脑电图引导下针刺治疗癫痫的临床观察

Clinical Observation of Electroencephalogram-guided Acupuncture in Treating Epilepsy

目的观察脑电图引导头皮针配合体针治疗癫痫的临床疗效。方法将60例间歇期癫痫患者随机分为定向针刺组、体针对照组和西药对照组,定向针刺组予脑电图引导头皮针配合体针治疗,体针对照组行普通体针治疗,西药对照组不进行针刺,评估临床疗效,并通过脑电图及脑电地形图检测观察治疗前后?、?、?、?频段功率和发作间期癫痫样放电(IEA)的变化情况。结果全部病例治疗后与治疗前比较脑电图中IEA均减少(P<0.05),但定向针刺组与两个对照组间比较差异无统计学意义(P>0.05)。定向针刺组、体针对照组均能明显改善发作间期癫痫患者脑电?1、?2及?2的绝对功率,并且降低?和?功率值(P<0.05),与西药对照组比较差异均具有统计学意义(P<0.05),但定向针刺组较体针对照组改善脑电功率谱的作用更显著(P<0.05)。结论脑电图引导头皮针配合体针治疗癫痫的临床疗效确定,可能与抑制脑电图的痫性放电和改善脑电功率谱相关。

Objective To observe the clinical efficacy of electroencephalogram（EEG）-guided scalp acupuncture plus body acupuncture in treating epilepsy. Method Sixty epilepsy patients in interictal stage were randomized into a guided acupuncture group, a body acupuncture group, and a Western medication group. The guided acupuncture group was given scalp plus body acupuncture under the guidance of EEG; the body acupuncture group was given ordinary body acupuncture treatment; the Western medication group didn＇t receive acupuncture treatment. The clinical efficacy was evaluated; before and after the treatment, the powers of ？, ？, ？ and ？ bands and interictal epileptic activity（IEA） were observed by EEG and brain electrical activity mapping（BEAM）. Result After the treatment, IEA declined significantly in all cases according to EEG（P〈0.05）, while the guided acupuncture group was insignificantly different from the other two groups in comparing IEA（P〈0.05）. In the guided acupuncture group and body acupuncture group, the absolute powers of ？1, ？2 and ？2 bands were significantly improved, and the powers of ？ and ？ bands were decreased significantly（P〈0.05）; the values of these two groups were significantly different from those of the Western medication group（P〈0.05）, but the guided acupuncture group showed a more significant effect in improving EEG power spectrum compared to the body acupuncture group（P〈0.05）. Conclusion EEG-guided scalp plus body acupuncture is effective in treating epilepsy, which is possibly related to the inhibition of IEA and improvement of EEG power spectrum.