癲癇寧輔助治療癲癇的臨床研究
發(fā)布時(shí)間：2019-06-01 08:06
【摘要】：研究背景:癲癇(Epilepsy)又稱“羊癲風(fēng)”,是由多種原因引起的具有自限性的腦部神經(jīng)元高度同步化異常放電所致的綜合征,以反復(fù)發(fā)作性、短暫性和通常為刻板性的中樞神經(jīng)系統(tǒng)功能失常為特征。國(guó)際抗癲癇聯(lián)盟將癲癇定義為一組以恒定的癲癇發(fā)作傾向和相應(yīng)的神經(jīng)生物學(xué)、認(rèn)知、心理和社會(huì)后果為特征的腦部疾病。癲癇寧(Epilepsy tablets)主要是由石菖蒲、纈草、馬蹄香、鉤藤、甘松、薄荷腦、牽牛子、千金子等組成,具芳香之氣,行散之力較強(qiáng),為宣氣通竅之佳品,既能芳香化濕、醒脾健胃,又可化濁祛痰、滌痰開竅之藥,具有化痰開竅、化濕和胃、醒神益智、理氣活血、散風(fēng)祛濕等功效。主治風(fēng)痰上擾之癇病。近些年來(lái)已被廣泛應(yīng)用于原發(fā)性、繼發(fā)性癲癇治療中,與西藥協(xié)同發(fā)揮作用,揚(yáng)長(zhǎng)避短,從而增強(qiáng)療效,改善西藥不良反應(yīng)[1,2]�？R西平(Carbamazepine)是一種常見精神性藥物,能降低神經(jīng)細(xì)胞膜對(duì)Na+和Ca2+的通透性,導(dǎo)致細(xì)胞的興奮性降低,使不應(yīng)期延長(zhǎng);也可能增強(qiáng)γ-氨基丁酸GABA的突觸傳遞功能。強(qiáng)化抑制突觸的強(qiáng)直后期,阻止致癇灶的擴(kuò)散和異常放電�？R西平中主要的代謝產(chǎn)物有10,11-環(huán)氧化卡馬西平,而10,11-環(huán)氧化卡馬西平具有抗驚厥和抗神經(jīng)痛相關(guān)作用。而其中的抗躁狂癥和精神病的作用有可能抑制了其邊緣系統(tǒng)和腦部顳葉部分的點(diǎn)燃作用。而它的化學(xué)作用和三環(huán)類抗抑郁藥藥是相類似的,具有抗膽堿活動(dòng)、抗抑郁、抑制肌肉神經(jīng)接頭的傳遞和抗節(jié)律失常等作用。研究目的通過(guò)對(duì)臨床資料的觀察研究,分析癲癇寧聯(lián)合單種抗癲癇西藥卡馬西平治療癲癇的研究進(jìn)行統(tǒng)計(jì)分析,進(jìn)一步評(píng)價(jià)中西藥聯(lián)合使用對(duì)癲癇的治療作用。研究方法本課題采用臨床調(diào)查的研究方法,對(duì)2013年3月至2014年9月在湖北省十堰市人民醫(yī)院癲癇�？崎T診和神經(jīng)內(nèi)科、神經(jīng)外科病房住院的癲癇患者,將符合診斷標(biāo)準(zhǔn)的76例患者采用隨機(jī)均衡方法分為治療組和對(duì)照組,治療組在單用卡馬西平治療的基礎(chǔ)上輔以癲癇寧,對(duì)照組患者單純服用卡馬西平。一段時(shí)間后,分別統(tǒng)計(jì)各組患者用藥前后的各項(xiàng)臨床指標(biāo),如檢測(cè)并記錄腦電圖、發(fā)作頻率、發(fā)作程度、癥狀是否減輕等情況,加以記錄并分析。研究結(jié)果1.臨床療效統(tǒng)計(jì):治療組總有效率為78%,對(duì)照組總有效率為52%。治療組和對(duì)照組比較有顯著差異(p0.05)2.對(duì)76例癲癇患者治療前后發(fā)作時(shí)間及頻率的比較:治療組與對(duì)照組有顯著差異(p0.05)3.腦電圖改變:治療組在治療前有31例腦電圖異常,通過(guò)癲癇寧聯(lián)合卡馬西平治療后,腦電圖不同程度好轉(zhuǎn)有23例。改善率為74.19%;對(duì)照組在治療前有31例腦電圖異常,通過(guò)單用卡馬西平治療后,腦電圖不同程度好轉(zhuǎn)有14例。改善率為45.16%。兩組比較有顯著差異(p0.05)4.用藥副反應(yīng):本次研究過(guò)程中,治療組有個(gè)別病人出現(xiàn)口干舌燥、輕度頭暈及胃部不適等癥狀,但都不影響病人繼續(xù)服藥,沒(méi)有給予特殊處理。對(duì)照組有個(gè)別病人出現(xiàn)惡心、嗜睡等癥狀,給予對(duì)癥支持治療后好轉(zhuǎn),不影響繼續(xù)服藥。研究結(jié)論癲癇寧作為治療癲癇的一種輔助用藥效果顯著,可以在一定程度上改善癲癇患者的癥狀、減少發(fā)病次數(shù),值得進(jìn)一步臨床推廣。
[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.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R742.1
本文編號(hào)：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.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R742.1
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