温针灸联合豁痰息痉汤对脑梗死继发癫痫患者生命质量及脑电图的影响
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摘要
目的:探讨温针灸联合豁痰息痉汤对脑梗死继发癫痫患者生命质量及脑电图的影响。方法:选取2015年8月至2017年7月南通大学附属海安市人民医院收治的脑梗死继发癫痫患者112例作为研究对象,随机分为对照组和观察组,每组56例。对照组采用常规治疗,观察组在对照组基础上加用温针灸联合豁痰息痉汤治疗。比较2组患者治疗前后脑电图情况、明尼苏达生命质量评分(MLHFQ)、蒙特利尔认知评估量表(MoCA)、神经功能缺损量表(NFD)、中医临床症状评分及治疗的总改善率。结果:治疗后,观察组总改善率为78. 50%,显著高于对照组总改善率(57. 20%),差异有统计学意义(P <0. 05)。2组患者MLHFQ评分和NFD评分均显著降低,且观察组评分均低于对照组,差异有统计学意义(P <0. 05)。治疗后,2组患者MoCA评分均显著升高,且观察组评分高于对照组,差异有统计学意义(P <0. 05)。与治疗前比较,2组患者中医临床症状评分均显著降低,且观察组评分低于对照组,差异有统计学意义(P <0. 05)。结论:温针灸联合豁痰息痉汤能够改善脑梗死继发癫痫患者脑电图情况,提高患者生命质量及认知水平,有效控制癫痫的发作。
Objective: To explore the effects of warm acupuncture combined with Huotan Xijing Decoction on quality of life and electroencephalogram in patients with epilepsy secondary to cerebral infarction. Methods: A total of 112 patients with epilepsy secondary to cerebral infarction in Hai'an People's Hospital Affiliated to Nantong University from August 2015 to July 2017 were randomly divided into a control group and an observation group,with 56 cases in each group. The control group was treated with routine treatment,while the observation group was treated with warm acupuncture combined with Huotan Xijing Decoction. The electroencephalogram,the scores of MLHFQ,MoCA and NFD,the total improvement rate and the score of traditional Chinese medicine symptoms were compared between the 2 groups. Results: After treatment,the total improvement rate in the observation group was78. 50%,which was significantly higher than 57. 20% in the control group,and the difference was statistically significant( P <0. 05). The scores of MLHFQ and NFD in the 2 groups decreased significantly( P < 0. 05),and those scores in the observation group were lower than those in the control group,and the difference was statistically significant( P < 0. 05). After treatment,the scores of MoCA in the 2 groups increased significantly( P < 0. 05),and the one in the observation group was higher than that in the control group. The difference was statistically significant( P < 0. 05). Compared with before treatment,the scores of traditional Chinese medicine symptoms in the 2 groups decreased significantly( P < 0. 05),and the score in the observation group was lower than that in the control group( P < 0. 05). The difference was statistically significant( P < 0. 05). Conclusion: Warm acupuncture combined with Huotan Xijing Decoction can not only improve the electroencephalogram,quality of life and cognitive level,but also effectively control the onset of epilepsy in the patients with epilepsy secondary to cerebral infarction,which is worthy of clinical application.
Objective: To explore the effects of warm acupuncture combined with Huotan Xijing Decoction on quality of life and electroencephalogram in patients with epilepsy secondary to cerebral infarction. Methods: A total of 112 patients with epilepsy secondary to cerebral infarction in Hai'an People's Hospital Affiliated to Nantong University from August 2015 to July 2017 were randomly divided into a control group and an observation group,with 56 cases in each group. The control group was treated with routine treatment,while the observation group was treated with warm acupuncture combined with Huotan Xijing Decoction. The electroencephalogram,the scores of MLHFQ,MoCA and NFD,the total improvement rate and the score of traditional Chinese medicine symptoms were compared between the 2 groups. Results: After treatment,the total improvement rate in the observation group was78. 50%,which was significantly higher than 57. 20% in the control group,and the difference was statistically significant( P <0. 05). The scores of MLHFQ and NFD in the 2 groups decreased significantly( P < 0. 05),and those scores in the observation group were lower than those in the control group,and the difference was statistically significant( P < 0. 05). After treatment,the scores of MoCA in the 2 groups increased significantly( P < 0. 05),and the one in the observation group was higher than that in the control group. The difference was statistically significant( P < 0. 05). Compared with before treatment,the scores of traditional Chinese medicine symptoms in the 2 groups decreased significantly( P < 0. 05),and the score in the observation group was lower than that in the control group( P < 0. 05). The difference was statistically significant( P < 0. 05). Conclusion: Warm acupuncture combined with Huotan Xijing Decoction can not only improve the electroencephalogram,quality of life and cognitive level,but also effectively control the onset of epilepsy in the patients with epilepsy secondary to cerebral infarction,which is worthy of clinical application.
引文
[1]邢孔鸯,黄绮娟,林丽卿,等.脑梗死继发癫痫的临床研究[J].中风与神经疾病杂志,2015,32(10):926-928.
[2]Santamarina E,Sueiras M,Toledo M,et al. Epilepsy in patients with malignant middle cerebral artery infarcts and decompressive craniectomies[J]. Epilepsy Res,2015,112:130-136.
[3]Bates K. Epilepsy:current evidence-based paradigms for diagnosis and treatment[J]. Prim Care,2015,42(2):217-232.
[4]张艳,刘国成,石云,等.针灸治疗癫痫的研究[J].中医药临床杂志,2016,28(11):1504-1507.
[5]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑血管疾病分类2015[J].中华神经科杂志,2017,50(3):168-171.
[6]Robert S,Fisher J,Cross H,等. 2016年国际抗癫痫联盟癫痫发作分类的更新及介绍[J].癫痫杂志,2017,3(1):60-69.
[7]MoshéSL,Perucca E,Ryvlin P,et al. Epilepsy:new advances[J].Lancet,2015,385(9971):884-898.
[8]赵永顺.针刺联合豁痰息痉汤治疗脑梗死合并癫痫临床研究[J].中医学报,2015,30(2):303-305.
[9]雷军. Mo CA与MMSE在缺血性脑卒中患者认知功能改变中的应用价值[J].中国实用神经疾病杂志,2016,19(8):26-29.
[10]郑红丽.脑卒中后癫痫发作的临床特征及视频脑电图特征分析[J].中国实用医刊,2018,45(20):91-93.
[11]Baxendale S. Epilepsy on the silver screen in the 21st century[J].Epilepsy Behav,2016,57(Pt B):270-274.
[12]Bonello M,Michael BD,Solomon T. Infective Causes of Epilepsy[J]. Semin Neurol,2015,35(3):235-244.
[13]高长玉,吴成翰,赵建国,等.中国脑梗死中西医结合诊治指南(2017)[J].中国中西医结合杂志,2018,38(2):136-144.
[14]张青川.针刺、豁痰息痉汤联合西药对脑梗死合并癫痫患者神经功能的影响[J].实用临床医药杂志,2016,20(3):25-27.
[15]邢孔鸯,黄绮娟,林丽卿,等.脑梗死继发癫痫的临床研究[J].中风与神经疾病杂志,2015,32(10):926-928.
[16]辛思源,杨志新,郭建恩,等.从三阴交-悬钟的经穴效应探讨相对穴与经穴效应的关系[J].中国针灸,2017,37(10):1073-1076.
[17]李德辉,孙春霞,范焕芳,等.针刺足三里、太冲、合谷穴配合三阶梯止痛治疗胃癌痛临床观察[J].广州中医药大学学报,2017,34(3):344-347.
[18]李波,马丽娜.柴胡龙骨牡蛎汤应用体会[J].河南中医,2015,35(2):231-233.
[19]赵松峰,张晓,师秀琴,等.石菖蒲的化学成分研究[J].中国药学杂志,2018,53(8):585-588.
[2]Santamarina E,Sueiras M,Toledo M,et al. Epilepsy in patients with malignant middle cerebral artery infarcts and decompressive craniectomies[J]. Epilepsy Res,2015,112:130-136.
[3]Bates K. Epilepsy:current evidence-based paradigms for diagnosis and treatment[J]. Prim Care,2015,42(2):217-232.
[4]张艳,刘国成,石云,等.针灸治疗癫痫的研究[J].中医药临床杂志,2016,28(11):1504-1507.
[5]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑血管疾病分类2015[J].中华神经科杂志,2017,50(3):168-171.
[6]Robert S,Fisher J,Cross H,等. 2016年国际抗癫痫联盟癫痫发作分类的更新及介绍[J].癫痫杂志,2017,3(1):60-69.
[7]MoshéSL,Perucca E,Ryvlin P,et al. Epilepsy:new advances[J].Lancet,2015,385(9971):884-898.
[8]赵永顺.针刺联合豁痰息痉汤治疗脑梗死合并癫痫临床研究[J].中医学报,2015,30(2):303-305.
[9]雷军. Mo CA与MMSE在缺血性脑卒中患者认知功能改变中的应用价值[J].中国实用神经疾病杂志,2016,19(8):26-29.
[10]郑红丽.脑卒中后癫痫发作的临床特征及视频脑电图特征分析[J].中国实用医刊,2018,45(20):91-93.
[11]Baxendale S. Epilepsy on the silver screen in the 21st century[J].Epilepsy Behav,2016,57(Pt B):270-274.
[12]Bonello M,Michael BD,Solomon T. Infective Causes of Epilepsy[J]. Semin Neurol,2015,35(3):235-244.
[13]高长玉,吴成翰,赵建国,等.中国脑梗死中西医结合诊治指南(2017)[J].中国中西医结合杂志,2018,38(2):136-144.
[14]张青川.针刺、豁痰息痉汤联合西药对脑梗死合并癫痫患者神经功能的影响[J].实用临床医药杂志,2016,20(3):25-27.
[15]邢孔鸯,黄绮娟,林丽卿,等.脑梗死继发癫痫的临床研究[J].中风与神经疾病杂志,2015,32(10):926-928.
[16]辛思源,杨志新,郭建恩,等.从三阴交-悬钟的经穴效应探讨相对穴与经穴效应的关系[J].中国针灸,2017,37(10):1073-1076.
[17]李德辉,孙春霞,范焕芳,等.针刺足三里、太冲、合谷穴配合三阶梯止痛治疗胃癌痛临床观察[J].广州中医药大学学报,2017,34(3):344-347.
[18]李波,马丽娜.柴胡龙骨牡蛎汤应用体会[J].河南中医,2015,35(2):231-233.
[19]赵松峰,张晓,师秀琴,等.石菖蒲的化学成分研究[J].中国药学杂志,2018,53(8):585-588.