中西医结合治疗脑梗死后迟发型癫痫的临床研究

Clinical research on treating tardive epilepsy after cerebral infarction in the integrative medicine

目的:中药可减少丙戊酸钠的用量,减轻其毒副作用,延缓脑梗死后癫痫的病情进展,并可提高脑梗死的治疗效果。方法:采用随机双盲安慰剂对照试验设计方法,选择60例癫痫患者,中医辨证证型均为风痰闭窍,癖阻脑络者,分为西药对照组、西药+中药组,分别服用,疗程104周。观察:①中医证侯疗效;②对患者发作次数的影响;③对患者脑电图的影响;④对患者生活质量的影响;⑤对患者认知功能的影响。⑥安全性观察。结果:①患者发作次数减少,治疗组和对照组总有效率分别为85.9%和63.1%,两组比较有统计学意义(P<0.05)。②中医证候疗效,治疗组和对照组总有效率分别为82.8%(24/29)和71.4%(20/28),两组比较有统计学意义(P<0.05)。③脑电图改变明显好转两组脑电图比较,治疗组总有效率82.7%(24/29),对照组总有效率57.1%(16/28),差异有统计学意义(U=1.87,P<0.05)。④生活质量:治疗组改善生活质量优于对照组(P<0.05)。⑤认知功能评价:中药治疗组改善认知障碍优于西药对照组(P<0.05)。⑥安全性观察:治疗组和对照组无明显不良反应。结论:中药可以提高脑梗死后癫痫的治疗效果,具有明显疗效和良好的安全性。

Objective： To investigate the clinical effect of treating tardive epilepsy after cerebral infarction in the integrative medicine. Methods： Random double-blind experiments were carried out. 60 patients of epilepsy were randomly divided into the modem medicine group and the integrative medicine group. The treatment lasted for 104 weeks. The efficacy, effects on attacking times, EEC life quality and cognitive function, and safety were investigated. Results： @The attacking times： The total effective rates in the integrative medicine group and the modem medicine group were 85.9% and 63.1% respectively, with significant differences （P〈0.05）. @TCM syndromes efficacy： The total effective rates in the integrative medicine group and the modem medicine group were 82.8% and 71.4% respectively, with significant differences （P〈0.05）. @EEG： The total effective rates in the integrative medicine group and the modem medicine group were 82.7% and 57.1% respectively, with significant differences （P〈0.05）. Life quality： That the integrative medicine group was better than that in the modem medicine group （P〈0.05）. Cognitive function： The improvement of cognitive disorder in the integrated medicine group was better than that in the modem medicine group （P〈0.05）.Safety： No obvious side effects were detected in both roul0s. Conclusion： The integrative medicine was effective and safe in treating epilepsy after cerebral infarction.