镇静针法治疗癫痫强直阵挛发作及对视频脑电图监测指标的疗效研究  

Efficacy Analysis on Sedative Acupuncture in the Treatment of Generalized Tonic Clonic Seizures by Video EEG Monitoring

作　　者：叶家盛[1] 刘星辰[1] 王寅[1] 吴建恒 Ye Jiasheng;Liu Xingchen;Wang Yin;Wu Jianheng(Zhongshan Hospital of Traditional Chinese Medicine,Guangdong,Zhongshan 528400,China)

机构地区：[1]广东省中山市中医院,广东中山528400

出　　处：《中国中医急症》2022年第11期1924-1927,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20211415)。

摘　　要：目的 通过视频脑电图监测分析镇静针法治疗癫痫强直阵挛发作(GTCS)的临床疗效。方法 将符合纳入标准的60例癫痫GTCS患者随机分为治疗组与对照组各30例,两组患者均予丙戊酸钠片[15 mg/(kg·d)]抗癫痫治疗,在此基础上治疗组加予镇静针法治疗,治疗疗程为1周,采用精简QOLIE-31-P评分评价患者治疗前后变化,并在治疗前、治疗后及治疗后1周进行5 h的连续视频脑电图监测,比较两组患者发作间歇期癫痫样放电数量(IED)及非快速动眼期睡眠3期(N3)时长。结果 结果显示两组患者性别、年龄及癫痫病程上无统计学差异;在总有效率方面,治疗组高于对照组,且治疗组在GTCS的电-临床控制率上高于对照组,差异具有统计学意义(P<0.05)。两组患者在治疗后与随访1周,总IED频次、N3睡眠期时长较基线水平差异具有统计学意义(P<0.05),治疗组在治疗后及随访1周的NREM期IED频次较基线水平明显降低(P<0.05)。治疗组与对照组比较,在治疗后与随访1周后的总IED频次、NREM期IED频次及N3时长,差异有统计学意义(P<0.05)。治疗后,治疗组患者自我感受、再发作担忧及总体生活质量评分优于对照组(P<0.05)。结论 对于两组患者,不同时间电-临床改善的程度有所不同,镇静针法对治疗癫痫GTCS患者疗效确切,脑电监测显示镇静针法可改善发作后睡眠状态,抑制大脑皮层神经元异常放电。Objective:To study the clinical efficacy of sedative acupuncture in the treatment of generalized ton?ic clonic seizures(GTCS)by the video EEG monitoring.Methods:A total of 60 cases of epilepsy patients with GTCS who met the inclusion criteria were randomly divided into a treatment group and a control group with 30 cas?es in each group.The two groups were treated with sodium valproate tablets[15 mg/(kg·d)].On this basis,the treatment group was treated with sedative acupuncture,and the treatment course was 1 week.Simplified QOLIE-31-P score was used to evaluate the changes of patients before and after treatment and the patients in the two groups were monitored by continuous video EEG for 5 hours before treatment,after treatment and 1 week after treatment,respectively.The two groups were compared by the number of interictal epileptiform discharge(IED)andthe duration of non-rapid eye movement sleep stage 3(NREM 3)during the interictal period of the patients.Results:The results showed that there was no statistical difference in gender,age and course of epilepsy between the two groups.In terms of overall curative effect,the overall improvement rate of the treatment group was higher than that of the control group.The control rate was higher than that of the control group,and the result was statisti?cally significant(P<0.05).After treatment and at the 1 week follow-up,the total IED frequency and N3 sleep pe?riod duration in the two groups were significantly different from baseline levels(P<0.05),and the IED frequency of NREM stage after treatment and at 1 week follow-up was significantly decreased compared with baseline(P<0.05).Compared with the control group,the total IED frequency,IED frequency of NREM stage and N3 duration after treatment and at 1 week of follow-up in the treatment groupshowed statistically significant differences(P<0.05).After treatment,the patients in the treatment group were better than those in the control group in self feel?ing,relapse worry and overall life treatment evaluation(P<0.05).Conclusi

关 键 词：癫痫强直阵挛发作 针刺 丙戊酸钠 视频脑电图 镇静针法 

分 类 号：R742.1[医药卫生—神经病学与精神病学]