加味镇心定痫汤对小儿癫痫痰火扰神证认识功能和生活质量的影响

发布时间：2018-02-19 23:52

  本文关键词： 癫痫 儿童 镇心定痫汤 认识功能 炎性因子 氧化应激　出处：《中国实验方剂学杂志》2017年24期 　论文类型：期刊论文

【摘要】：目的:探讨加味镇心定痫汤对小儿癫痫(痰火扰神证)认识功能和生活质量的影响及其抗炎、抗氧化应激作用。方法:将124例患者采用SAS软件生成,随机按数字表法分为对照组和观察组各62例。对照组口服左乙拉西坦片,起始治疗剂量是10 mg·kg~(-1),根据临床效果及耐受性,剂量可以增加至30 mg·kg~(-1),2次/d。观察组在对照组治疗的基础上采用加味镇心定痫汤内服,1剂/d,每周服药5 d,停药2 d。两组疗程均连续治疗12个月。记录癫痫发作次数和持续时间,进行治疗前后脑电图检测和痰火扰神证评分;进行治疗前后癫痫患者生活质量问卷(QOLIE-AD-48)和韦氏儿童智力量表中国修订版(WISC-CR)评价;检测治疗前后高迁移率族蛋白B1(HMGB1),白细胞介素-6(IL-6),肿瘤坏死因子-α(TNF-α),超氧化物歧化酶(SOD)和丙二醛(MDA)水平。结果:观察组临床疗效总有效率为92.86%,高于对照组的78.18%(χ~2=4.844,P0.05);观察组脑电图疗效总有效率为96.43%,高于对照组的81.82%(χ~2=6.143,P0.05);治疗后观察组癫痫发作次数少于对照组,持续时间短于对照组,痰火扰神证评分低于对照组(P0.01);治疗后观察组QOLIE-AD-48量表癫痫态度、躯体功能、学校表现、健康观念、羞耻感、记忆注意力、癫痫影响等因子评分均高于对照组(P0.01);治疗后观察组患者WISC-CR量表中言语智商(VIQ),操作智商(PIQ),总智商(FIQ)均高于对照组(P0.01);治疗后观察组患者HMGB1,IL-6,TNF-α和MDA水平均低于对照组,SOD水平高于对照组(P0.01)。结论:加味镇心定痫汤联合左乙拉西坦片治疗儿童癫痫(痰火扰神证),能控制癫痫的发作,改善临床症状,提高患儿的生活质量和认识能力,并具有一定的抗炎症反应和抗氧化损伤作用,临床疗效优于单纯的西医治疗。
[Abstract]:Objective: to investigate the effect of Jiawei Zhenxin Dingxian decoction on the cognitive function and quality of life of children with epilepsy (phlegm and fire disturbing spirit syndrome) and its anti-inflammatory and anti-oxidative stress effects. Methods: 124 patients were produced with SAS software. Patients in the control group were randomly divided into control group (n = 62) and observation group (n = 62). The control group was treated with levoethylacetam tablets at an initial dose of 10 mg 路kg ~ (-1), according to the clinical effect and tolerance. The dosage can be increased to 30 mg 路kg ~ (-1) 路L ~ (-1) / d. On the basis of the treatment in the control group, the observation group was treated with Jiawei Zhending Xinxian decoction for 5 days per week and stopped for 2 days. The two groups were treated continuously for 12 months. The number and duration of epileptic seizures were recorded. Before and after treatment, EEG examination and phlegm and fire disturbance score, QOLIE-AD-48 (QOLIE-AD-48) and Wechsler Children Intelligence scale (WISC-CRR) were performed before and after treatment. The levels of HMGB1, IL-6, TNF- 伪, SOD and MDAwere measured before and after treatment. Results: the total effective rate of the observation group was 92.86, which was higher than that of the control group (78.18) (蠂 ~ 24.844A, P 0.05). The total effective rate of electrogram was 96.43, which was higher than that of the control group (81.82%) (蠂 2 + 6.143% P 0.05), and the number of epileptic seizures in the observation group was less than that in the control group after treatment. The duration of treatment was shorter than that of the control group, and the score of phlegm and fire disturbance was lower than that of the control group (P 0.01). After treatment, the QOLIE-AD-48 scale in the observation group included epileptic attitude, somatic function, school performance, health concept, shame, memory and attention. The scores of Epilepsy and other factors were higher than those of the control group (P 0.01), the verbal intelligence quotient (VIQ), the operating IQ (IQ) and the total intelligence quotient (FIQ) in the WISC-CR scale of the observation group were higher than those in the control group (P 0.01), and the levels of HMGB1, IL-6, TNF- 伪 and MDA in the observation group were lower than those in the control group after treatment. Conclusion: Jiawei Zhenxin Dingxian decoction combined with levoethoxetam tablet can control epilepsy in children. To improve clinical symptoms, improve the quality of life and cognitive ability of children, and have some anti-inflammatory and anti-oxidative effects, the clinical efficacy is better than the simple Western medicine treatment.
【作者单位】： 郑州大学第二附属医院;
【基金】：河南省科学技术研究项目(2015JQ4014G)
【分类号】：R742.1
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本文编号：1518280