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[头皮电针治疗对帕金森病患者脑内多巴胺转运体的影响]

[Effects on electro-scaip acupuncture on cerebral dopamine transporter in patients with Parkinson' s disease].

作者信息

Huang Yong, Jiang Xue-mei, Li Dong-jiang

机构信息

School of Traditional Chinese Medicine, Southern Medical University, Guangzhou.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2006 Apr;26(4):303-7.

Abstract

OBJECTIVE

To investigate the effect of electro-scalp acupuncture (ESA) on dopamine transporter (DAT) in basal ganglia (BG) of patients with Parkinson's disease (PD) by single photon emission computed tomography (SPECT).

METHODS

Ten patients with primary PD were divided equally into two groups randomly. Patients in the treated group received ESA at points of MS6, MS4, MS8, MS9 and MS14, for patients with unilateral lesions, ESA was applied on contralateral points, while for those with bilateral lesions, points of both sides were stimulated, the depth of puncturing was made to arrive at the galea aponeurotica. Patients in the control group took medopa orally in the dosage of 125 mg, 3 times per day for mild, 250 mg, 3 times per day for moderate and 250 mg, 4 times per day for severe cases. All the patients were examined with 99mTc-TRODAT- 1 SPECT before and after 6 weeks' treatment to analyze the activity of DAT by ratio of basal ganglia/occipital (BG/OC) using regional of interesting (ROI) technique.

RESULTS

The uptake of 99mTc-TRODAT-1 increased after treatment in both groups. In the treated group, the homolateral (of the affected limbs, the same below) BG/OC ratios before and after treatment were 1.1883 +/- 0.1471 and 1.2416 +/- 0.3146 respectively, and those in the control group 1.1597 +/- 0.0568, 1.2053 +/- 0.1153, showing no significant difference between them (P > 0.05); while the contralateral BG/OC ratios before and after treatment were 0.9019 +/- 0. 1210 and 0.9496 +/- 0.2522 respectively in the treated group, and 1.0436 +/- 0.1393 and 1.2972 +/- 0.2612 respectively in the control group. The difference value of contralateral BG/OC before and after treatment in the control groups was significantly different (P<0.05). But at other cerebral regions, 99mTc-TRODAT-1 SPECT showed no difference between the two groups in changes before and after treatment, therefore, showed no difference in effect of improving DAT between the two groups (P > 0.05).

CONCLUSION

ESA could reduce the loss of DAT in basal ganglia and improve its activity in patients with PD to protect the dopamine neuron, so as to delay the progression of PD and alleviate clinical symptoms of patients.

摘要

目的

采用单光子发射计算机断层扫描(SPECT)技术,探讨头皮电针(ESA)对帕金森病(PD)患者基底节(BG)区多巴胺转运体(DAT)的影响。

方法

将10例原发性PD患者随机均分为两组。治疗组患者于MS6、MS4、MS8、MS9和MS14穴位行头皮电针治疗,单侧病变者取对侧穴位,双侧病变者双侧穴位均予刺激,进针深度达帽状腱膜。对照组轻度患者口服美多巴125mg,每日3次;中度患者口服250mg,每日3次;重度患者口服250mg,每日4次。所有患者在治疗6周前后均行99mTc-TRODAT-1 SPECT检查,采用感兴趣区(ROI)技术,通过基底节/枕叶(BG/OC)比值分析DAT活性。

结果

两组治疗后99mTc-TRODAT-1摄取均增加。治疗组患侧(患侧肢体同侧,下同)治疗前后BG/OC比值分别为1.1883±0.1471和1.2416±0.3146,对照组分别为1.1597±0.0568、1.2053±0.1153,两组比较差异无统计学意义(P>0.05);治疗组对侧治疗前后BG/OC比值分别为0.9019±0.1210和0.9496±0.2522,对照组分别为1.0436±0.1393、1.2972±0.2612,对照组对侧治疗前后BG/OC差值有统计学意义(P<0.05)。但在其他脑区,99mTc-TRODAT-1 SPECT显示两组治疗前后变化无差异,即两组改善DAT的效果无差异(P>0.05)。

结论

头皮电针可减少PD患者基底节区DAT的丢失,提高其活性,保护多巴胺能神经元,从而延缓PD进展,减轻患者临床症状。

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