本文選題：抑郁癥 + 肝郁型��； 參考：《北京中醫(yī)藥大學(xué)》2014年碩士論文

【摘要】：背景：抑郁癥(depression)是情感障礙的一種,多表現(xiàn)為心境低落、思維遲緩、行為減少的“三低”癥狀,是人群中最為常見的精神障礙之一,它發(fā)生于全球各國(guó)、社會(huì)各階層和各種環(huán)境的各類人群中。目前全世界約有3.4億人受其影響。在此刻,至少有1/50低于12歲的兒童、1/20的青少年、1/10的男性和1/4的女性成人曾經(jīng)或正在發(fā)生抑郁障礙。近幾年來(lái),對(duì)于抑郁癥發(fā)病機(jī)理的研究,抑郁癥病人的腦功能影像學(xué)改變逐漸成為熱點(diǎn)。國(guó)內(nèi)外學(xué)者利用fMRI技術(shù)也取得了一定成果,發(fā)現(xiàn)抑郁癥是某些腦區(qū)代謝障礙所致,額葉、杏仁核、扣帶回等處的功能障礙與抑郁有關(guān)。但是在中醫(yī)方面,中醫(yī)治療抑郁癥是根據(jù)辨證分型進(jìn)行分證論治,證型的差異是否也會(huì)存在腦功能影像學(xué)方面的差異?各證型的功能影像學(xué)與中醫(yī)理論基礎(chǔ)又有什么聯(lián)系?都亟需我們深入研究。 目的：對(duì)肝郁型中度抑郁癥患者與正常對(duì)照組進(jìn)行fMRI,并通過(guò)面孔表情識(shí)別研究,比較腦功能區(qū)激活情況,從而完成肝郁型抑郁癥患者與正常人的腦功能影像學(xué)差異的研究。 方法：利用3.0T功能核磁共振成像系統(tǒng)觀察15例肝郁型患者和15例正常受試者,在識(shí)別恐懼、憤怒、高興、中性四類情緒面孔時(shí)的腦功能激活反應(yīng),并比較兩組間的差異。本研究中行為數(shù)據(jù)通過(guò)SPSS13軟件分析,腦功能圖像數(shù)據(jù)經(jīng)SPM8軟件處理和統(tǒng)計(jì)分析,獲得腦區(qū)激活圖。 結(jié)果：1.肝郁型抑郁癥患者在反應(yīng)時(shí)間、面孔表情識(shí)別正確率方面與正常組無(wú)顯著差異。2.肝郁型抑郁癥患者在識(shí)別憤怒與中性面孔時(shí),雙側(cè)杏仁核、雙側(cè)扣帶回比正常對(duì)照組腦血流量活動(dòng)增強(qiáng),而背外側(cè)前額皮質(zhì)較正常對(duì)照組活動(dòng)減弱3.肝郁型抑郁癥患者在識(shí)別恐懼與中性面孔時(shí),雙側(cè)杏仁核比正常對(duì)照組腦血流量活動(dòng)增強(qiáng)。4.肝郁型抑郁癥患者在識(shí)別高興與中性面孔時(shí)：雙側(cè)額上回及左側(cè)殼核較正常對(duì)照組腦血流量活動(dòng)過(guò)度激活。 結(jié)論：1.肝郁型抑郁癥患者在識(shí)別憤怒面孔時(shí),雙側(cè)杏仁核、雙側(cè)扣帶回較正常人激活顯著,背外側(cè)前額皮質(zhì)較正常人激活減弱。因?yàn)樾尤屎�、扣帶回管理憤怒情緒,因此肝郁患者相應(yīng)腦區(qū)激活,為“肝在志為怒”的中醫(yī)理論提供了腦影像學(xué)基礎(chǔ)。2.肝郁型抑郁癥患者在識(shí)別恐懼面孔時(shí),雙側(cè)杏仁核較正常人激活顯著。因?yàn)樾尤屎伺c恐懼情緒的識(shí)別有關(guān),負(fù)責(zé)負(fù)性情緒的管理,符合“肝氣虛則恐實(shí)則怒”的理論。3.肝郁型抑郁癥患者在識(shí)別高興面孔時(shí),雙側(cè)額上回及左側(cè)殼核較正常人激活顯著。額上回與殼核是與認(rèn)知功能有關(guān)的腦區(qū),中醫(yī)理論中人的認(rèn)知功能是由心神決定的,“肝藏魂,主謀慮”,肝郁型抑郁癥患者肝主謀慮功能下降,為了完成正常的認(rèn)知活動(dòng),則需要心神代償能力的增強(qiáng),表現(xiàn)為認(rèn)知腦區(qū)的激活,符合中醫(yī)觀點(diǎn)。4.研究提示中醫(yī)“肝”在情志調(diào)節(jié)方面可能與邊緣環(huán)路中的杏仁核、扣帶回相關(guān),中醫(yī)肝氣虛、肝郁等癥候可能是邊 緣環(huán)路中的杏仁核、扣帶回功能的異常表現(xiàn)。
[Abstract]:Background: depression (depression) is one of the affective disorders. It is characterized by low mood, slow thinking, and reduced behavior of "three low" symptoms. It is one of the most common mental disorders in the population. It occurs in all the countries of the world, all classes of society and all kinds of environment. At present, about 340 million people all over the world are affected by it. At least 1/50 children under 12 years of age, 1/20 teenagers, 1/10 men and 1/4 female adults have been or are depressive disorders. In recent years, the brain functional imaging changes of depression patients have gradually become hot spots in the study of the pathogenesis of depression. The domestic and foreign researchers have also achieved some results with fMRI technology and found depression. The dysfunction of the frontal, amygdala and cingulate gyrus is related to depression in some brain areas. But in traditional Chinese medicine, Chinese medicine treatment of depression is based on syndrome differentiation and differentiation, whether the difference of syndrome type also exists in the imaging of brain function? Functional imaging and theoretical basis of traditional Chinese Medicine What's the connection? We need to study deeply.
Objective: to carry out fMRI in patients with depression of liver depression and normal control group, and to compare the activation of brain function area by facial expression recognition, so as to complete the study of brain functional imaging differences between depression patients with liver depression and normal people.
Methods: the 3.0T functional magnetic resonance imaging system was used to observe the brain function activation responses of 15 patients with liver depression and 15 normal subjects in identifying the four emotional faces of fear, anger, happiness and neutral. The difference between the two groups was compared. The behavioral data in this study were analyzed by SPSS13 software and the brain function image data were processed by SPM8 software. And statistical analysis, the activation map of the brain area was obtained.
Results: 1. in patients with depression of liver depression, there was no significant difference in the response time, the correct rate of facial expression recognition was not significantly different from that of the normal group..2. liver depression patients with depressed and neutral faces, bilateral amygdala, bilateral cingulate gyrus increased more than the normal control group, while the dorsolateral prefrontal cortex was less active than the normal control group. In the identification of fear and neutral face in the weak 3. depressive patients, the bilateral amygdala, compared with the normal control group, increased the activity of.4. liver depression in identifying the happy and neutral faces: the activation of the cerebral blood flow activity in the bilateral frontal and left putamen compared with the normal control group.
Conclusion: 1. during the identification of angry faces, bilateral amygdala and bilateral cingulate gyrus were significantly activated and the lateral prefrontal cortex was less activated than normal people. The amygdala and cingulate cortex managed anger, so the corresponding brain areas of the liver depression were activated, providing a brain shadow for the Chinese theory of "liver in Zhi Wrath". When identifying fear faces, the bilateral amygdala is more significant than normal people in identifying fear faces. Because the amygdala is related to the recognition of the fear mood, the management of the negative emotion is responsible for the management of the negative emotion, which is in line with the theory of "liver qi deficiency and the fear of real anger". The.2. liver depression type depression patients have both the upper and the left frontal gyrus and the left side when identifying the happy faces. The putamen is more significant than that of the normal person. The upper frontal gyrus and the putamen are the brain areas related to the cognitive function. The cognitive function of people in Chinese medicine theory is determined by the mind, "the liver is hidden in the soul, the master is concerned", the liver depression of the depressed patients with liver depression is reduced. In order to complete the normal cognitive activity, it needs the enhancement of the mental compensatory ability, which is manifested as cognition. The activation of the brain area is in accordance with the.4. study of traditional Chinese medicine. It is suggested that the "liver" in Chinese medicine may be related to the amygdala and cingulate gyrus in the edge loop. The syndrome of liver qi deficiency and liver depression may be the side of the TCM.
The abnormality of the cingulate gyrus function in the amygdala.

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R277.7;R445.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 肖怡;趙志付;;中醫(yī)對(duì)抑郁癥的認(rèn)識(shí)和治療概述[J];北京中醫(yī)藥;2008年09期

2 胡隨瑜,張宏耕,鄭林,張海男,陳澤奇,陳昌華,趙志付,王新本,劉發(fā)榮,李順民,黃信初,俸建林,張捷;1977例抑郁癥患者中醫(yī)不同證候構(gòu)成比分析[J];中國(guó)醫(yī)師雜志;2003年10期

3 方向軍;劉軍;朱仁勇;康卯吉;伍中華;湯永紅;湯艷清;龍響云;;首發(fā)重性抑郁癥患者面部表情刺激的腦功能磁共振研究[J];醫(yī)學(xué)臨床研究;2008年10期

4 張良棟;張亞莉;徐聲漢;周剛;金舒白;;情感性精神障礙的中醫(yī)分型及治療[J];上海精神醫(yī)學(xué);1990年01期

5 曲淼,唐啟盛;抑郁癥與中醫(yī)“郁證”的關(guān)系探討[J];北京中醫(yī)藥大學(xué)學(xué)報(bào);2004年01期

6 章洪流,王天芳,郭文,田潤(rùn)萍,馬玉平;抑郁癥中醫(yī)證型的近10年文獻(xiàn)分析[J];北京中醫(yī)藥大學(xué)學(xué)報(bào);2005年03期

7 丁德正;;肝氣虛則恐實(shí)則怒[J];遼寧中醫(yī)雜志;1989年10期

8 鄒海寧,王新素;關(guān)于隱匿性抑郁癥的診斷[J];山東精神醫(yī)學(xué);1999年04期

9 李東明;黃曉琦;吳杞柱;鄒可;孫學(xué)禮;龔啟勇;;抑郁癥的靜息態(tài)腦功能磁共振研究[J];生物醫(yī)學(xué)工程學(xué)雜志;2010年01期

10 楊林;論肝郁與抑郁癥[J];陜西中醫(yī);2000年06期

，

本文編號(hào)：1854867