针刺治疗儿童孤独症单光子发射计算机断层成像术可视化研究

作者	单位
贾少微	北京大学深圳医院核医学科
孙涛涛	北京大学深圳医院核医学科
樊蓉	北京大学深圳医院核医学科
高宙	北京大学深圳医院核医学科
胡疏	北京大学深圳医院核医学科
陈清	北京大学深圳医院核医学科

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中文摘要:

目的为针刺治疗儿童孤独症提供分子影像学的依据。方法34例儿童孤独症患儿,ABC行为量表测试>57分。电针穴位为双侧合谷、曲池、足三里和三阴交穴。采用SIEMENS ECAM/ICON双探头单光子发射计算机断层成像术(single photon emission computed tomography,SPECT)系统,进行针前和电针中2次SPECT脑灌注显像;显像剂为99m锝双半胱乙酯(99mTc-ECD);对SPECT影像进行视觉和定量分析。结果视觉分析显示,34例患儿针刺前可见114处局灶性脑血流灌注和功能低下区,其中28例同时显现左侧(或者双侧)额叶前部、左侧语言运动区(Broca)和左侧颞叶听语言区(Wernicke)异常,占患儿总数的82.35%。电针时上述病灶区皆有不同程度的增高。定量分析显示,针刺前病灶Ff和镜侧Ff差异显著(P<0.01);针刺前病灶Ff和电针时病灶Fe差异显著(P<0.01);病灶BFCR%和镜侧BFCR%差异非常显著(P<0.01)。脑血流灌注和脑功能改善情况显示,电针显效为78.95%。结论初步证明针刺治疗儿童孤独症有疗效。

英文摘要:

Objective To provide the molecular iconographic evidence for acupuncture treatment of children autism(CA).Methods Electric acupuncture(EA)was applied on acupoints of bilateral Hegu(LI4),Quchi(LI11),Zusanli(ST36)and Sanyinjiao(SP6)in 34 CA patients’ with ABC scale > 57 scores.Using SIEMENS ECAM /ICON double head system,single photon emission computed tomography(SPECT)brain perfusion imaging were performed before and during EA with 99mTc-ECD.Then SPECT images were analyzed visually and quantitatively.Results Visual analysis showed that 114 foci of low cerebral perfusion and function were found in 34 CA patients before EA,28 cases(82.35%)of them with abnormalities in left(or both)front lobes,left Broca area and left Wernicke area.During EA,the affected areas improved to different extent.Quantitative analysis showed that significant difference existed between pre-EA focal Ff and mirror-side Ff,pre-EA Ff and mid-EA Fe,focal BFCR% and mirror-side BFCR%(all P<0.01).The improving analysis of cerebral perfusion and function showed that the efficacy of EA was 78.95%.Conclusion Acupuncture was proved preliminarily effective in treating children autism.

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