摘要
目的 利用脑涨落图仪分析以躯体症状为表现的焦虑抑郁患者，研究脑涨落神经递质功能增高和降低患者临床症状的差异性。方法 选择2018年8月-2019年3月在成都市第一人民医院门诊和住院患者210例，诊断心身障碍，符合纳入标准和排除标准，在就诊1-3日内完成症状自评量表(SCL-90)评定、躯体症状评定、脑涨落图仪检测。 结果 210例患者心理评估的阳性率为71.5%，使用脑涨落仪评估的阳性率为100%。 脑功能增高组神经递质水平明显高于降低组，差异有统计学意义（P<0.05）。两组SCL-90评定比较，脑功能增高组在躯体化、恐怖、精神病性分量表分值高于降低组，比较有统计学意义（P<0.05）；两组临床症状比较，脑功能增高组在头晕、疲软、心悸、体重下降、震颤症状方面发病低，比较有统计学意义（P<0.05）。结论 以躯体症状为表现的焦虑抑郁患者用量表评定存在假阴性，而脑涨落图能准确评定神经递质异常。脑涨落递质增高与降低组比较在症状量表分值，躯体症状表现方面存在差异性。
关键词： 脑涨落图；焦虑抑郁；躯体症状；神经递质
Abstract
Objective To investigate variation characteristics of cerebral neurotransmitter on anxiety-depression Patients with somatic symptoms by encephalonuctuograph(EFG)．And to investigate the clinical symptom of patients were studied in the increase of brain fluctuation neurotransmitter function and the decrease. Methods 210 cases with anxiety and depression in Chengdu first People's Hospital outpatient and inpatient patients in August 2018 to March 2019 were chosen, in line with the inclusion criteria and exclusion criteria, Participants were assessed by SCL-90 and somatic symptoms in 1-3 days，and the relative value of six kinds of neurotransmitters(GABA，5-HT，DA，Ach，NE，Glu)were measured by Encephalofluctuograph (EFG).Results The positive rate of psychological assessment in 210 patients was 71.5%, which made the positive rate assessed by Encephalofluctuograph (EFG) instrument 100%. The level of neurotransmitters in the brain function increase group was significantly higher than that in the lower group(P<0.05). Compared with the two groups of SCL-90 assessment, the brain function increase group had higher scores in somatic, scary, psychotic component syllables than the decreased group(P<0.05).and the two groups of clinical symptoms compared，the brain function increase group with lower incidence of dizziness, weakness, palpitation, weight loss, and tremor symptoms(P<0.05). Conclusion There were false negatives in the dosage table of patients with anxiety and depression, which showed physical symptoms, while the brain fluctuation map could accurately evaluate the neurotransmitter abnormalities. There were differences in symptom scale and somatic symptom expression between the increase of brain fluctuation transmitter and the decrease of group.
Key words： Encephalofluctuograph; Depression And Anxiety; Somatic Symptoms; Neurotransmitter
参考文献 References
[1] 吴文源,魏镜,陶明.综合医院焦虑抑郁诊断和治疗的专家共识.中华医学杂志,2012,92(31):2174-2181.
[2] 蒋帅,吴银侠,王大刚,等.精神分裂症、神经症、抑郁症患者的脑电超慢涨落图分析.山东医药,2014,54(20):1-4.
[3] 胡垒.躯体形式障碍患者中枢神经递质功能的脑涨落图分析.中国现代医药杂志,2015,17(9):44-46.
[4] 陈建平,陈庆喻,张国华,等.脑涨落图检测阿尔茨海默病病人脑神经递质变化特点.岭南急诊医学杂志,2007,12(3):182-183.
[5] 季建林,赵梅,王崇顺.抑郁症门诊病人躯体症状主诉及疗效比较研究.中国行为医学科学,2005,14(10):892-896.
[6] Nakao M, yano E. Reporting of somatic symptoms as a screening marker for detecting major depression in a population of Japanese white-collar workers. Journal of Clinical Epidemiology. 2003,56(10):1021-6
[7] 郭田生.脑涨落图的技术原理及临床研究应用，国际神经病学神经外科学杂志，2014,41(2):127-130
[8] Nunez PL,SrinivasanＲ.A theoretical basis for standing andtraveling brain waves measured with human EEG with implicationsfor an integrated consciousness． Clin Neurophysiol，2006，117( 11 ) : 2424-2435．
[9] Greden JF. Physical symptoms of depression: unmet need[J].J Clin Psychiatry,2003,64(7):5-11.
[10] Stewart DE. Physical symptoms of depression: unmet needs in special populations[J].J Clin Psychiatry,2003, 64(7):12-16.
[11] 姜荣环, 党卫民, 马弘, 等. 非精神科医生对抑郁障碍的识别和相关因素[J].中华内科杂志, 2010, 49(6): 477-479
[12] 宋扬,刘津,臧大维,等.神经递质功率及血浆 ５-羟色胺水平与脑卒中后抑郁的相关性.中国老年学杂志,2017,2(37):439-440.
[13] 张加强,刘飞虎,张燕,等.抑郁症36例患者5-HT、NE、DA水平检测及临床意义.陕西医学杂志, 2014,4(43):467-468.
[14] 唐卫东,李培芬,屈珍,等.精神医学杂志，2012, 1(25):25-28.
[15] 王校斌,杨媚.脑涨落图检查对单纯头晕患者的临床价值.社区医学杂, 2007,5(13):30-31.
[16] Abolghasem E，Kamran G.GABA A receptors as novel drug targets for treatment of mental disorders [J]. J Paramed Sci,2010,1(3):50-61.