本文關(guān)鍵詞： 癲癇 兒童 鎮(zhèn)心定癇湯 認(rèn)識(shí)功能 炎性因子 氧化應(yīng)激　出處：《中國(guó)實(shí)驗(yàn)方劑學(xué)雜志》2017年24期 　論文類(lèi)型：期刊論文

【摘要】：目的:探討加味鎮(zhèn)心定癇湯對(duì)小兒癲癇(痰火擾神證)認(rèn)識(shí)功能和生活質(zhì)量的影響及其抗炎、抗氧化應(yīng)激作用。方法:將124例患者采用SAS軟件生成,隨機(jī)按數(shù)字表法分為對(duì)照組和觀察組各62例。對(duì)照組口服左乙拉西坦片,起始治療劑量是10 mg·kg~(-1),根據(jù)臨床效果及耐受性,劑量可以增加至30 mg·kg~(-1),2次/d。觀察組在對(duì)照組治療的基礎(chǔ)上采用加味鎮(zhèn)心定癇湯內(nèi)服,1劑/d,每周服藥5 d,停藥2 d。兩組療程均連續(xù)治療12個(gè)月。記錄癲癇發(fā)作次數(shù)和持續(xù)時(shí)間,進(jìn)行治療前后腦電圖檢測(cè)和痰火擾神證評(píng)分;進(jìn)行治療前后癲癇患者生活質(zhì)量問(wèn)卷(QOLIE-AD-48)和韋氏兒童智力量表中國(guó)修訂版(WISC-CR)評(píng)價(jià);檢測(cè)治療前后高遷移率族蛋白B1(HMGB1),白細(xì)胞介素-6(IL-6),腫瘤壞死因子-α(TNF-α),超氧化物歧化酶(SOD)和丙二醛(MDA)水平。結(jié)果:觀察組臨床療效總有效率為92.86%,高于對(duì)照組的78.18%(χ~2=4.844,P0.05);觀察組腦電圖療效總有效率為96.43%,高于對(duì)照組的81.82%(χ~2=6.143,P0.05);治療后觀察組癲癇發(fā)作次數(shù)少于對(duì)照組,持續(xù)時(shí)間短于對(duì)照組,痰火擾神證評(píng)分低于對(duì)照組(P0.01);治療后觀察組QOLIE-AD-48量表癲癇態(tài)度、軀體功能、學(xué)校表現(xiàn)、健康觀念、羞恥感、記憶注意力、癲癇影響等因子評(píng)分均高于對(duì)照組(P0.01);治療后觀察組患者WISC-CR量表中言語(yǔ)智商(VIQ),操作智商(PIQ),總智商(FIQ)均高于對(duì)照組(P0.01);治療后觀察組患者HMGB1,IL-6,TNF-α和MDA水平均低于對(duì)照組,SOD水平高于對(duì)照組(P0.01)。結(jié)論:加味鎮(zhèn)心定癇湯聯(lián)合左乙拉西坦片治療兒童癲癇(痰火擾神證),能控制癲癇的發(fā)作,改善臨床癥狀,提高患兒的生活質(zhì)量和認(rèn)識(shí)能力,并具有一定的抗炎癥反應(yīng)和抗氧化損傷作用,臨床療效優(yōu)于單純的西醫(yī)治療。
[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- 偽, 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- 偽 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.
【作者單位】： 鄭州大學(xué)第二附屬醫(yī)院;
【基金】：河南省科學(xué)技術(shù)研究項(xiàng)目(2015JQ4014G)
【分類(lèi)號(hào)】：R742.1
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本文編號(hào)：1518280