醒神愈痫汤辅助治疗小儿难治性癫痫50例临床观察  

Clinical observation on 50 cases of Xingshen Yuxian Tang(醒神愈痫汤)in adjuvant treatment of children with intractable epilepsy

作　　者：蒋小锋 蒋冬杰 吴菲 汤军[4] JIANG Xiaofeng;JIANG Dongjie;WU Fei;TANG Jun(School of Postgraduate,Zhejiang Chinese Medical University,Hangzhou,Zhejiang,310051,China;Department of TCM Pediatrics,Community Health Service Center of Mishixiang Street in Gongshu District of Hangzhou,Hangzhou,Zhejiang,310005,China;Department of Pediatrics,Health Service Center of Song'ao Town in Fenghua District of Ningbo,Ningbo,Zhejiang,315517,China;Department of TCM Internal Medicine,Zhejiang Provincial Hospital of TCM,Hangzhou,Zhejiang,310002,China)

机构地区：[1]浙江中医药大学研究生院,浙江杭州310051 [2]杭州市拱墅区米市巷街道社区卫生服务中心中医儿科,浙江杭州310005 [3]宁波市奉化区松岙镇卫生院中医科,浙江宁波315517 [4]浙江省中医院中内科,浙江杭州310002

出　　处：《中医儿科杂志》2022年第5期57-61,共5页Journal of Pediatrics of Traditional Chinese Medicine

基　　金：浙江省中医药重点研究项目(2020ZZ009)。

摘　　要：目的观察醒神愈痫汤辅助治疗小儿难治性癫痫的临床疗效。方法选取2015年8月至2019年8月在杭州市拱墅区米市巷街道社区卫生服务中心中医儿科和浙江省中医院中内科收治的100例难治性癫痫患儿,按照随机数字表法分为治疗组和对照组,各50例。对照组予托吡酯片和左乙拉西坦片口服治疗,治疗组在对照组治疗方法的基础上予醒神愈痫汤口服。2组均以1个月为1个疗程,连续治疗6个疗程后统计疗效。结果治疗组总有效率为92.00%(46/50),显著高于对照组的74.00%(37/50),2组比较,差异有统计学意义(P<0.05)。治疗前,2组的总智商(FIQ)、言语智商(VIQ)和操作智商(PIQ)评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组的FIQ、VIQ和PIQ评分均较同组治疗前明显升高,差异有统计学意义(P<0.05),且治疗组升高更显著(P<0.05)。治疗前,2组的免疫球蛋白A(IgA)、免疫球蛋白G(IgG)以及免疫球蛋白M(IgM)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组的IgA、IgG以及IgM水平均较同组治疗前明显降低,差异有统计学意义(P<0.05),且治疗组降低更显著(P<0.05)。治疗前,2组的血清T细胞亚群分化簇3^(+)(CD3^(+))、分化簇4^(+)(CD4^(+))、分化簇8^(+)(CD8^(+))以及CD4^(+)/CD8^(+)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较同组治疗前明显升高,CD8^(+)明显降低,差异均有统计学意义(P<0.05),且治疗组升高或降低更显著(P<0.05)。治疗组出现食欲不振1例,嗜睡1例,疲乏无力1例,不良反应发生率为6.00%(3/50);对照组出现食欲不振3例,嗜睡1例,疲乏无力2例,脑力受损1例,低热2例,易怒1例,不良反应发生率为20.00%(10/50)。2组不良反应发生率比较,差异有统计学意义(P<0.05)。结论醒神愈痫汤辅助治疗小儿难治性癫痫,临床疗效显著,可明显提高患儿的认知功能,显著改善血清免疫球Objective To observe the clinical efficacy of Xingshen Yuxian Tang(醒神愈痫汤,XSYXT)in adjuvant treatment of children with intractable epilepsy.Methods From August 2015 to August 2019,100 cases of children with intractable epilepsy admitted into pediatrics department of Community Health Service Center of Mishixiang Street in Gongshu District of Hangzhou and department of TCM internal medicine of Zhejiang Provincial Hospital of TCM were divided into treatment group and control group according to random number table method,with 50cases in each group.The control group was given oral administration of topiramate tablets and levetiracetam tablets,on this basis,the treatment group was given oral administration of XSYXT.One month constituted 1 course of treatment for both groups,and the efficacy was assessed after consecutive 6 courses of treatment.Results The total effective rate of the treatment group was 92.00%(46/50),which was significantly higher than 74.00%(37/50)of the control group,and the difference was statistically significant between the 2 groups(P<0.05).Before treatment,the differences were not statistically significant in full-scale intelligence quotient(FIQ),verbal intelligence quotient(VIQ)and performance intelligence quotient(PIQ)between the 2 groups(P>0.05),indicating comparability.After treatment,the scores of FIQ,VIQ and PIQ all significantly increased in the 2 groups as compared with the same group before treatment,and the difference was statistically significant(P<0.05),moreover,the increase was more significant in the treatment group(P<0.05).Before treatment,the difference was not statistically significant in levels of immunoglobulin(Ig)A,IgG and IgM between the 2 groups(P>0.05),indicating comparability.After treatment,the levels of IgA,IgG and IgM in the 2 groups significantly decreased as compared with the same group before treatment,and the difference was statistically significant(P<0.05),moreover,the decrease was more significant in the treatment group(P<0.05).Before treatment,the levels

关 键 词：难治性癫痫 小儿 醒神愈痫汤 免疫功能 认知功能 临床观察 

分 类 号：R274.1[医药卫生—中医骨伤科学]