温针灸治疗儿童癫痫的疗效观察及对血清PSD-95水平的影响  

Observation of the therapeutic effect of needle-warming moxibustion in the treatment of children with epilepsy and its effect on serum PSD-95 level

作　　者：秦玲玲 孟祥磊 梁力泳 杨添淞 QIN Lingling;MENG Xianglei;LIANG Liyong;YANG Tiansong(Hospital of Traditional Chinese Medicine of Qiqihar,Qiqihar 161005,China;Qiqihar Emergency Center,Qiqihar 161099,China)

机构地区：[1]齐齐哈尔市中医医院,齐齐哈尔161005 [2]齐齐哈尔急救中心,齐齐哈尔161099

出　　处：《上海针灸杂志》2024年第4期445-450,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金项目(82074539);齐齐哈尔市科学技术计划项目(SFZD-2019117)。

摘　　要：目的观察温针灸涌泉和百会穴治疗儿童癫痫的临床疗效及对患者神经损伤状态和血清突触后致密区95(postsynaptic density-95,PSD-95)水平的影响。方法对110例癫痫儿童患者展开回顾性研究,根据治疗方法的不同将其分为对照组和观察组,每组55例。对照组采用口服拉莫三嗪治疗,观察组在对照组口服药物基础上采用温针灸涌泉和百会穴治疗。比较两组临床疗效,观察两组治疗前后韦氏儿童智力量表(Wechsler intelligence scale for children-Ⅳ,WISC-Ⅳ)和简易精神状态检查表(mini-mental state examination,MMSE)评分、癫痫发作频率、癫痫持续时间、脑电图指标以及血清S100β、胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)和PSD-95水平的变化。结果观察组总有效率高于对照组(P<0.05)。观察组治疗后WISC-Ⅳ和MMSE评分均高于对照组(P<0.05),癫痫发作频率低于对照组(P<0.05),癫痫持续时间短于对照组(P<0.05)。观察组治疗后脑电图β功率、δ功率、θ功率和α功率均高于对照组(P<0.05)。观察组治疗后血清S100β和GFAP水平均低于对照组(P<0.05),血清PSD-95水平高于对照组(P<0.05)。结论在口服拉莫三嗪治疗基础上,采用温针灸涌泉和百会穴治疗儿童癫痫可改善神经损伤状态,改善认知功能和精神状态,减少癫痫发作次数,缩短发作持续时间,上调血清PSD-95表达量,降低血清S100β和GFAP水平,提高临床疗效。Objective To observe the clinical efficacy of needle-warming moxibustion at Yongquan(KI1)and Baihui(GV20)in the treatment of epilepsy in children and its effect on the nerve injury state and serum postsynaptic density 95(PSD-95)level.Method A total of 110 children with epilepsy were divided into a control group and an observation group according to different treatment methods,with 55 cases in each group.The control group was treated with oral Lamotrigine,and the observation group was treated with needle-warming moxibustion at Yongquan and Baihui on the basis of oral medication in the control group.The clinical efficacy was compared between the two groups,and the scores of Wechsler intelligence scale for children Ⅳ(WISC-Ⅳ)and mini-mental state examination(MMSE)were observed before and after treatment in the two groups.The changes of MMSE score,seizure frequency,seizure duration,electroencephalogram(EEG)indexes,S100βlevel,glial fibrillary acidic protein(GFAP)level and PSD-95 level were observed.Result The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the scores of WISC-Ⅳ and MMSE in the observation group were higher than those in the control group(P<0.05),the frequency of seizures was lower than that in the control group(P<0.05),and the duration of seizures was shorter than that in the control group(P<0.05).After treatment,the β power,δ power,θ power and α power of EEG in the observation group were higher than those in the control group(P<0.05).After treatment,the serum levels of S100β and GFAP in the observation group were lower than those in the control group(P<0.05),and the serum level of PSD-95 was higher than that in the control group(P<0.05).Conclusion On the basis of oral Lamotrigine,needle-warming moxibustion at Yongquan and Baihui in the treatment of children with epilepsy can improve the state of nerve injury,improve cognitive function and mental state,reduce the frequency of seizures,shorten the duration of seizures,up-regulate

关 键 词：温针疗法 针药并用 穴 涌泉 穴 百会 癫痫 儿童 神经功能 突触后致密区95 

分 类 号：R246.6[医药卫生—针灸推拿学]