关 键 词：抑郁症 舒肝解郁胶囊 低频振幅 功能磁共振成像 

分 类 号：R749.4[医药卫生—神经病学与精神病学]