本文關(guān)鍵詞： 繼發(fā)性癲癇 顱腦外傷 經(jīng)顱磁刺激 醫(yī)癇丸　出處：《山東醫(yī)藥》2017年20期 　論文類型：期刊論文

【摘要】：目的探討經(jīng)顱磁刺激聯(lián)合醫(yī)癇丸輔助治療顱腦外傷繼發(fā)性癲癇的臨床療效及其可能的機制。方法選擇顱腦外傷繼發(fā)性癲癇患者132例,隨機分為對照組、磁刺激組和聯(lián)合組各44例。三組均予常規(guī)治療(注射苯巴比妥鈉或口服丙戊酸鈉片,癲癇發(fā)作時口服氯硝西泮片)12周;磁刺激組在常規(guī)治療的基礎(chǔ)上行經(jīng)顱磁刺激連續(xù)治療1周;聯(lián)合組在磁刺激基礎(chǔ)上口服醫(yī)癇丸,共12周。三組治療12周評價臨床療效,計算總有效率。比較兩組治療前及治療12周癲癇持續(xù)狀態(tài)嚴(yán)重程度量表(STESS)評分及癲癇持續(xù)狀態(tài)的發(fā)作持續(xù)時間、發(fā)作頻率,生活質(zhì)量調(diào)查表31(QOLIE-31)評分以及血清ROS、NF-κB、IL-1β、TNF-α水平(采用ELISA法檢測)。記錄三組治療期間不良反應(yīng)發(fā)生情況。結(jié)果對照組總有效率為70.45%,磁刺激組為75.00%,聯(lián)合組為90.91%;聯(lián)合組總有效率高于對照組及磁刺激組(P均0.05)。三組治療后STESS評分、發(fā)作持續(xù)時間、發(fā)作頻率及血清ROS、NF-κB、IL-1β、TNF-α水平均低于治療前,QOLIE-31評分均高于治療前,但聯(lián)合組變化更明顯(P均0.01),對照組與磁刺激組治療后上述指標(biāo)比較差異均無統(tǒng)計學(xué)意義(P均0.05)。三組不良反應(yīng)發(fā)生率比較差異均無統(tǒng)計學(xué)意義(P均0.05)。結(jié)論經(jīng)顱磁刺激聯(lián)合醫(yī)癇輔助治療顱腦外傷性繼發(fā)癲癇效果確切且較為安全;抑制氧化應(yīng)激及炎性反應(yīng)可能是其作用機制。
[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- 偽 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- 偽 was lower than that of QOLIE-31 before treatment, but the change of TNF- 偽 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.
【作者單位】： 河南大學(xué)第一附屬醫(yī)院;
【基金】：河南省中醫(yī)藥科學(xué)研究專項課題(2013ZY02081)
【分類號】：R651.15;R742.1
【正文快照】： 顱腦外傷繼發(fā)性癲癇(PTE)為顱腦損傷后的嚴(yán)重并發(fā)癥,其在顱腦原發(fā)性損傷的基礎(chǔ)上引起腦組織損傷加重,并促進神經(jīng)元發(fā)生生化改變,導(dǎo)致患者死亡率升高[1,2]。目前臨床治療PTE的藥物和方法較多,但是治療效果不佳,患者病情容易反復(fù)[3]。經(jīng)顱磁刺激是一種神經(jīng)電生理技術(shù),通過調(diào)控大

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