【摘要】：目的：研究嬰兒痙攣癥中醫(yī)證型分布特點(diǎn)及與視頻腦電圖、預(yù)后的關(guān)系。 方法：按照一定的診斷、納入標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn),采用問卷調(diào)查的方式,收集嬰兒痙攣癥患兒病例100例,問卷設(shè)計(jì)了中醫(yī)辯證診斷所需的所有癥狀的證候調(diào)查內(nèi)容。對嬰兒痙攣癥患兒進(jìn)行正確的中醫(yī)辯證分型,同時使用美國BMSI6000128通道全數(shù)字化視頻腦電圖儀,按照國際10-20系統(tǒng)標(biāo)準(zhǔn),安放19導(dǎo)聯(lián)記錄電極,雙側(cè)耳電極為參考電極,并附加心電及肌電。所有納入試驗(yàn)的患兒均未使用催眠藥物,采用自然睡眠或剝奪睡眠的方法,進(jìn)行2-3h清醒和睡眠期的視頻腦電圖監(jiān)測。治療上采用2007歐洲專家的共識方案,并進(jìn)行1-2年跟蹤隨訪。 結(jié)果：嬰兒痙攣癥的中醫(yī)證型的分布情況,結(jié)果由多到少依次為：肝腎虧虛型、痰癇、瘀血癇、驚癇。100例IS患兒中,治療前腦電圖典型的高峰節(jié)律紊亂53例,變異型高峰節(jié)律紊亂23例,局灶性異常的尖棘波24例。各證型與腦電圖間有一定的關(guān)系,但關(guān)聯(lián)度不強(qiáng)(rp=0.372)。經(jīng)治療后1個月短期的痙攣發(fā)作控制情況顯示：4種證型IS患兒療效有顯著性差異(P0.01),肝腎虧虛型VS痰癇有顯著性差異(P0.01)；肝腎虧虛型VS驚癇有顯著性差異(P0.01)；瘀血癇VS痰癇有顯著性差異(P0.05)；其它各證型之間的療效無顯著性差異(P0.05)。 結(jié)論：通過對嬰兒痙攣癥的流行病學(xué)調(diào)查研究,發(fā)現(xiàn)嬰兒痙攣癥中醫(yī)證型主要以肝腎虧虛型為主,其次為痰癇、瘀血癇、驚癇。嬰兒痙攣癥的中醫(yī)證型與視頻腦電圖的異常有一定的相關(guān)性,肝腎虧虛型與瘀血癇患兒視頻腦電圖多見變異型高峰節(jié)律紊亂和局灶性尖棘波。而痰癇及驚癇患兒其視頻腦電圖多為典型高峰節(jié)律紊亂。IS患兒預(yù)后差,大多數(shù)患兒伴有不同程度的精神運(yùn)動發(fā)育落后。IS各中醫(yī)證型中,肝腎虧虛型、瘀血癇患兒預(yù)后差,痰癇、驚癇患兒預(yù)后優(yōu)于肝腎虧虛型、瘀血癇。
[Abstract]:Objective: to study the distribution of TCM syndromes of infantile spasm and its relationship with video EEG and prognosis. Methods: 100 cases of infantile spasticity were collected by questionnaire according to certain diagnosis, inclusion standard and exclusion standard. The questionnaire designed the content of syndrome investigation of all the symptoms needed for dialectical diagnosis of TCM. The correct Chinese medicine dialectical classification of infantile spasms was carried out. At the same time, according to the international 10-20 system standard, 19 lead recording electrodes and double lateral ear electrodes were placed as reference electrodes using the BMSI6000128 channel full digital video EEG instrument in the United States, according to the international standard of 10-20 system. The electrocardiogram and myoelectricity were added. No hypnotic drugs were used in all the children who participated in the study. The visual electroencephalogram (VEEG) was monitored by natural sleep or sleep deprivation during 2 to 3 hours of waking and sleeping. The treatment was followed by a consensus protocol of 2007 European experts and followed up for 1-2 years. Results: the distribution of TCM syndromes of infantile spasticity was as follows: deficiency of liver and kidney, phlegm epilepsy, eclampsia and convulsion. Among the 100 cases of IS, 53 cases had typical peak rhythm disorder of EEG before treatment. There were 23 cases with abnormal peak rhythm and 24 cases with focal abnormal spikes. There is a certain relationship between each syndrome type and EEG, but the correlation degree is not strong (rp=0.372). One month after treatment, the control of spasmodic seizure showed that there were significant differences in the curative effect among the four types of IS (P0.01), the phlegm epilepsy of VS with deficiency of liver and kidney (P0.01), the type of VS with deficiency of liver and kidney (P0.01), the type of VS with deficiency of liver and kidney (P0.01), and the control of sputum epilepsy with VS with deficiency of liver and kidney (P0.01). There was significant difference in phlegm epilepsy of VS with blood stasis (P0.05), but there was no significant difference among other syndromes (P0.05). Conclusion: based on the epidemiological investigation of infantile spasticity, it is found that the main types of TCM syndrome of infantile spasm are deficiency of liver and kidney, followed by phlegm epilepsy, blood stasis epilepsy and convulsion epilepsy. There is a certain correlation between TCM syndrome type of infantile spasm and abnormal video-EEG. In children with deficiency of liver and kidney and ecchymosis, the abnormal peak rhythm disorder and focal sharp spike were found in the video-EEG of children with liver and kidney deficiency and ecchymosis. Most of the children with sputum epilepsy and convulsion had poor prognosis of the typical peak rhythm disorder. The majority of the children had different degrees of mental and motor retardation. Among the syndrome types of different TCM syndromes, deficiency of liver and kidney, poor prognosis of children with blood stasis epilepsy, phlegm epilepsy, etc. The prognosis of children with epilepsy was better than that of deficiency of liver and kidney and ecchymosis.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R272

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張喜蓮;馬融;;小兒癲癇的辨證治療[J];中華中醫(yī)藥雜志;2007年06期

2 鄭承寧;嬰兒痙攣癥治療進(jìn)展[J];國外醫(yī)學(xué)(兒科學(xué)分冊);2002年06期

3 石世同,劉洪玉,李亞玲,劉紅林,安昆;丙戊酸治療嬰兒痙攣癥40例療效觀察[J];河北醫(yī)藥;2002年04期

4 毛開新;孫艷萍;周雄飛;彭曙輝;;強(qiáng)的松治療嬰兒痙攣的療效觀察[J];中國實(shí)用神經(jīng)疾病雜志;2007年01期

5 任純明;;妥泰治療嬰兒痙攣22例觀察[J];鄭州大學(xué)學(xué)報(醫(yī)學(xué)版);2006年05期

6 林詩書,周開元,梁文旺;嬰兒痙攣癥的中醫(yī)治療體會[J];新中醫(yī);1991年07期

7 于海麗;王學(xué)禹;席加水;孫文秀;;兩種劑量ACTH治療嬰兒痙攣的療效及不良反應(yīng)對比分析[J];山東大學(xué)學(xué)報(醫(yī)學(xué)版);2010年02期

8 呂玉霞,王海,姜毅;中西醫(yī)結(jié)合治療嬰兒痙攣癥34例[J];上海中醫(yī)藥雜志;2001年08期

9 廖建湘;;生酮飲食在兒童癲沲治療中的應(yīng)用進(jìn)展[J];實(shí)用兒科臨床雜志;2007年24期

10 黃亞玲;徐三清;劉京華;王芳琳;蔡馥丞;魯娜;;左乙拉西坦治療嬰兒痙攣癥的療效[J];實(shí)用兒科臨床雜志;2008年24期

，

本文編號：2201120