Effect of <italic style="font-style: italic">Wenzhen Yunqi Formula</italic> （温振运气方） on Brain Function and Cerebral Metabolism in Patients with Chronic Fatigue Syndrome of <italic style="font-style: italic">Qi </italic>Deficiency Pattern

Yao HUANG; Zhenxian ZHANG; Guanwu LI; Chang CHEN; Jianing SHI; Min CHEN; Weijia ZHANG

doi:10.13288/j.11-2166/r.2022.10.010

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Effect of Wenzhen Yunqi Formula （温振运气方） on Brain Function and Cerebral Metabolism in Patients with Chronic Fatigue Syndrome of Qi Deficiency Pattern

更新时间：2022-05-11

- Effect of Wenzhen Yunqi Formula （温振运气方） on Brain Function and Cerebral Metabolism in Patients with Chronic Fatigue Syndrome of Qi Deficiency Pattern
- Journal of Traditional Chinese Medicine Vol. 63, Issue 10, Pages: 943-950(2022)
- 作者机构：
  
  上海中医药大学附属岳阳中西医结合医院，上海市虹口区甘河路110号，200437
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2022.10.010
  CLC：
- Received：28 October 2021，
  
  Revised：2022-02-23，
  
  Published：17 May 2022
- 稿件说明：
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黄瑶,张振贤,李冠武等.温振运气方对慢性疲劳综合征气虚证患者脑功能和脑代谢的影响[J].中医杂志,2022,63(10):943-950.

HUANG Yao,ZHANG Zhenxian,LI Guanwu,et al.Effect of Wenzhen Yunqi Formula （温振运气方） on Brain Function and Cerebral Metabolism in Patients with Chronic Fatigue Syndrome of Qi Deficiency Pattern[J].Journal of Traditional Chinese Medicine,2022,63(10):943-950.
黄瑶,张振贤,李冠武等.温振运气方对慢性疲劳综合征气虚证患者脑功能和脑代谢的影响[J].中医杂志,2022,63(10):943-950. DOI： 10.13288/j.11-2166/r.2022.10.010.

HUANG Yao,ZHANG Zhenxian,LI Guanwu,et al.Effect of Wenzhen Yunqi Formula （温振运气方） on Brain Function and Cerebral Metabolism in Patients with Chronic Fatigue Syndrome of Qi Deficiency Pattern[J].Journal of Traditional Chinese Medicine,2022,63(10):943-950. DOI： 10.13288/j.11-2166/r.2022.10.010.

摘要

目的

观察温振运气方干预慢性疲劳综合征气虚证患者疲劳及负性情绪的临床疗效并探索其中枢作用机制。

方法

60例慢性疲劳综合征气虚证患者随机分为治疗组与对照组各30例，对照组给予基础治疗，治疗组给予基础治疗联合温振运气方口服，疗程12周。于治疗前及治疗6周、12周时测定中医证候量表评分并判定中医证候疗效，治疗前后进行疲劳量表（FS-14）评分并判定疲劳疗效，治疗前后采用汉密顿抑郁量表（HAMD）与汉密顿焦虑量表（HAMA）评分判定负性情绪情况，运用血氧水平依赖功能磁共振（BOLD-fMRI）、氢质子磁共振波谱成像（

H-MRS）检测治疗前后患者脑功能、脑代谢变化。

结果

治疗组中医证候疗效总有效率为90.00%，FS-14疗效总有效率86.67%，对照组分别为66.67%、60.00%，治疗组均优于对照组（

＜0.05）。与本组治疗前比较，治疗组治疗6、12周时中医证候总积分及神疲、气短、乏力症状评分降低，治疗后FS-14总分、躯体疲劳评分与脑力疲劳评分均较治疗前降低，且均显著优于对照组（

＜0.05或

＜0.01）。治疗后治疗组HAMD总分、焦虑/躯体化、日夜变化、睡眠障碍、绝望感、认知障碍及HAMA总分、躯体性焦虑、精神性焦虑评分均较治疗前显著降低（

＜0.05或

＜0.01）。治疗组治疗后在双侧额中回、右侧三角部额下回、左侧背外侧额上回均出现低频振幅（ALFF）与局部一致性方法（ReHo）增高，在右侧梭状回、右侧楔前叶出现ALFF降低（

＜0.001）；治疗组双侧额中回N-乙酰天门冬氨酸（NAA）/肌酸（Cr）较治疗前升高（

＜0.05），且较对照组升高更显著（

＜0.05）。

结论

温振运气方可有效改善慢性疲劳综合征患者的中医临床症状，缓解疲劳，改善抑郁、焦虑状态，其机制可能与提高前额叶部分脑区神经活动及调节双侧额中回NAA脑代谢相关。

Abstract

Objective

To observe the clinical effect of

Wenzhen Yunqi Formula

（温振运气方， WYF） on fatigue and negative emotions in patients with chronic fatigue syndrome （CFS） and

deficiency pattern， and to explore its central mechanism.

Methods

In a randomized controlled trial， 60 CFS patients with

deficiency pattern were divided into the treatment group （30 cases） and the control group （30 cases）. The control group was given basic treatment， while the treatment group additionally received oral WYF， both for 12 weeks. The scores of traditional Chinese medicine （TCM） syndrome scale were assessed before， after 6w- and 12w-treatment. The fatigue scale-14 （FS-14）， Hamilton Depression Scale （HAMD） and Hamilton Anxiety Scale （HAMA） were assessed before and after treatment. The changes of brain function and brain metabolism were detected by blood oxygen level dependent functional magnetic resonance imaging （BOLD-fMRI） and hydrogen proton magnetic resonance spectroscopy （

H-MRS）.

Results

The total effective rate regarding TCM syndrome and FS-14 in the treatment group was 90.00% and 86.67%， respectively， while that in the control group was 66.67% and 60.00%， respectively （

＜0.05）. The total score of TCM syndrome and the scores of mental fatigue， shortness of breath， and fatigue significantly decreased after 6w- and 12w-treatment， and FS-14 total score and physical and mental fatigue scores also decreased after 12w-treatment in the treatment group， with more remarkable decreases than the control group （

＜0.05 or

＜0.01）. The total score of HAMD， scores of anxiety/somatization， day and night change， sleep disorder， sense of despair， cognitive impairment， as well as total score of HAMA， somatic and mental anxiety scores in the treatment group were significantly reduced after treatment （

＜0.05 or

＜0.01）. The amplitude of low-frequency fluctuation （ALFF） and regional homogeneity （ReHo） increased in bilateral middle frontal gyrus， right trigonal inferior frontal gyrus and left dorsalateral superior frontal gyrus in the treatment group， while ALFF decreased in right fougate gyrus and right precuneus after treatment （

＜0.001）. The N-acetyl aspartate/creatine （NAA/Cr） of bilateral middle frontal gyrus in the treatment group increased after treatment （

＜0.05）， with more increase than that in the control group （

＜0.05）.

Conclusion

WYF can effectively improve the TCM clinical symptoms， relieve fatigue， improve depression and anxiety in CFS patients with

deficiency pattern. The mechanism may be related to the increase of neural activity in some brain regions of the prefrontal lobe and the regulation of NAA content in bilateral middle frontal gyrus.

关键词

Keywords

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⁰

Effect of Wenzhen Yunqi Formula （温振运气方） on Brain Function and Cerebral Metabolism in Patients with Chronic Fatigue Syndrome of Qi Deficiency Pattern

DOI：10.13288/j.11-2166/r.2022.10.010

摘要

Abstract

关键词

Keywords

references