| 陈嫣,于恩彦,苏衡,等.复方海蛇胶囊干预轻度认知功能障碍患者的静息态脑功能局部一致性分析[J].浙江中医药大学学报,2020,44(9):837-844, 857. |
| 复方海蛇胶囊干预轻度认知功能障碍患者的静息态脑功能局部一致性分析 |
| Focal Consistent Analysis on Brain Function in Resting State of Mild Cognitive Impairment Patients Intervened by Compound Sea Cucumber Capsule |
| DOI：10.16466/j.issn1005-5509.2020.09.003 |
| 中文关键词: 轻度认知功能障碍 复方海蛇胶囊 静息态功能磁共振 局部一致性 神经心理学评估 药理机制 临床研究 |
| 英文关键词: mild cognitive impairment Compound Sea Cucumber Capsule resting-state functional magnetic resonance regional homogeneity neuropsychological assessment pharmacological mechanism clinical trials |
| 基金项目:国家自然科学基金面上项目(81771158)；浙江省中医药科技计划项目(2017ZA005)；浙江省医药卫生科技计划面上项目(2020KY405) |
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| 中文摘要: |
| [目的]探索轻度认知功能障碍(mild cognitive impairment，MCI)患者基于局部一致性(regional homogeneity，ReHo)的脑自发活动异常模式，并探究复方海蛇胶囊治疗MCI的疗效及潜在的脑功能药理机制。[方法]分别对入组的15例MCI患者及15例健康对照组受试者行静息态功能磁共振(resting-state functional magnetic resonance imaging，rs-fMRI)扫描，获取基线的影像数据，并对MCI患者进行智能以及日常生活能力量表评估，予单药复方海蛇胶囊口服治疗，0.9g/次，3次/d，于第6个月末再次对患者进行上述神经心理量表、不良反应的评估以及rs-fMRI扫描。分别比较健康对照组与MCI患者以及MCI患者治疗前后的神经心理评分和ReHo的差异。[结果]与健康对照组比较，基线时MCI患者右侧岛叶的ReHo值增高(P＜0.01，体素≥29)，左侧楔前叶以及右侧中央后回的ReHo值降低(P＜0.01，体素≥29)。基线时MCI患者的简易智力状态检查(mini-mental state examination，MMSE)量表评分与左侧楔前叶的标准化ReHo值呈正相关(P＜0.05，r=0.705)，蒙特利尔认知评估(Montreal cognitive assessment，MoCA)量表评分与左侧楔前叶(P＜0.01，r=0.782)以及右侧中央后回(P＜0.05，r=0.586)的标准化ReHo值呈正相关。治疗第6个月末，MCI患者的MMSE评分以及MoCA评分明显改善(P＜0.01，P＜0.01)；MCI患者左侧楔前叶的ReHo值高于基线水平(P＜0.01，体素≥29)，变化差值与MoCA评分差值呈正相关(P＜0.01，r=0.725)，其余脑区未见明显改变。[结论]MCI患者在左侧楔前叶、右侧中央后回以及右侧岛叶存在ReHo改变。复方海蛇胶囊能够明显改善MCI患者的总体认知水平，并且与左侧楔前叶的ReHo存在相关性。 |
| 英文摘要: |
| [Objective] To observe the clinical effect and brain function mechanism of Compound Sea Cucumber Capsule on mild cognitive impairment(MCI) by using regional homogeneity(ReHo) to explore the abnormal spontaneous brain activity patterns of MCI patients.[Methods]Fifteen MCI patients and 15 healthy control went through the baseline imaging data using resting-state functional magnetic resonance imaging(rs-fMRI)， and neuropsychological assessment was performed for MCI patients. Au the MCI patients were treated with Compound Sea Cucumber Capsule， 0.9g each time， 3 times perday for 6 months. At the end of 6 months of the treatment， neuropsychological assessment was evaluated again for all the MCI patients， as well as the scanning of rs-fMRI. The difference of neuropsychological assessment and ReHo were compared in healthy controls and MCI patients， and the MCI patients before and after treatment.[Results]At the baseline， MCI patients showed increased ReHo in the right insular lobe(P＜0.01，Voxel≥29)， and decreased ReHo in the left precuneus and right postcentral gyrus compared with healthy control(both P＜0.01，Voxel≥29). In MCI patients， mini-mental state examination(MMSE) scores(P＜0.05，r=0.705) and Montreal cognitive assessment(MoCA) scores(P＜0.01， r=0.782) were positively correlated with the standard ReHo value of left precuneus， and MoCA scores were positively correlated with standardized ReHo value of right postcentral gyrus(P＜0.05， r=0.586).The MMSE score of MCI patients and MoCA score were significantly improved at the end of 6 month after treated with Compound Sea Cucumber Capsule(P＜0.01， P＜0.01); MCI patients had an more increased ReHo value than baseline in the left precuneus(P＜0.01，Voxel≥29)， and was positively correlated with D-value of MoCA(P＜0.01，r=0.725).[Conclusion]MCI patients showed impaired ReHo in the right insular lobe， left precuneus and right postcentral gyrus. After the treatment of compound Sea Cucumber Capsule， MCI patients have an increased ReHo value and the ReHo value is positively correlated with D-value of MoCA. |
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