疏肝调气针法对抑郁症患者自杀意念脑功能网络调控的多模态神经成像研究

自杀是一种毁灭性的重大医学和社会问题，伴有自杀意念性抑郁症（SID）的有效防治对降低自杀率具有重大意义。针灸对抑郁症具有明确疗效，且可以调节相关脑网络，但对SID 研究较少且中枢机制不明。前期应用“疏肝调气针法”（综合调节脏腑、神志、元气及灵龟八法）治疗SID初步提示具有较好疗效。研究表明SID患者在海马旁回、缰核、中央前回、额下回等脑区功能网络异常与自杀意念的产生密切相关。故我们提出“对以海马旁回-缰核-中央前回-额下回为核心的功能网络调节可能是疏肝调气针法改善抑郁、降低自杀意念的起效中枢机制”这一假说。本项目综合了针灸学、心理学、神经影像学等学科技术，采用疏肝调气针法对照帕罗西汀干预SID，提取多模态脑功能神经影像学特征数据，从结构和功能连接变化与临床疗效指标改善相互关联分析，进而探明疏肝调气针法治疗SID的脑功能网络调控机制，为针灸干预 SID提供科学依据。

Suicide is a devastating medical and social problem. Effective prevention and treatment of suicidal ideation depression (SID) is of great significance in reducing the suicide rate. Acupuncture has a definite effect on depression and can regulate the relevant brain network, but there are few studies on SID and the central mechanism is unknown. Preliminary study implies a good effect with the application of " soothing liver and regulating qi acupuncture " (comprehensive regulation of zang-fu organs, consciousness, vitality and linggui eight methods) for the treatment of SID. Studies have shown that the abnormal functional network of brain regions such as parietal hippocampus, habenula nucleus, anterior central gyrus and the inferior frontal gyrus in SID patients are closely related to the occurrence of suicidal ideation. Therefore, we hypothesize that the network regulation with the nucleus of the para-hippocampal gyrus - habenula- anterior central gyrus - inferior frontal gyrus may be the effective central mechanism of the reduction of suicidal impulse in depression by soothing liver and regulating qi acupuncture. The study will be combining acupuncture, psychology and neuroimaging technology, using acupuncture intervention contrasted to paroxetine on SID, extracting the brain characteristics form multimodal neuroimaging data, analyzing the changes of functional connection and construction, and further to explore the correlation analysis with clinical data, and then to prove the brain function network regulation mechanism regulated by the soothing liver and regulating qi acupuncture on SID, which will provide scientific evidence for acupuncture on SID.