卡马西平与丙戊酸合并中药治疗癫癎异常灌注灶的修复对比研究  

Contrast studies of fepairation of abnormal perfusion foci on SPECT in epileptic patients with the treated by carbamazepine and valproate with the application of traditional Chinese medicine

作　　者：张永琴[1] 王为民[1] 

机构地区：[1]兰州大学第二医院癫痫中心,甘肃癫痫治疗基地,甘肃兰州730030

出　　处：《癫痫与神经电生理学杂志》2013年第1期5-10,共6页Journal of Epileptology and Electroneurophysiology(China)

基　　金：甘肃省攻兰课题项目（NO：432398）

摘　　要：目的；观察卡马西平（CBZ）与丙戊酸（VPA）控制临床发作后中药辅助修复癫癎患者脑部异常灌注灶的疗效和长程视频恼电图（V—EEG）的动态变化。方法；检查200例病人治疗前后的发作间期SPECT显像、长程EEG及CT和（或）MRI，抗癫癎药发作控制后加入中药，对比性研究其结果。结果；①CBZ控制组：病因明确者65例，治疗前SPECT异常88例（88％）。异常灌注灶143个。V—EEG异常82例（82％），癎样放电为86．6％。CT和（或）MRI异常34％。治疗后SPECT正常增加24％（P〈0.05），异常灶减少34，3％。V—EEG正常增加19％（P〈0.05），癎样放电减少28．1％；②VPA控制组；病因明确48例。治疗前SPECT异常90例（90％）。异常灌注灶为137个。V—EEG异常90例（90％）。痫样放电率为97．8％。CT和（或）MRI异常12例（12％）。治疗后SPECT正常增加52％（P〈0.05）。异常灶减少55，5％。VEEG正常增加46％（P〈0，05），癎样放电减少70．5％。绪论；VPA组修复异常灌注灶和消除、减少癎样放电的疗效明显太于CBZ组（SPECT正常增加52：24例；异常灶减少55.5％：34．3％；痂样放电减少70．5％，28，1％）；中药修复异常灌注灶发挥了重要作用。Objective： To contrast the curative effect of repairing abnormal perfusion foci on SPECT and dynamic changes of V-EEG in patients with epilepsy before and after long-term eontrol of epilepsy with Carhamagepine and Va!proate combined with traditiQna! Chinese medicine, Methods：The interietal SPECT,long-term EEG and CT/MRI were performed before and after treatment in 200 patients with epilepsy, Chinese medicine was added after control of epilepsy, The result of comparison was an alysed, Reaults： （1） Carbamaxepine group;Cause-awared cases took up 65 %, Before treatment the interictcal SPECT abnQrmality was in 88N, There were !4a cases of abnormal perfusion focus, V-EEG abnormality was in 82%（epileptie discharge was in 86, 6%）, CT/MR! abnormality was in a4M. After treatmeat interictcal SPECT normal increased by 24% （P〈0. 05） and ahnormal perfusion fuci decreased by 34,3%, normal V-EEG increased hy 19 % （ P〈0. 05 ） and epileptic discharge decreased by .28.1%, （2） Valproate group：Cause-awared cases took up 48%, Before treatment abnormal by interleteal SPECT abnormality was in 90%, There were 137 of abnormal perfusion loci, ahnormal V-EEG was in 90M （epileptic discharge was in 97, 8%）, abnormal CT/MRI was in 12%. After treatment normal interictcal SPECT increased by 52% （P〈0, 05） and abnormal perfusion loci decreased by 55, 5%. normal V-EEG increased by 46% （P〈0.05）and epileptic discharges decreased by 70.5 %, Coneluslon： Through the experiment, Valproie acid＇s effective repavation of abnormal perfusion loci effect and reduction of epileptic discharge are confirmed and better than the mere application of Carbamazepine（SPECT increased in 52：24;abhor mal perfusion loci decreased by 55.5% ：34.3% ;epileptic discharge decreased by 70.5% ：28. 1%）. Traditional Chinese medicine plays an important role in repairing abnormal perfusion loci.

关 键 词：癫癎 卡马西平 丙戊酸 中药 发作间期SPECT 异常灌注灶 长程视频脑电图(V-EEG) 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R971.6[医药卫生—临床医学]