| Objective:1.Literature research: This study summarizes and analyzes the acupuncture prescriptions for the treatment of anxiety over the past 20 years,and summarizes the acupuncture prescription for the treatment of generalized anxiety disorder by "adjust zang-fu and relieve depression" electro-acupuncture,taking into account the etiology of generalized anxiety disorder and the tutor’s academic ideas.2.Clinical research: This study takes patients with generalized anxiety disorder as the research object,takes "adjust zang-fu and relieve depression" electroacupuncture as the clinical therapeutic intervention means,and applies the resting-state functional magnetic resonance imaging technology and magnetic resonance spectroscopic imaging technology,to reveal the pathogenesis of the cerebral centers of generalized anxiety disorder,and to elucidate "adjust zang-fu and relieve depression" electroacupuncture as the clinical therapeutic intervention means.We will reveal the central pathogenesis of generalized anxiety disorder and elucidate the central effect mechanism of "adjust zang-fu and relieve depression" electroacupuncture to improve the symptoms of generalized anxiety.Methods:Literature study: Exploring the selection of acupuncture points for generalized anxiety disorder from the perspective of "adjust zang-fu and collaterals to relieve depression".We summarized and analyzed the acupuncture prescriptions for the treatment of anxiety disorders in the past 20 years,and found out the frequency of using acupuncture points in the acupuncture prescriptions,their meridians,parts,specific points,etc.We also analyzed the association rules of the use of acupuncture points,and summarized the acupuncture prescriptions and point selection ideas for the "adjust zang-fu and relieve depression" method,taking into account the etiology and mechanism of generalized anxiety disorder and the tutor’s academic thoughts.It will summarize the ideas of acupuncture and point selection for the method of "adjust zang-fu and relieve depression" in the light of the etiology and mechanism of generalized anxiety disorder and the academic ideas of the tutor.Clinical research:1.Clinical efficacy observation of "adjust zang-fu and relieve depression " electroacupuncture in the treatment of generalized anxiety disorder(GAD).Patients with GAD were taken as research subjects,and were treated with "adjust zang-fu and relieve depression" electro-acupuncture method,with one course of treatment in 6days and a total of 4 courses of treatment,and were evaluated by the Hamilton Anxiety Rating Scale(HAMA),Hamilton Depression Rating Scale 17(HAMD-17),Generalized Anxiety Disorder Rating Scale(GAD-7),Body Perception Questionnaire(BPQ),Self-assessment Questionnaire of Mood(DASS),Pittsburgh Sleep Quality Index Scale(PSQI).The improvement of anxiety and depression,somatosensory perception,anxiety and depression stress,and sleep in GAD patients was observed with the "adjust zang-fu and relieve depression" electroacupuncture method.2.Research on the effect of "adjust zang-fu and relieve depression" on the metabolic changes of brain neurotransmitters in generalized anxiety disorder(GAD).Using healthy people and GAD patients as research subjects,magnetic resonance spectroscopic imaging technology was applied to carry out a clinical study to detect the changes of metabolites in the basal ganglia region of the brain of the subjects and explore the central pathogenesis of GAD.We also applied the electroacupuncture method of "adjust zang-fu and relieve depression" to treat GAD patients,and observed the changes of metabolites in the basal ganglia region of the brain before and after the electroacupuncture treatment of "adjust zang-fu and relieve depression" to explore the potential mechanism of the effect of electroacupuncture on GAD.3.Research on the effect of "adjust zang-fu and relieve depression" electrotherapy on brain function in generalized anxiety disorder(GAD).Clinical studies were conducted on healthy people and GAD patients using resting-state functional magnetic resonance(rs-f MRI)technology to detect changes in brain function and explore the central pathogenesis of GAD,and electro-acupuncture to regulate the viscera and relieve depression was applied to treat GAD patients to observe the changes in brain function before and after treatment.We also applied the electroacupuncture method of "adjust zang-fu and relieve depression" to treat patients with GAD,and observed the changes in the brain function of patients with GAD before and after the electroacupuncture treatment of "radjust zang-fu and relieve depression",to explore the mechanism of "adjust zang-fu and relieve depression" electroacupuncture to improve the symptoms of GAD.4.Research on the effect of "adjust zang-fu and relieve depression" electroacupuncture on the brain network of generalized anxiety disorder(GAD).Using healthy people and GAD patients as the research subjects,applying the resting-state functional magnetic resonance(rs-f MRI)technology to carry out clinical research,utilizing the graph theory analysis method,exploring the overall structure of the brain and the pathogenesis of GAD from the imaging point of view,and observing the effect of "adjust zang-fu and relieve depression" electro-acupuncture on the brain network of the patients with GAD,to reveal We will observe the effects of "adjust zang-fu and relieve depression" electro-acupuncture on the brain network of GAD patients,reveal the relationship between the whole brain network and the local information,and explore the mechanism of electroacupuncture in treating GAD.Results:Literature research:Nearly 20 years of acupuncture treatment of anxiety acupuncture prescription analysis combined with the tutor’s academic thinking,concluded that the pathogenesis of generalized anxiety is not pass through the liao qi,liao deficiency can not be caused by the viscera and internal organs,brain liao loss of nourishment,so in the treatment of "adjust zang-fu" and "adjust collaterals","through the brain" three steps.The method of "adjust zang-fu and collaterals to relieve depression"(referred to as the "adjust zang-fu and relieve depression" method)is proposed for the treatment of generalized anxiety disorder.The five visceral acupoints are selected together with "Baihui-Shenting","Hegu-Taichong","Zusanli-Sanyinjiao",Neiguan and other acupoints in order to regulate the internal organs,clear the collaterals,clear the cerebral collaterals,and mobilize the qi to relieve depression.Clinical study:1.GAD patients treated with "regulating the viscera and relieving depression" electro-acupuncture method can improve the patients’ anxiety symptoms,anxiety and depression,sleep,HAMA,HAMD,GAD,BPQ,DASS,PSQI scores are reduced after treatment(P<0.05),and the patients were followed up with HAMA,HAMD,GAD scales at the end of the treatment,HAMD,GAD scale for follow-up investigation,the results showed that its long-term efficacy is accurate.2.GAD patients the left and right m I values of the basal ganglia region were significantly higher,the right NAA value was lower,the right Cr value was lower,the right Cho/Cr value was significantly higher,and the right GABA/Cr value was higher,and the difference was statistically significant(P<0.01);After the electroacupuncture treatment of "adjust zang-fu and relieve depression",the NAA value of the left side of the basal ganglia region of the patients was significantly reduced,the Cr value of the left side was significantly reduced,and the Glu+Gln value of the right side was significantly increased after the treatment,and the difference was statistically significant(P<0.01).3.Brain structure of GAD patients: the volume of the left amygdala was reduced,and the volume of the right amygdala was reduced with statistical significance(P<0.01);functional connectivity: the hippocampal area was reduced in the right subfrontal gyrus of the insula.After the electroacupuncture treatment of "adjust zang-fu and relieve depression",the functional connectivity of the left hippocampal region was enhanced in the right superior cerebellar peduncle,left postcentral gyrus,left middle frontal gyrus,and right postcentral gyrus;and the functional connectivity of the right hippocampal region was enhanced in the left parahippocampal gyrus,right lingual gyrus,left transverse temporal gyrus,right middle frontal gyrus,right medial and paracuneus gyrus,and right anterior central gyrus.The amygdala region had enhanced functional connectivity in the left parahippocampal gyrus and right lingual gyrus.The parahippocampal gyrus had enhanced functional connectivity in the right supramarginal gyrus.The insula enhanced functional connectivity in the left precuneus,and the difference was statistically significant(P<0.01).4.GAD patients had reduced node efficiency in the left orbitofrontal inferior gyrus and right paracentral lobule nodes;increased node degree in the left middle frontal gyrus;reduced node median in the right orbitofrontal intermediate gyrus and right gyrus rectus;increased node cluster coefficients in the left middle frontal gyrus,left subparietal marginal angular gyrus,right subparietal marginal angular gyrus,and left temporal subglottic gyrus;and reduced localized efficiency in the left orbitofrontal inferior gyrus node and increased localized efficiency in the right temporal transverse gyrus node The difference was statistically significant(P<0.05).After the electroacupuncture treatment of "adjust zang-fu and relieve depression",the efficiency of the nodes of the left infraorbital frontal gyrus,right infraorbital frontal gyrus,left subparietal marginal angular gyrus,right paracentral lobule,and left pea-like pallidum increased;the node degree of the left infraorbital frontal gyrus increased,and the node degree of the right hippocampal gyrus decreased;the number of mediators of the right amygdala,the left parietal gyrus,and the left angular gyrus increased;and the nodes of the right fusiform gyrus,right fusiform gyrus,right transverse temporal gyrus increased.right fusiform gyrus and right inferotemporal gyrus node clustering coefficients were elevated,and in the left postcentral gyrus node clustering coefficients were decreased;in the left orbitoinferior frontal gyrus,and in the right fusiform gyrus node localization efficiencies were elevated,and the differences were statistically significant(P<0.05).Conclusion:1.The results of this study showed that "adjust zang-fu and relieve depression" can improve the anxiety symptoms,anxiety and depression,six dimensions of somatosensory perception,and sleep in GAD,and that the efficacy of the treatment is definite and long-lasting.2.Changes in the values of m I,NAA,Cr,Cho/Cr and GABA/Cr in the basal ganglia region of patients with GAD may be associated with apoptosis,cell proliferation and impaired neurological function in the brain,which is a potential pathogenesis for the development of GAD."The therapeutic effect of electroacupuncture may be exerted by improving the function of nerve cells through improving the content of m I,NAA,Cho/Cr and GABA/Cr in the basal ganglia region of the brain,and the elevated value of Glu+Gln may be the potential effect mechanism of electroacupuncture in GAD.Elevated Glu+Gln values may be a potential effect mechanism of "adjust zang-fu and relieve depression" electroacupuncture.3.The amygdala and the right inferior frontal gyrus of the insula may be the key brain areas for the development of GAD."Adjust zang-fu and relieve depression" electroacupuncture can enhance the functional connectivity of the hippocampus,amygdala,parahippocampal gyrus,insula,and other brain regions related to emotional processing.The left supraorbital frontal gyrus and the left parahippocampal gyrus may be the key brain areas for the effect of "adjust zang-fu and relieve depression" electroacupuncture.4.Alterations in network connectivity of brain regions such as inferior frontal gyrus,transverse temporal gyrus,inferior temporal gyrus and angular gyrus of the orbit may be a potential mechanism for the pathogenesis of GAD.Local index changes in brain regions closely related to emotions,such as the inferior frontal gyrus,hippocampus,and amygdala,may be the key brain regions in the mechanism of the electroacupuncture effect of "adjust zang-fu and relieve depression". |
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