运脾柔肝方治疗便秘型肠易激综合征疗效观察及基于rs-fMRI脑区活动水平变化的研究
Study on the Clinical effect of Yunpi Rougan Formula in Treating Irritable Bowel Syndrome with Constipated and Research on Changes in Brain Ac-tivity Levels Based on Rs-fMRI
章细霞 1丁雪菲 1滕剑 2李慧 1顾超 1魏兰福 1潘程宇1
作者信息
- 1. 南京中医药大学附属中西医结合医院消化科,南京 210028
- 2. 南京中医药大学附属中西医结合医院放射科,南京 210028
- 折叠
摘要
目的:观察运脾柔肝方治疗肝郁气滞型便秘型肠易激综合征(IBS-C)的临床疗效,运用静息态功能性磁共振(rs-fMRI)观察IBS-C患者的脑区活动水平变化.方法:选取我院门诊43例IBS-C患者,评价运脾柔肝方的临床疗效.选取20例健康受试者,观察IBS-C患者及健康受试者脑区活动水平差异.进行焦虑、抑郁评估,观察伴与不伴焦虑抑郁状态的患者脑区活动水平的差异.观察IBS-C患者治疗前后脑区活动水平差异.结果:治疗组与对照组治疗均有效(P>0.05).治疗组患者经治疗后SAS和SDS评分均降低(P<0.05).对照组患者经治疗后SAS评分降低(P<0.05).静息状态下,IBS-C组患者左舌回的脑区活动水平升高,左额下回、右额中回的脑区活动水平降低(P<0.05).伴焦虑抑郁情绪的IBS-C患者右额下回的脑区活动水平较不伴有焦虑抑郁情绪的患者升高(P<0.05).治疗后IBS-C患者左顶叶中央后回、左侧距状裂周围皮层的脑区活动水平降低,小脑的脑区活动水平升高(P<0.05).结论:运脾柔肝方可有效缓解IBS-C患者的临床症状,改善焦虑、抑郁情绪.在静息状态下,IBS-C患者大脑的特定区域活动异常,说明大脑的某些特定区域和相应网络的自发神经元活动的变化可能与IBS-C的病理生理密切相关.
Abstract
Objective:To observe the clinical efficacy of Yunpi Rougan Formula in treating IBS-C of liver depression and Qi stagnation type.Adopt the method of resting-state functional MRI to observe the changes in brain activity levels in patients with IBS-C.Methods:A total of 43 IBS-C patients who were treated in the Outpatient Department of Gastroenterology of Jiangsu Provincial Hospital of Integrated Tradi-tional Chinese and Western Medicine were selected.20 healthy subjects were selected.To evaluate the clinical efficacy of Yunpi Rougan Formula.To observe the difference of brain activity level between IBS-C patients and healthy subjects.IBS-C patients were evaluated for anxiety and depression,and observe the differences of brain activity levels between IBS-C patients with anxiety and depression and those without anxiety and depression were observed.To observe the difference of brain activity level before and after IBS-C treatment.Results:Comparison of clinical efficacy:Both the treatment group and control group were effective(P<0.05).After treatment,the scores of SAS and SDS in treatment group were significantly re-duced(P<0.05).The SAS score of the control group was lower than that before treatment(P<0.05).In the resting-state,the brain activity level in left lingual gyrus in IBS-C group was significantly increased,and the brain activity level in left Inferior frontal gyrus and right middle frontal gyrus in IBS-C group was sig-nificantly reduced(P<0.05).The brain activity level of IBS-C patients with anxiety and depression in the right inferior frontal gyrus was significantly higher than that of IBS-C patients without anxiety and depres-sion(P<0.05).After treatment,the brain activity level of IBS-C patients in left parietal lobe central pos-terior gyrus and cortical layer around the left talus fissure was significantly reduced,and the brain activity in cerebellum was significantly increced(P<0.05).Conclusion:Yunpi Rougan Formula can effectively re-lieve the clinical symptoms of IBS-C patients,significantly improve the anxiety and depression of patients.In the resting-state,specific areas of the brain of IBS-C patients are abnormally active,indicating that changes in spontaneous neuronal activity in certain specific regions and corresponding networks of the brain may be related to the pathophysiology of IBS-C.
关键词
便秘型肠易激综合征/静息态功能性磁共振/运脾柔肝方/脑-肠轴/脑区活动水平Key words
Irritable bowel syndrome with constipation/Resting-state functional magnetic resonance imaging/Yunpi Rougan Formula/Brain-gut axis/Brain activity level引用本文复制引用
基金项目
国家中医临床研究基地开放课题资助(JD2019SZXYB06)
江苏省中医护理骨干人才高级研修项目(苏中医科教[2022]10号)
田耀洲江苏省名老中医药专家传承工作室(20SGZS003)
中医消化领域优势病种(肠易激综合征)专科专病循证能力提升(2019XZZX-XH007)
出版年
2024
NETL
NSTL
万方数据