豁痰息痉汤辅助针刺治疗脑梗死继发癫痫临床研究

Clinical Study on Huotan Xijing Tang Combined with Acupuncture for Epilepsy Secondary to Cerebral Infarction

目的:观察豁痰息痉汤辅助针刺对脑梗死继发癫痫患者神经功能及神经元特异性烯醇化酶(NSE)、血清脑源性神经营养因子(BDNF)的影响。方法:将80例脑梗死继发癫痫患者按随机数字表法分为观察组和对照组各40例。2组患者均给予常规西药对症治疗,对照组加用针刺治疗,观察组在对照组基础上加用豁痰息痉汤治疗。比较2组临床疗效、美国国立卫生院神经功能缺损评分(NIHSS)、Barthel指数的变化,检测NSE、BDNF、炎症因子水平。结果:观察组总有效率为92.50%,高于对照组75.00%,差异有统计学意义(χ^2=4.501,P=0.034<0.05)。治疗前,2组NIHSS评分、Barthel指数比较,差异无统计学意义(P>0.05)。治疗后,2组NIHSS评分较治疗前降低,Barthel指数较治疗前升高;且观察组NIHSS评分低于对照组,Barthel指数高于对照组;差异均有统计学意义(P<0.05)。治疗前,2组NSE、BDNF、白细胞介素-1β(IL-1β)、白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)水平比较,差异均无统计学意义(P>0.05)。治疗后,2组NSE、IL-1β、IL-2、TNF-α水平较治疗前降低,BDNF水平较治疗前升高;且观察组NSE、IL-1β、IL-2、TNF-α水平低于对照组,BDNF水平高于对照组;差异均有统计学意义(P<0.05)。结论:豁痰息痉汤辅助针刺可改善脑梗死继发癫痫患者神经功能,减轻炎症反应,调节NSE、BDNF的表达水平,提高日常生活能力。

Objective:To observe the effect of Huotan Xijing tang combined with acupuncture on neurological function,neuron-specific enolase(NSE)and serum brain-derived neurotrophic factor(BDNF)in patients with epilepsy secondary to cerebral infarction.Methods:A total of 80 cases of patients with epilepsy secondary to cerebral infarction were divided into the observation group and the control group according to the random number table method,40 cases in each group.Both groups were given routine western medicine for symptomatic treatment;the control group was additionally treated with acupuncture,and the observation group was additionally treated with Huotan Xijing tang based on the treatment of the control group.The changes in the clinical effect,National Institute of Health Stroke Scale(NIHSS)scores and Barthel indexes in the two groups were compared,and the levels of NSE,BDNF and inflammatory factors were detected.Results:The total effective rate was 92.50%in the observation group,higher than that of 75.00%in the control group,the difference being significant(χ^2=4.501,P=0.034<0.05).Before treatment,there was no significant difference being found in the comparison of the NIHSS scores and Barthel indexes between the two groups(P>0.05).After treatment,NIHSS scores in the two groups were decreased when compared with those before treatment,and Barthel indexes were increased;the NIHSS score in the observation group was lower than that in the control group,and Barthel index was higher,differences being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of the levels of NSE,BDNF,interleukin-1β(IL-1β),interleukin-2(IL-2)and tumor necrosis factor-α(TNF-α)between the two groups(P>0.05).After treatment,the levels of NSE,IL-1β,IL-2 and TNF-αin the two groups were decreased when compared with those before treatment,and BDNF levels were increased;the levels of NSE,IL-1β,IL-2 and TNF-αin the observation group were lower than those in the control group,and BDNF level was higher,differences being significant(P<0.05).Conclusion:The therapy of Huotan Xijing tang combined with acupuncture can improve the neurological function of patients with epilepsy secondary to cerebral infarction,reduce inflammatory factors,regulate the expression levels of NSE and BDNF,and enhance the ability of daily life.