中国科学院心理研究所机构知识库

目的观察太极拳辅助治疗对轻中度慢性阻塞性肺疾病(COPD)患者的疗效和相关神经机制。方法选取20例轻中度COPD患者，在西医常规治疗基础上辅助太极拳康复训练，每周3次，每次90 min ,计8周。干预前后采用慢性阻塞性肺疾病症状评估量表(CAT)及改良后的呼吸困难量表(mMRC)评估患者临床症状和呼吸困难程度;使用E-prime 2. 0软件编制疼痛共情程序及注意网络侧试，记录疼痛强度、疼痛不愉悦度评分，警觉、定向和执行控制评分;使用静息态功能性磁共振成像(fMRI)扫描，计算反映局部大脑功能的低频振幅(ALFF)和局部功能一致性(ReHo)指标、反映大脑功能网络连接属性的度中心性(DC)指标以及反映半球偏侧化程度的体素一镜像同伦连接(VMHC)指标。结果研究期间，有3例患者未能坚持训练而脱落，最终干预后纳入统计分析患者17例。与干预前比较，干预后患者CAT评分、疼痛强度评分和疼痛不愉悦度评分均显著降低，警觉功能评分显著提高(P＜0.05或PG＜0.01)，但mMRC评分、定向和执行控制功能评分差异无统计学意义(P>0. 05)。影像学分析发现，额叶、扣带回和楔前叶在DC, ReHo, VMHC的局部功能指标出现稳定下降。相关分析发现，右侧额下回DC值降低与疼痛强度评分降低(r=0.68, P＜0.05)、疼痛不愉悦度评分降低(r=0.79, P＜0.05)呈显著正相关，与执行控制提升也呈显著正相关(r=0.82, PG0.05)。结论太极拳辅助治疗能改善轻中度COPD患者的临床症状、缓解疼痛、提升认知功能，额下回功能改变可能是患者疼痛和认知功能改善的潜在神经机制。

This paper introduced Professor SANG Lie's experience in the treatment of children with mental and behavioral disorders，which is also called "delusional syndrome" .The kidney and brain insufficiency and the heart and liver in superabundance are the key of the pathogenesis，affected by both congenial and acquired factors. Congenial manifestation，that is，insufficiency of endowment，is mainly caused by many factors such as advanced maternal age，fatigue，drunkenness drug medication and emotional disorders，laying the pathological basis of acquired disease. Many risk factors in the process of children's growth and development are the main acquired factors of the disease. According to the exuberance and debilitation of deficiency and excess and the changes of the disease，delusional syndrome is divided into attack stage，remission stage and stable stage for syndrome differentiation and treatment. During the attack stage，it is appropriate to calm the liver and clear the heart，calm the mind and spirit and selfmade Wangwei Powder （妄为散)can be used with modification. In the remission stage，it is advisable to nourish the heart and calm the liver，tranquilize the brain and boost the kidney，and use self-made Annao Decoction(安脑饮) with modification. In the stable stage，it is appropriate to nourish the kidney and replenish the marrow，consolidate the root and prevent recovery , and self-made Zishen Powder(滋肾散)with modification is suggested.

基金项目:国家自然科学基金(31671163);北京市中医药科技发展
资金项目(JJ2018-90);中国中医科学院科技创新工程(CI2021AO
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