【作者】 金京南；

【导师】 李跃华；

【作者基本信息】 中国中医科学院 ， 中医内科学， 2010， 硕士

【摘要】 目的通过高级脑电神经递质分析(SET)系统脑功能检测,可对抑郁症患者脑内神经递质如5-羟色胺、乙酰胆碱、多巴胺、去甲肾上腺素、抑郁递质(Y-氨基丁酸、甘氨酸等)、兴奋递质(谷氨酸等)等功能变化检测分析,为抑郁症的诊断提供客观依据。通过研究,找出抑郁症患者与正常人之间的S-ET差异、不同中医证型与正常人之间的S-ET的差异分析以及不同中医证型之间的S-ET的差异分析。探索神经递质之间的平衡失调情况。由此为抑郁症患者S-ET分析对于抑郁症诊断及中医辨证分型提供可行的客观指标,对于抑郁症的发病机制提供客观性依据。方法收集抑郁症患者244例,均符合诊断筛选标准。正常人为71例,为符合选择标准。抑郁症患者以相关症状分为肝郁气滞型、肝郁脾虚型、肝郁痰阻型、心脾两虚型、心肾不交型。对抑郁症患者和正常人进行脑功能S-ET检测。所获得数据运用统计软件SPSS13.0进行统计分析。结果1.抑郁症患者的5-HT(P<0.01)、ACH(P<0.05)、DA(P<0.01)、NE(P<0.01)、EXC(P<0.01)五种神经递质功能明显低于正常人。2.抑郁症患者各神经递质功能低于正常人均值的S-ET比较肝郁气滞型：5-HT(P<0.05)、ACH(P<0.01)、DA(P<0.05)、NE(P<0.01)、EXC(P<0.05)递质功能明显低于正常(P<0.05)。以ACH占76%,NE占74%为主。肝郁脾虚型：5-HT(P<0.05)、DA(P<0.01)、NE(P<0.05)递质功能明显低于正常(P<0.05)。以DA占70.21%,5-HT占61.7%为主。肝郁痰阻型：5-HT(P<0.01)、DA(P<0.01)、NE(P<0.05)、EXC(P<0.05)递质功能明显低于正常(P<0.05)。以DA占81.13%,5-HT占75.47%为主。心脾两虚型：DA(P<0.05)、EXC(P＜0.05)递质功能明显低于正常(P＜0.05)以DA占75.61%,EXC占63.41%为主。心肾不交型：5-HT(P<0.05)、DA(P<0.05)递质功能明显低于正常(P<0.05)以5-HT占62.26%,DA占62.26%为主。3.抑郁症神经递质功能高于正常人均值的S-ET比较肝郁气滞型：各神经递质功能高于正常人的百分率：5-HT占44%、ACH占24%、DA占34%、NE占26%、EXC占36%。以5-HT占44%,EXC占36%为主。肝郁脾虚型：各神经递质功能高于正常人的百分率：5-HT占38.3%、DA占29.79%、NE占40.43%。以NE占40.43%,5-HT占38.3%为主。肝郁痰阻型：各神经递质功能高于正常人的百分率：INH递质功能明显高于正常(P<0.05)占67.92%；5-HT占24.53%、DA占18.87%、NE占32.08%、EXC占32.08%。以INH占67.92%,NE、EXC均占32.08%为主。心脾两虚型：各神经递质功能高于正常人的百分率：DA占24.39%、EXC占36.59%。心肾不交型：各神经递质功能高于正常人的百分率：5-HT占37.74%,DA占37.74%。4.各中医证型之间的S-ET比较：肝郁气滞型的ACH功能(0.01±11.53)明显低于心脾两虚型(7.22±11.36)(P<0.01)、心肾不交型(5.16±11.49)(P<0.05)5.5-HT与DA,ACH与NE两组神经递质的平衡失调情况研究5-HT与DA,ACH与NE两组神经递质均呈正相关关系(P<0.01)。患者的5-HT与DA相差值(7.62±2.34)与正常人(5.66±4.51)明显有差异(P<0.01),相差值大于正常人占31.15%；患者的ACH与NE相差值(10.97±4.2)与正常人(9±5.75)明显有差异,占31.56%(P<0.01)结论1.抑郁症患者的脑功能S-ET表现与正常人不同,抑郁症发病与神经递质的功能低下有关。但是,发现患者神经递质中也有功能亢进的,认为抑郁症患者不是某神’经递质功能的一律下降或一律增强引起的。2.不同中医证型的脑功能S-ET表现与正常人明显有差异。3.抑郁症患者不同中医证型的脑功能各异。4.抑郁症患者5-HT与DA、ACH与NE存在相互制约的关系,5-HT与DA、ACH与NE相差值明显大于正常人,可认为5-HT与DA、ACH与NE的平衡失调也是发生抑郁症的因素之一。更多还原

【Abstract】 ObjectiveSET (SuPPer EEG Technology) system is used to brain function tests. Patients with depr-ession are used to test and neurotransmitters such as 5-HT, acetylcholine, dopamine, norepinephrine, depression neurotransmitters(γ-aminobutyric acid, glycine, etc.), excited neurotransmitters (glutamate, etc)are examined. Neurotransmitters in depression patients and normal subjects are examined and compared, Traditional Chinese Medicine (TCM) types and its correlation were compared. This study is to identify the differences of S-ET between patients and normal people, to identify the differences of S-ET between different TCM types and normal people, to identify the differences of S-ET between different TCM types. Also this study tested the balance between DA and 5-HT, ACH and NE. Wish to provide an objective reference for the diagnosis of depression and treatment determination based on TCM Syndrome differentiation, TCM theory can be used to explain mechanism of depression.MethodCollect the 244 depression patients totally. There are 71 ordinary person in compari-son group. Measure the depression patients and the normal person’s S-ET, deal with the data by SPSS 13.0 statistics software.Result:1. Contrast with the normal man, depression patient’s 5-HT(P<0.01), ACH (P<0.05), DA (P<0.01), NE(P<0.01), EXC(P<0.01) brain function distinct fall. 2. Contrast S-ET with the normal man and five TCM syndrome types, depression patient’s lower brain function than normal man’s S-ET:Liver qi stagnation:5-HT (P<0.05),ACH (P<0.01),DA (P<0.05),NE (P<0.01),EXC (P<0.05) brain function distinct fall. (ACH76%, NE74%)Liver stagnation and spleen deficiencies:5-HT (P<0.05),DA (P<0.01),NE (P<0.05) brain function distinct fall. (DA 70.21%,5-HT 61.7%)Liver stagnation and phlegm obstruction:5-HT (P<0.01),DA (P<0.01),NE (P<0.05), EXC (P<0.05) brain function distinct fall. (DA 81.13%,5-HT 75.47%)Deficiencies of both the heart and spleen:DA (P<0.05),EXC (P<0.05) brain function distinct fall. (DA 75.61%, EXC 63.41%)Non-interaction of heart and kidney:5-HT (P<0.05),DA (P<0.05) brain function distinct fall. (5-HT 62.26%, DA 62.26%)3. Contrast S-ET with the normal man and five TCM syndrome types, depression patient’s hyper brain function than normal S-ET:Liver qi stagnation:S-ET hyper-function rates:5-HT 44%, ACH 24%, DA 34%NE 26%EXC 36%, (5-HT 44%, EXC 36%)Liver stagnation and spleen deficiencies:S-ET hyper-function rates 5-HT 38.3%,DA 29.79%,NE 40.43%. (NE 40.43%5-HT 38.3%)Liver stagnation and phlegm obstruction:S-ET hyper-function rates:5-HT 24.53%, DA 18.87%, NE 32.08%, EXC 32.08%(INH 67.92%, NE and EXC 32.08%)Deficiencies of both the heart and spleen:DA 24.39%, EXC 36.59%Non-interaction of heart and kidney:5-HT 37.74%, DA37.74%.4. Contrast S-ET between TCM syndrome typesLiver qi stagnation ACH brain function (0.01±11.53) distinct fall with Deficiencies of both the heart and spleen (7.22±11.36) (P<0.01) and Non- interaction of heart and kidney (5.16±11.49) (P<0.05).5.5-HT and DA, ACH and NE all have positive correlation(P<0.01). Contrast with the normal man, depression patient’s the subtrahend value of 5-HT and DA i s distinct fall(P<0.01); depression patient’s the subtrahend value of ACH and NE is distinct fall(P<0.05).Conclusions:1.Depression patients with normal man’s brain function show different in SET. Contrast with the normal man, depression patient’s 5-HT, ACH, DA, NE, EXC brain function distinct fall. Pathogenesis of depression could be correlative to the lower function of neurotransmitter. Through the study found, depression patients also have Hyper-function with Neurotransmitter. We can infer that depression is not be decline or be enhanced with all neurotransmitter function.2. Five TCM syndrome types and depression patient’s S-ET are different.3. Between Five TCM syndrome types also have difference function in S-ET.4. between 5-HT and DA, ACH and NE have The relationship of antagonism, contrast depression patient with the normal man, the subtrahend value in 5-HT and DA, ACH and NE show distinct fall, Speculated that neurotransmitter imbalance is related to depression.更多还原