重型急性缺血性卒中合并癫痫发作患者的中医证型与视频脑电图表现的相关性研究  

Study on the Correlation between TCM Syndromes and Video-EEG Manifestations in Patients with Severe Acute Ischemic Stroke Complicated with Seizure

作　　者：刘星辰 吴健恒 彭慧渊 何宇峰 杨楠 Liu Xingchen;Wu Jianheng;Peng Huiyuan;He Yufeng;Yang Nan(Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine,Guangdong,Zhongshan 528400,China)

机构地区：[1]广州中医药大学附属中山中医院,广东中山528400

出　　处：《中国中医急症》2022年第8期1175-1178,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省医学科研基金项目(A2022546);广东省中医药重点学科建设项目[粤中医办函(2021)129号];中山市科技计划重大项目(2019B1005);中山市科技计划项目(202131051);中山市医学科研项目(2020J113)。

摘　　要：目的研究重型急性缺血性卒中合并癫痫发作患者的中医证型与视频脑电图表现的相关性。方法回顾性收集2015年1月至2020年12月136例重型急性缺血性卒中后出现癫痫发作患者,按照中医中风中脏腑辨证分为痰热内闭、痰湿蒙神和元气败脱3个证型组,对各组患者基线临床资料、癫痫发作特征进行比较,应用视频脑电图监测分别对背景节律、脑电图反应性、发作间歇期放电(IED)特征进行观察,分析各监测指标与中风中脏腑各证型之间的关系。结果研究患者共136例,其中男性75例,女性62例。中风中脏腑中医证型分布规律:痰热内闭证53例(38.97%)>痰湿蒙神证51例(37.50%)>元气败脱证32例(23.53%)。元气败脱证患者年龄及入院卒中严重程度高于另外两组患者(P<0.05)。在局灶扩布全身的强直-阵挛发作、癫痫持续状态的发生比例上,元气败脱证高于痰湿蒙神证及痰热内闭证(P<0.05)。元气败脱证组患者脑电图背景节律异常比例、脑电图反应性受累比例、每小时IED频次、多灶性或广泛性IED比例皆高于痰热内闭证组及痰湿蒙神证组患者(P<0.05)。元气败脱证组患者在脑电图背景节律异常比例、脑电图反应性受累比例、每小时IED频次、多灶性或广泛性IED比例皆高于痰热内闭证组及痰湿蒙神证组患者(P<0.05)。在证型与出院转归的调查中发现,痰热内闭证与良好转归相关,元气败脱证与恶化及死亡相关(P<0.001)。结论本研究结合“中风-中脏腑”患者的癫痫发作特点及视频脑电图特征发现其与中医证型存在一定关联,因此视频脑电图表现可为重症急性缺血卒中患者的辨证分型提供重要依据。Objective:To study the correlation between traditional Chinese medicine(TCM)syndrome types and video-electroencephalogram(VEEG)manifestations in patients with severe acute ischemic stroke complicated with seizures.Methods:A total of 136 patients with seizures after severe acute ischemic stroke were retrospective⁃ly collected and divided into three syndrome types of phlegm-heat,phlegm-dampness and primordial qi failure ac⁃cording to viscera syndrome differentiation of stroke in traditional Chinese medicine.The baseline clinical data and seizure characteristics of the three groups were compared,and the background rhythm,Electroencephalogram(EEG)reactivity and interictal discharge(IED)characteristics were observed and the relationship between the monitoring indexes and the syndrome types of viscera in stroke was analyzed.Results:A total of 136 patients were studied,including 75 males and 62 females.The distribution law of TCM syndrome types of apoplexy in vis⁃cera:53 cases(38.97%)of phlegm-heat syndrome,51 cases(37.50%)of phlegm-dampness syndrome,32 cases(23.53%)of primordial qi collapse syndrome.The age and severity of admission stroke of the patients with the syndrome of collapse of primordial qi were higher than those of the other two groups(P<0.05).The occurrence rate of tonic-clonic seizure and status epilepticus with focal extension was higher in the syndrome of collapse of primordial qi than in the syndrome of mental confusion due to phlegm-dampness and the syndrome of internal obstruction due to phlegm-heat(P<0.05).The proportion of abnormal EEG background rhythm,the proportion of in⁃volved EEG reactivity,the frequency of IED per hour and the proportion of multifocal or extensive IED in the group of syndrome of collapse of primordial qi were higher than those in the groups of syndrome of retention of phlegm-heat in the interior and syndrome of mental confusion due to phlegm-dampness(P<0.05).The proportion of abnormal EEG background rhythm,proportion of involved EEG reactivity,frequency of IED per hou

关 键 词：急性缺血性卒中 癫痫发作 中医证型 视频脑电图 

分 类 号：R743.9[医药卫生—神经病学与精神病学]