经颅磁刺激联合医痫丸辅助治疗颅脑外伤继发性癫痫效果观察

发布时间：2018-01-30 11:07

本文关键词： 继发性癫痫颅脑外伤经颅磁刺激医痫丸　出处：《山东医药》2017年20期 　论文类型：期刊论文

【摘要】：目的探讨经颅磁刺激联合医痫丸辅助治疗颅脑外伤继发性癫痫的临床疗效及其可能的机制。方法选择颅脑外伤继发性癫痫患者132例,随机分为对照组、磁刺激组和联合组各44例。三组均予常规治疗(注射苯巴比妥钠或口服丙戊酸钠片,癫痫发作时口服氯硝西泮片)12周;磁刺激组在常规治疗的基础上行经颅磁刺激连续治疗1周;联合组在磁刺激基础上口服医痫丸,共12周。三组治疗12周评价临床疗效,计算总有效率。比较两组治疗前及治疗12周癫痫持续状态严重程度量表(STESS)评分及癫痫持续状态的发作持续时间、发作频率,生活质量调查表31(QOLIE-31)评分以及血清ROS、NF-κB、IL-1β、TNF-α水平(采用ELISA法检测)。记录三组治疗期间不良反应发生情况。结果对照组总有效率为70.45%,磁刺激组为75.00%,联合组为90.91%;联合组总有效率高于对照组及磁刺激组(P均0.05)。三组治疗后STESS评分、发作持续时间、发作频率及血清ROS、NF-κB、IL-1β、TNF-α水平均低于治疗前,QOLIE-31评分均高于治疗前,但联合组变化更明显(P均0.01),对照组与磁刺激组治疗后上述指标比较差异均无统计学意义(P均0.05)。三组不良反应发生率比较差异均无统计学意义(P均0.05)。结论经颅磁刺激联合医痫辅助治疗颅脑外伤性继发癫痫效果确切且较为安全;抑制氧化应激及炎性反应可能是其作用机制。
[Abstract]:Objective to investigate the clinical effect and possible mechanism of transcranial magnetic stimulation combined with medical-epileptic pill in the treatment of secondary epilepsy caused by craniocerebral trauma. Methods 132 patients with secondary epilepsy after craniocerebral trauma were randomly divided into control group. 44 cases in magnetic stimulation group and 44 cases in combination group were treated with routine therapy (injection of phenobarbital sodium or oral sodium valproate, oral clonazepam tablets for 12 weeks during seizure; In the magnetic stimulation group, transcranial magnetic stimulation was performed for 1 week on the basis of routine treatment. Combined group on the basis of magnetic stimulation on the basis of oral medicine-induced pills, a total of 12 weeks, three groups of 12 weeks to evaluate the clinical efficacy. The total effective rate was calculated. The scores of STESS before treatment and 12 weeks after treatment were compared as well as the duration and frequency of epileptic status. QOLIE-31) and serum ROSNF- 魏 B IL-1 尾. The level of TNF- 伪 was measured by ELISA method. The adverse reactions in the three groups were recorded. Results the total effective rate was 70.45 in the control group and 75.00% in the magnetic stimulation group. The combined group was 90.91; The total effective rate in the combined group was higher than that in the control group and the magnetic stimulation group (P < 0.05). The STESS score, attack duration, attack frequency and serum ROSNF- 魏 B IL-1 尾 in the three groups after treatment were higher than those in the control group and the magnetic stimulation group. The level of TNF- 伪 was lower than that of QOLIE-31 before treatment, but the change of TNF- 伪 in combination group was more obvious than that before treatment (P < 0.01). There was no significant difference in the above indexes between the control group and the magnetic stimulation group after treatment (P < 0.05), and there was no significant difference in the incidence of adverse reactions among the three groups (P < 0.05). Conclusion Transcranial magnetic stimulation combined with medically assisted epilepsy is effective and safe in the treatment of traumatic brain epilepsy. Inhibition of oxidative stress and inflammatory response may be its mechanism.
【作者单位】：河南大学第一附属医院;
【基金】：河南省中医药科学研究专项课题(2013ZY02081)
【分类号】：R651.15;R742.1
【正文快照】： 颅脑外伤继发性癫痫(PTE)为颅脑损伤后的严重并发症,其在颅脑原发性损伤的基础上引起脑组织损伤加重,并促进神经元发生生化改变,导致患者死亡率升高[1,2]。目前临床治疗PTE的药物和方法较多,但是治疗效果不佳,患者病情容易反复[3]。经颅磁刺激是一种神经电生理技术,通过调控大

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