癫痫宁辅助治疗癫痫的临床研究
发布时间：2019-06-01 08:06
【摘要】：研究背景:癫痫(Epilepsy)又称“羊癫风”,是由多种原因引起的具有自限性的脑部神经元高度同步化异常放电所致的综合征,以反复发作性、短暂性和通常为刻板性的中枢神经系统功能失常为特征。国际抗癫痫联盟将癫痫定义为一组以恒定的癫痫发作倾向和相应的神经生物学、认知、心理和社会后果为特征的脑部疾病。癫痫宁(Epilepsy tablets)主要是由石菖蒲、缬草、马蹄香、钩藤、甘松、薄荷脑、牵牛子、千金子等组成,具芳香之气,行散之力较强,为宣气通窍之佳品,既能芳香化湿、醒脾健胃,又可化浊祛痰、涤痰开窍之药,具有化痰开窍、化湿和胃、醒神益智、理气活血、散风祛湿等功效。主治风痰上扰之痫病。近些年来已被广泛应用于原发性、继发性癫痫治疗中,与西药协同发挥作用,扬长避短,从而增强疗效,改善西药不良反应[1,2]。卡马西平(Carbamazepine)是一种常见精神性药物,能降低神经细胞膜对Na+和Ca2+的通透性,导致细胞的兴奋性降低,使不应期延长;也可能增强γ-氨基丁酸GABA的突触传递功能。强化抑制突触的强直后期,阻止致痫灶的扩散和异常放电。卡马西平中主要的代谢产物有10,11-环氧化卡马西平,而10,11-环氧化卡马西平具有抗惊厥和抗神经痛相关作用。而其中的抗躁狂症和精神病的作用有可能抑制了其边缘系统和脑部颞叶部分的点燃作用。而它的化学作用和三环类抗抑郁药药是相类似的,具有抗胆碱活动、抗抑郁、抑制肌肉神经接头的传递和抗节律失常等作用。研究目的通过对临床资料的观察研究,分析癫痫宁联合单种抗癫痫西药卡马西平治疗癫痫的研究进行统计分析,进一步评价中西药联合使用对癫痫的治疗作用。研究方法本课题采用临床调查的研究方法,对2013年3月至2014年9月在湖北省十堰市人民医院癫痫专科门诊和神经内科、神经外科病房住院的癫痫患者,将符合诊断标准的76例患者采用随机均衡方法分为治疗组和对照组,治疗组在单用卡马西平治疗的基础上辅以癫痫宁,对照组患者单纯服用卡马西平。一段时间后,分别统计各组患者用药前后的各项临床指标,如检测并记录脑电图、发作频率、发作程度、症状是否减轻等情况,加以记录并分析。研究结果1.临床疗效统计:治疗组总有效率为78%,对照组总有效率为52%。治疗组和对照组比较有显著差异(p0.05)2.对76例癫痫患者治疗前后发作时间及频率的比较:治疗组与对照组有显著差异(p0.05)3.脑电图改变:治疗组在治疗前有31例脑电图异常,通过癫痫宁联合卡马西平治疗后,脑电图不同程度好转有23例。改善率为74.19%;对照组在治疗前有31例脑电图异常,通过单用卡马西平治疗后,脑电图不同程度好转有14例。改善率为45.16%。两组比较有显著差异(p0.05)4.用药副反应:本次研究过程中,治疗组有个别病人出现口干舌燥、轻度头晕及胃部不适等症状,但都不影响病人继续服药,没有给予特殊处理。对照组有个别病人出现恶心、嗜睡等症状,给予对症支持治疗后好转,不影响继续服药。研究结论癫痫宁作为治疗癫痫的一种辅助用药效果显著,可以在一定程度上改善癫痫患者的症状、减少发病次数,值得进一步临床推广。
[Abstract]:Background of the study: Epilepsy, also known as the "the wind of the sheep", is a syndrome caused by a variety of reasons for the highly synchronized abnormal discharge of the brain neurons with self-interest, characterized by recurrent, transient and generally rigid central nervous system dysfunction. The International Antiepileptic Alliance defines epilepsy as a group of brain diseases characterized by a constant seizure tendency and corresponding neurobiological, cognitive, psychological and social consequences. Epilepsy tablets is mainly composed of the following components in parts by weight: cattail, grass, horse chestnut, uncaria, carpine, mentholum, lead and gold, and the like, and has the advantages of aromatic and qi-like, strong and strong dispersing power, and is a good product for promoting the circulation of qi, and can be used for aromatizing and wetting, and can be used for invigorating the spleen and stomach, and also can be used for treating the turbid and eliminating phlegm. The medicine for removing phlegm and inducing resuscitation has the effects of reducing phlegm, inducing resuscitation, eliminating dampness and stomach, refreshing mind, improving intelligence, regulating qi, promoting blood circulation, dispelling wind and removing dampness, and the like. It is mainly used for treating epilepsy caused by wind-phlegm. Has been widely used in the treatment of primary and secondary epilepsy in recent years, has a synergistic effect with the western medicine, and has the advantages of being long and short, thereby enhancing the curative effect and improving the adverse reaction of the western medicine[1,2]. Carbamazepine is a kind of common psychotropic drug, which can reduce the permeability of the nerve cell membrane to the Na + and Ca2 +, which leads to the decrease of the excitability of the cells and the prolongation of the refractory period. It is also possible to enhance the synaptic transmission function of the GABA of the 1-aminobutyric acid. It is necessary to enhance the inhibition of the late stage of the synapse and to prevent the diffusion and abnormal discharge of the focal point. The main metabolites in carbamazepine are 10,11-ring-oxidized carbamazepine, while 10,11-ring-oxidized carbamazepine has an anti-shock and anti-neuralgia-related effect. The antimanic and psychotic effects of this may have the potential to inhibit the ignition of the limbic system and the lobe of the brain. Its chemical and tricyclic antidepressants are similar, with anticholinergic activity, antidepressants, inhibition of muscle and nerve joints, and anti-dysrhythmias. The purpose of this study was to analyze the clinical data and to analyze the effect of combination of Chinese and Western medicine on the treatment of epilepsy. The method of the study is to study the epileptic patients in the department of epilepsy and neurology and neurosurgery in the People's Hospital of Shiyan, Hubei, from March 2013 to September,2014. 76 patients who met the diagnostic criteria were divided into the treatment group and the control group by using the random equalization method, and the treatment group was supplemented with the epilepsy in the basis of the carbamazepine treatment alone, and the patients in the control group were given carbamazepine alone. After a period of time, the clinical indicators before and after the administration of each group of patients were counted separately, such as detecting and recording the electroencephalogram, the frequency of the attack, the degree of attack, whether the symptoms were reduced or the like, and recording and analyzing. Study Results 1. The total effective rate of the treatment group was 78% and the total effective rate of the control group was 52%. There was a significant difference in the treatment group and the control group (p0.05)2. The time and frequency of the treatment before and after the treatment of 76 patients with epilepsy: the treatment group and the control group had significant difference (p0.05)3. Electroencephalogram (EEG) changes: in the treatment group, there were 31 cases of abnormal EEG in the treatment group, and 23 cases were improved after the treatment with the combination of the epilepsy and the carbamazepine. The improvement rate was 74.19%; in the control group, there were 31 cases of abnormal EEG in the control group, and 14 cases were improved after the treatment with carbamazepine alone. The rate of improvement was 45.16%. There was a significant difference between the two groups (p0.05)4. Side effects of administration: In the course of this study, individual patients in the treatment group had the symptoms of dry tongue, mild dizziness, and stomach discomfort, but none of the patients affected the patient to continue taking the medicine, and no special treatment was given. The control group had the symptoms of nausea and somnolence in the individual patients, and the symptoms of nausea and somnolence were given in the control group. Conclusion Epilepsy is a kind of auxiliary drug for treating epilepsy. It can improve the symptoms of epileptic patients to some extent, reduce the number of times, and be worth further clinical promotion.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R742.1
本文编号：2490117
[Abstract]:Background of the study: Epilepsy, also known as the "the wind of the sheep", is a syndrome caused by a variety of reasons for the highly synchronized abnormal discharge of the brain neurons with self-interest, characterized by recurrent, transient and generally rigid central nervous system dysfunction. The International Antiepileptic Alliance defines epilepsy as a group of brain diseases characterized by a constant seizure tendency and corresponding neurobiological, cognitive, psychological and social consequences. Epilepsy tablets is mainly composed of the following components in parts by weight: cattail, grass, horse chestnut, uncaria, carpine, mentholum, lead and gold, and the like, and has the advantages of aromatic and qi-like, strong and strong dispersing power, and is a good product for promoting the circulation of qi, and can be used for aromatizing and wetting, and can be used for invigorating the spleen and stomach, and also can be used for treating the turbid and eliminating phlegm. The medicine for removing phlegm and inducing resuscitation has the effects of reducing phlegm, inducing resuscitation, eliminating dampness and stomach, refreshing mind, improving intelligence, regulating qi, promoting blood circulation, dispelling wind and removing dampness, and the like. It is mainly used for treating epilepsy caused by wind-phlegm. Has been widely used in the treatment of primary and secondary epilepsy in recent years, has a synergistic effect with the western medicine, and has the advantages of being long and short, thereby enhancing the curative effect and improving the adverse reaction of the western medicine[1,2]. Carbamazepine is a kind of common psychotropic drug, which can reduce the permeability of the nerve cell membrane to the Na + and Ca2 +, which leads to the decrease of the excitability of the cells and the prolongation of the refractory period. It is also possible to enhance the synaptic transmission function of the GABA of the 1-aminobutyric acid. It is necessary to enhance the inhibition of the late stage of the synapse and to prevent the diffusion and abnormal discharge of the focal point. The main metabolites in carbamazepine are 10,11-ring-oxidized carbamazepine, while 10,11-ring-oxidized carbamazepine has an anti-shock and anti-neuralgia-related effect. The antimanic and psychotic effects of this may have the potential to inhibit the ignition of the limbic system and the lobe of the brain. Its chemical and tricyclic antidepressants are similar, with anticholinergic activity, antidepressants, inhibition of muscle and nerve joints, and anti-dysrhythmias. The purpose of this study was to analyze the clinical data and to analyze the effect of combination of Chinese and Western medicine on the treatment of epilepsy. The method of the study is to study the epileptic patients in the department of epilepsy and neurology and neurosurgery in the People's Hospital of Shiyan, Hubei, from March 2013 to September,2014. 76 patients who met the diagnostic criteria were divided into the treatment group and the control group by using the random equalization method, and the treatment group was supplemented with the epilepsy in the basis of the carbamazepine treatment alone, and the patients in the control group were given carbamazepine alone. After a period of time, the clinical indicators before and after the administration of each group of patients were counted separately, such as detecting and recording the electroencephalogram, the frequency of the attack, the degree of attack, whether the symptoms were reduced or the like, and recording and analyzing. Study Results 1. The total effective rate of the treatment group was 78% and the total effective rate of the control group was 52%. There was a significant difference in the treatment group and the control group (p0.05)2. The time and frequency of the treatment before and after the treatment of 76 patients with epilepsy: the treatment group and the control group had significant difference (p0.05)3. Electroencephalogram (EEG) changes: in the treatment group, there were 31 cases of abnormal EEG in the treatment group, and 23 cases were improved after the treatment with the combination of the epilepsy and the carbamazepine. The improvement rate was 74.19%; in the control group, there were 31 cases of abnormal EEG in the control group, and 14 cases were improved after the treatment with carbamazepine alone. The rate of improvement was 45.16%. There was a significant difference between the two groups (p0.05)4. Side effects of administration: In the course of this study, individual patients in the treatment group had the symptoms of dry tongue, mild dizziness, and stomach discomfort, but none of the patients affected the patient to continue taking the medicine, and no special treatment was given. The control group had the symptoms of nausea and somnolence in the individual patients, and the symptoms of nausea and somnolence were given in the control group. Conclusion Epilepsy is a kind of auxiliary drug for treating epilepsy. It can improve the symptoms of epileptic patients to some extent, reduce the number of times, and be worth further clinical promotion.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R742.1
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