认知行为疗法联合奥卡西平对癫痫患儿认知功能及血清BDNF、Hcy、IGF-1水平的影响  

Effects of Cognitive Behavioral Therapy Combined with Oxcarbazepine on Cognitive Function and Levels of Serum BDNF,Hcy and IGF-1 in Epilepsy Children

作　　者：羡一心[1] 王莉[1] 索军芳 徐凯丽 XIAN Yi-Xin;WANG Li;SUO Jun-fang;XU Kai-li(Department of Neurology,Affiliated Children's Hospital of Zhengzhou University/Henan Children's Hospital/Zhengzhou Children's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院神经内科,郑州450000

出　　处：《中国合理用药探索》2021年第4期85-90,共6页Chinese Journal of Rational Drug Use

基　　金：2018年河南省医学科技攻关计划联合共建项目(2018020594)。

摘　　要：目的:探讨认知行为疗法联合奥卡西平对癫痫患儿认知功能及血清脑源性神经营养因子(BDNF)、同型半胱氨酸(Hcy)、胰岛素样生长因子1(IGF-1)水平的影响。方法:选取2018年1月~2020年1月本院神经内科病房129例学龄期儿童作为研究对象(其中9例脱落),根据家长及患儿意愿分为奥卡西平组(n=54例)和联合组(n=66例)。比较两组认知功能、BDNF、Hcy、IGF-1水平、脑电图相关指标、癫痫发作减少率及不良反应。结果:干预3个月后,两组定向力、语言能力、注意力及计算力、记忆力、回忆力得分以及MMSE总分均得到提升,且联合组得分高于奥卡西平组(P<0.05);两组血清BDNF、Hcy、IGF-1水平均得到改善,且联合组血清BDNF、IGF-1水平高于奥卡西平组、血清Hcy水平低于奥卡西平组(P<0.05);两组α、θ波与干预前比较有统计学差异,且联合组α波高于奥卡西平组(P<0.05);联合组癫痫发作减少率(89.28%)高于奥卡西平组(80.44%),头晕、视物模糊、皮疹、共济失调、低血钠等不良反应总发生率低于奥卡西平组(P<0.05)。结论:认知行为疗法联合奥卡西平能有效提高癫痫患儿认知功能,改善血清BDNF、Hcy、IGF-1水平,且对脑电图背景波影响较小,安全性较高。Objective:To explore the effects of cognitive behavioral therapy combined with oxcarbazepine on cognitive function and levels of serum brain derived neurotrophic factor(BDNF),homocysteine(Hcy)and insulin-like growth factor 1(IGF-1)in children patients with epilepsy.Methods:From January 2018 to January 2020,129 school-aged children in the ward of neurology department were selected as the research subjects(including 9 cases withdrawal),and divided into oxcarbazepine group(n=54)and combined group(n=66)according to the wishes of parents and children cognitive function,levels of BDNF,Hcy and IGF-1,electroencephalogram related indicators,reduction rate of epileptic seizure and adverse reactions were compared between the two groups.Results:After 3 months of intervention,the scores of orientation,language ability,attention and calculation,memory and recall and total score of MMSE in the two groups were improved,and the scores in combined group were higher than those in oxcarbazepine group(P<0.05).The levels of serum BDNF,Hcy and IGF-1 in the two groups were improved.The levels of serum BDNF and IGF-1 in combined group were higher than those in oxcarbazepine group,while the levels of serum Hcy was lower than that in oxcarbazepine group(P<0.05).The α and θ waves in the two groups were statistically different from those before intervention,and theαwave in combined group was higher than that in oxcarbazepine group(P<0.05).The reduction rate of epileptic seizure in combined group(89.28%)was higher than that in oxcarbazepine group(80.44%),and the total incidence rate of adverse reactions such as dizziness,blurred vision,rash,ataxia and hyponatremia in combined group was lower than that in oxcarbazepine group(P<0.05).Conclusion:Cognitive behavioral therapy combined with oxcarbazepine can effectively enhance the cognitive function and improve the levels of serum BDNF,Hcy and IGF-1 of children patients with epilepsy,and it has little influence on electroencephalogram background waves,with high safety.

关 键 词：认知行为疗法 奥卡西平 癫痫 认知功能 脑源性神经营养因子 同型半胱氨酸 胰岛素样生长因子1 

分 类 号：R971.6[医药卫生—药品]