To Investigate The Efficacy Of Acupuncture Combined With Risperidone For The Treatment Of Aggressive Behavior In Men With Schizophrenia And Its Effect On The Level Of Amygdala Metabolism

Objective: To explore the effect of acupuncture with Brain-heart concurrent regulation therapy combined with risperidone on male patients with schizophrenia accompanied by aggressive behavior,and the effect on the amygdala metabolism,in order to provide new clinical evidence and neurobiological basis for the efficacy of acupuncture combined with medicine in the treatment of male schizophrenia with aggressive behavior.Methods: Thirty schizophrenic male patients with aggressive behavior who met the inclusion criteria were selected as the experimental group.According to the methods of treatment,they were divided into drug group(N = 15)and acupoint-drug group(N=15).The drug group was treated with risperidone,and the acupoint-drug group was treated with electroacupuncture combined with risperidone.Fifteen healthy volunteers served as the control group.All subjects used the Positive and Negative Symptoms Scale(PANSS)to assess psychotic symptoms and the Modified Overt Aggression Scale(MOAS)to measure Aggression.Metabolism of the amygdala in all subjects was measured using 1H-MRS.The observation period was 6 weeks.(1)to observe the changes of PANSS score and MOAS score in experimental group in pretherapy and post-treatment.(2)to observe the changes of NAA/(Cho+Cr),NAA/Cho,NAA/Cr,Cho/Cr ratio in the experimental group and in the healthy control group in pretherapy and post-treatment,and further analyze the correlation between the difference of MOAS score and the difference of amygdala ratio in the experimental group in pretherapy and post-treatment.Results: 1.After 6 weeks,the total score of PANSS(drug group t =23.921,P= 0.000 、acupoint-drug group t= 17.041,P= 0.000)and MOAS(the drug group t=10.007,P=0.000 、 the acupoint-drug group t=16.149,P=0.000)in the experimental group decreased significantly;Compared with the drug group,the total scores of PANSS(t=3.541,P=0.001)and MOAS(t=3.135,P=0.004)in the acupoint-drug group were significantly decreased(P<0.05).2.Compared with the healthy group,the ratio of NAA/(Cho+Cr),NAA/Cho,NAA/Cr and Cho/Cr in the amygdala of the two experimental groups were significantly decreased(F=229.245,311.018,2806.985,291.398,P<0.01).After6 weeks,the ratio of NAA/(Cho+Cr),NAA/Cho and NAA/Cr in the amygdala of the experimental group were significantly higher than those before treatment(the drug group t=3.448、9.363、16.652,P<0.01、the acupoint-drug group t=12.606、17.323、30.334,P<0.01),and the ratio in the acupoint-drug group were significantly higher than those in the drug group(t=14.838,10.424,16.902,P<0.01),and the differences were significant.There was no significant change in the ratio of Cho/Cr in the amygdala of the experimental group,and there was no statistically significant difference(P>0.05)3.Pearson correlation analysis showed that the difference of the MOAS total scores of the experimental group had positive correlation with the difference of ratio of NAA/(Cho+Cr)、NAA/Cr and NAA/Cho in the amygdala(r=0.412,P=0.024、r=0.562,P=0.001、r=0.562,P<0.001)in pretherapy and post-treatment.Conclusion: 1 Acupuncture with brain-heart concurrent regulation therapy combinated with risperidone can effectively improve the aggressive behavior and control the psychotic symptoms of male patients with schizophrenia.2.The decrease of the ratio of NAA/(Cho+Cr),NAA/Cho,NAA/Cr,and Cho/Cr in amygdala in male schizophrenic patients with aggressive behavior may be the neurobiological basis of male schizophrenics with aggressive behavior.Combined electroacupuncture and drug therapy can improve the amygdala neuron integrity and reduce the occurrence of aggressive behavior by increasing the ratio of NAA/(Cho+Cr),NAA/Cho and NAA/Cr in the amygdala,which provides a new objective basis for the treatment of aggressive behavior in male schizophrenic patients.