抗痫煎剂治疗痰瘀互结型缺血性脑卒中后癫痫临床研究  

Anti-epileptic decoction in the treatment of epilepsy after ischemic stroke of phlegm and blood stasis type

作　　者：王珊[1] 谭文澜[2] 张永全[2] 覃辉[2] 黄金媚 钟君[2] 张琼心 方伟 WANG Shan;TAN Wenlan;ZHANG Yongquan;QIN Hui;HUANG Jinmei;ZHONG Jun;ZHANG Qiongxin;FANG Wei(Guangxi University of Chinese Medicine,Nanning Guangxi,530200;Airport Branch of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Chongzuo Guangxi,532100)

机构地区：[1]广西中医药大学,广西南宁530200 [2]广西中医药大学附属瑞康医院空港院区,广西崇左532100

出　　处：《广西中医药》2022年第6期1-6,共6页Guangxi Journal of Traditional Chinese Medicine

基　　金：广西壮族自治区中医药管理局科研课题(编号:GZZC2020073);广西壮族自治区中医药管理局中医药适宜技术开发与推广项目(编号:GZSY21-39);崇左市科学技术局计划课题(编号:崇科FC2019009)。

摘　　要：目的:观察抗痫煎剂治疗痰瘀互结型缺血性脑卒中后癫痫(PSE)的临床疗效,探讨其作用机制。方法:将92例PSE患者随机分为治疗组和对照组各46例,两组均予脑卒中二级预防药物,此外,对照组予卡马西平片治疗,治疗组予卡马西平片联合抗痫煎剂治疗,疗程共3个月。观察两组癫痫发作控制疗效,比较两组治疗前后PSE患者生活质量评分(QOLIE-31评分)、中医证候积分、血清同型半胱氨酸(Hcy)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平的变化情况。结果:治疗组癫痫发作控制总有效率为89.1%,对照组为73.9%,治疗组疗效优于对照组(P<0.01);治疗后治疗组血清Hcy、LDL-C水平与对照组相比明显降低(P<0.01),而TG、TC、HDL-C水平未见明显差异;治疗后两组中医证候积分减少、脑电图改善及QOLIE-31评分升高,且治疗组改善更显著(P<0.05);治疗组中医证侯疗效优于对照组(P<0.05)。结论:抗痫煎剂治疗痰瘀互结型缺血性脑卒中后癫痫有较好的临床效果,其机制可能与降低血清Hcy、LDL-C水平有关。Objective:To observe the clinical effect of anti-epileptic decoction on ischemic epilepsy(PSE) and explore the function mechanism.Methods:Ninety-two PSE patients were randomly divided into treatment group and control group, with 46 cases in each group. The secondary preventive drugs for stroke were given to the patients from both groups. In addition, carbamazepine tablets were given to the control group, and carbamazepine tablets combined with anti-epileptic decoction were given to the treatment group. The two groups were treated for 3 months. The efficacy of seizure control was observed in the two groups. The quality of life score(QOLIE-31 score), TCM syndrome score, serum homocysteine(Hcy), triglyceride(TG), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C) and lowdensity lipoprotein cholesterol(LDL-C) were compared before and after the treatment.Results:The total effective rate of seizure control in the treatment group was 89.1%, which was better than 73.9% in the control group(P<0.01). After treatment, the levels of serum Hcy and LDL-C in the treatment group were significantly lower than those in the control group(P<0.01), while the levels of TG, TC and HDL-C were not significantly different. After treatment, the scores of TCM syndromes in the two groups decreased, the scores of EEG and QOLIE-31 increased, and the improvement in the treatment group was more significant(P<0.05). The curative effect of TCM syndromes in the treatment group was better than that in the control group(P<0.05).Conclusion:Anti-epileptic decoction has a good clinical effect in the treatment of epilepsy with phlegm and blood stasis after ischemic stroke. The mechanism may be related to lower serum Hcy, LDL-C levels.

关 键 词：缺血性脑卒中 癫痫 血清HCY 血脂 

分 类 号：R711.6[医药卫生—妇产科学]