加味镇心定痫汤对小儿癫痫痰火扰神证认识功能和生活质量的影响  

Effect of Modified Zhenxin Dingxian Tang on Function of Cognition and Quality of Life of Patients with Pediatric Epilepsy and Tanhuo Raoshen Symptom

作　　者：鲍茹[1] 李永凤[1] 陈莹[1] 

机构地区：[1]郑州大学第二附属医院,郑州450014

出　　处：《中国实验方剂学杂志》2017年第24期196-201,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河南省科学技术研究项目(2015JQ4014G)

摘　　要：目的:探讨加味镇心定痫汤对小儿癫痫(痰火扰神证)认识功能和生活质量的影响及其抗炎、抗氧化应激作用。方法:将124例患者采用SAS软件生成,随机按数字表法分为对照组和观察组各62例。对照组口服左乙拉西坦片,起始治疗剂量是10 mg·kg^(-1),根据临床效果及耐受性,剂量可以增加至30 mg·kg^(-1),2次/d。观察组在对照组治疗的基础上采用加味镇心定痫汤内服,1剂/d,每周服药5 d,停药2 d。两组疗程均连续治疗12个月。记录癫痫发作次数和持续时间,进行治疗前后脑电图检测和痰火扰神证评分;进行治疗前后癫痫患者生活质量问卷(QOLIE-AD-48)和韦氏儿童智力量表中国修订版(WISC-CR)评价;检测治疗前后高迁移率族蛋白B1(HMGB1),白细胞介素-6(IL-6),肿瘤坏死因子-α(TNF-α),超氧化物歧化酶(SOD)和丙二醛(MDA)水平。结果:观察组临床疗效总有效率为92.86%,高于对照组的78.18%(χ~2=4.844,P<0.05);观察组脑电图疗效总有效率为96.43%,高于对照组的81.82%(χ~2=6.143,P<0.05);治疗后观察组癫痫发作次数少于对照组,持续时间短于对照组,痰火扰神证评分低于对照组(P<0.01);治疗后观察组QOLIE-AD-48量表癫痫态度、躯体功能、学校表现、健康观念、羞耻感、记忆注意力、癫痫影响等因子评分均高于对照组(P<0.01);治疗后观察组患者WISC-CR量表中言语智商(VIQ),操作智商(PIQ),总智商(FIQ)均高于对照组(P<0.01);治疗后观察组患者HMGB1,IL-6,TNF-α和MDA水平均低于对照组,SOD水平高于对照组(P<0.01)。结论:加味镇心定痫汤联合左乙拉西坦片治疗儿童癫痫(痰火扰神证),能控制癫痫的发作,改善临床症状,提高患儿的生活质量和认识能力,并具有一定的抗炎症反应和抗氧化损伤作用,临床疗效优于单纯的西医治疗。Objective： To observe the effect of modified Zhenxin Dingxian Tang on the awareness function and the quality of life of patients with pediatric epilepsy（ Tanhuo Raoshen symptom）,anti-inflammatory and antioxidant stress. Method： One hundred and twenty-four patients were randomly divided into control group（ 62 cases） and observation group（ 62 cases） by random number table. Patients in control group were given levetiracetam,10 mg·kg^-1 for the initial treatment dose,which increased to 30 mg·kg^-1,2 times/day. In addition to the therapy in control group,patients in observation group were also given modified Zhenxin Dingxian Tang,5 days/week. And 12 months were a course of treatment. Epileptic seizure frequency and duration were recorded.Before and after treatment,electroencephalogram was detected. And score of Tanhuo Raoshen symptom was graded. Quality of life questionnaire score（ QOLIE-AD-48） and Wechsler Intelligence Scale for Children（ WISC）were evaluated. And levels of high mobility group protein B1（ HMGB1）,interleukin-6（ IL-6）,tumor necrosis factor-α（ TNF-α）,superoxide dismutase（ SOD）,and malondialdehyde（ MDA） were detected. Result： The total effect rate in observation group was 92. 86%,which was higher than 78. 18% in control group（ χ~2= 4. 844,P 0. 05）. The total effect rate of electroencephalogram in observation group was 96. 43%,which was higher than81. 82% in control group（ χ~2= 6. 143,P 0. 05）. After treatment,epileptic seizure frequency in observation group was less than that in control group,duration was shorter than that in control group,and score of Tanhuo Raoshen symptom was lower than that in control group（ P 0. 01）. And scores of social support,epilepsy attitude,body function,school performance,health concept,shame,memory/attention and epilepsy of QOLIE-AD-48 scale and FIQ,VIQ and PIQ of WISC-CR scale were all higher than those in control group（ P 0. 01）. And levels of HMGB1,IL-6,TNF-α and MDA were lower than those in control group

关 键 词：癫痫 儿童 镇心定痫汤 认识功能 炎性因子 氧化应激 

分 类 号：R287[医药卫生—中药学]