清心温胆汤治疗对卒中后继发性癫痫患者疗效及血清超氧化物歧化酶、丙二醛和谷胱甘肽过氧化物酶的影响

Curative Effects of Qingxin Wendan Decoction on Patients with Secondary Epilepsy After Stroke and Effects on Serum SOD,MDA and GSH-Px levels

目的:探讨清心温胆汤治疗对卒中后继发性癫痫患者疗效及血清超氧化物歧化酶(SOD)、丙二醛(MDA)和谷胱甘肽过氧化物酶(GSH-Px)水平的影响。方法:选取2014年1月至2016年2月广东省第二中医院收治的卒中后继发性癫痫患者76例为研究对象,按信封法随机分为观察组和对照组,每组38例。对照组常规给予地西泮和托吡酯治疗,观察组在对照组的基础上口服清心温胆汤治疗2个月,2组均进行为期1年的随访,比较2组疗效、Fugl-Meyer评分及治疗前后的血清超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)等氧化应激水平,并分析观察组氧化应激指标水平与其疗效的关系。统计比较2组血常规、尿常规、便常规以及肝肾功能异常等不良反应发生情况。结果:与对照组比较,观察组治疗有效率升高(P<0.05),且Fugl-Meyer评分明显优于对照组(P<0.05)。与治疗前比较,2组治疗2个月和1年的血清SOD和GSH-Px水平升高而同期血清MDA水平则降低(P<0.05)。观察组治疗2个月和1年的血清SOD和GSH-Px水平升高而同期血清MDA水平则降低(P<0.05),与对照组比较,观察组改变较优(P<0.05)。与治疗无效患者比较,其治疗有效患者治疗2个月和1年的血清SOD和GSH-Px水平升高而同期血清MDA水平则降低,差异有统计学意义(P<0.05),Spearman相关分析结果显示,观察组血清SOD、MDA、GSH-Px水平均与其治疗有效率密切相关(r=0.822,-0.805,0.874,P<0.05)。且2组均无明显不良反应的发生。结论:常规治疗基础上采用清心温胆汤治疗可安全有效地改善卒中后继发性癫痫疗效,其作用机制可能与改善患者的氧化应激有关。

Objective： To investigate the curative effects of Qingxin Wendan Decoction on patients with secondary epilepsy after stroke and effects on serum SOD,MDA and GSH-Px levels.Methods： Seventy six patients with secondary epilepsy after stroke were divided into observation group（ n = 38） and control group（ n = 38） according to the envelope method.The control group was treated with diazepam and topiramate for more than 1 year,and the observation group was treated with Qingxin Wendan Decoction for 2 months on the basis of the control group treatment.Curative effect of both groups were evaluated and compared.The serum superoxide dismutase（ SOD）,malondialdehyde（ MDA） and glutathione peroxidase（ GSH-Px） and other oxidative stress indicators levels were detected and compared before and after treatment.The relationship between serum oxidative stress index level with curative effect in the observation group were analyzed,and routine blood routine,urine routine,stool routine and abnormal liver and kidney function adverse reactions of two groups were compared.Results： Compared with the control group,the effective rate of the observation group was increased（ P 0.05）.The Fugl-Meyer score was significantly better than that of the control group（ P 0.05）.Compared with the control group,after treated for 2 months and 1 years serum SOD and GSH-Px levels in the observation group were increased,while in the same time,serum MDA level in the observation group decreased（ P 0.05）.Compared with before treatment,after treated for 2 months and 1 years serum SOD and GSH-Px levels in the 2 groups were increased,while in the same time serum MDA level in the 2 groups decreased（ P 0.05）.Compared with the patients who had ineffective treatment in the observation group,after treated for 2 months and 1 year serum SOD and GSH-Px levels in the patients who had effective treatment in the observation group were increased,while in the same time serum MDA level in the patients who had effective treatment in the observation group decreased（ P 0.05）.Spearman correlation analysis showed that the serum SOD,MDA and GSH-Px levels in the observation group were closely related to the treatment efficiency（ r = 0.822,-0.805,0.874,P 0.05）.There were no obvious adverse reactions in the two groups.Conclusion： Based on conventional treatment,Qingxin Wendan Decoction can effectively and safely improve the curative effect and oxidative stress of secondary epilepsy after stroke,and its mechanism may be related to improving oxidative stress in patients.