醒脑开窍针刺联合柴桂温胆定志汤对卒中后癫痫患者脑电活动的影响

Influence of Xing Nao Kai Qiao Acupuncture Combined with Chai Gui Wen Dan Ding Zhi Decoction on Electroencephalogram in Patients with Post-stroke Epilepsy

目的观察醒脑开窍针刺联合柴桂温胆定志汤对卒中后癫痫(PSE)患者脑电活动的影响。方法选取PSE患者152例,按照治疗方法的不同分为对照组和联合组,每组76例。对照组予口服柴桂温胆定志汤治疗,联合组在对照组口服中药基础上联合醒脑开窍针刺法治疗。比较两组治疗前、治疗1个月后及治疗3个月后患者脑电频率(α、β、θ、δ频段)、癫痫样放电、累及导联数和发作持续时间,并观察患者血清单核细胞趋化因子-1(MCP-1)、非对称二甲基精氨酸(ADMA)和神经元特异性烯醇化酶(NSE)水平的变化。比较两组认知功能的变化和临床疗效。结果与治疗前比较,两组患者治疗1个月后、治疗3个月后α频段相对功率、操作情商、语言智商、总智商分水平均升高(P<0.05),β、θ、δ频段相对功率、癫痫样放电、累及导联数、发作持续时间、及血清MCP-1、ADMA、NSE水平均降低(P<0.05);治疗1个月后、治疗3个月后,联合组α频段相对功率、操作情商、语言智商、总智商分水平均高于对照组,β、θ、δ频段相对功率、癫痫样放电、累及导联数、发作持续时间、及血清MCP-1、ADMA、NSE水平均低于对照组(P<0.05)。治疗3个月后,联合组总有效率高于对照组(P<0.05)。结论醒脑开窍针刺联合柴桂温胆定志汤可改善PSE患者脑电活动、临床症状及神经功能,缓解患者病情,提高患者认知功能,疗效优于单纯口服柴桂温胆定志汤。

Objective To observe the influence of Xing Nao Kai Qiao(brain-awakening and orifice-opening)acupuncture plus Chai Gui Wen Dan Ding Zhi decoction on electroencephalogram in patients with post-stroke epilepsy(PSE).Method A total of 152 PSE patients were recruited and divided into a control group and an integration group based on the difference in treatment methods,with 76 cases in each group.The control group was given oral administration of Chai Gui Wen Dan Ding Zhi decoction,and the integration group received additional Xing Nao Kai Qiao acupuncture treatment.Before the treatment,and after 1-month and 3-month treatments,the electroencephalographic frequencies(α,β,θandδfrequency ranges),epileptic discharge,number of the involved leads,and duration of the attack in the two groups were compared,and the serum levels of monocyte chemoattractant protein(MCP)-1,asymmetric dimethylarginine(ADMA),and neuron-specific enolase(NSE)were observed.The change in cognitive function and clinical efficacy were also compared.Result Compared with the baseline,the relative power of frequency rangeα,operation emotional quotient(EQ),language intelligence quotient(IQ),and total IQ increased after 1-month and 3-month treatments,respectively,in both groups(P<0.05),and the relative powers of frequency rangesβ,θ,andδ,epileptic discharge,number of involved leads,duration of the attack,and serum levels of MCP-1,ADMA,and NSE all decreased(P<0.05).After 1-month and 3-month treatments,respectively,the relative power of frequency rangeα,operation EQ,language IQ,and total IQ were higher in the integration group than in the control group,and the relative powers of frequency rangesβ,θ,andδ,epileptic discharge,number of involved leads,duration of the attack,and serum levels of MCP-1,ADMA,and NSE were lower in the integration group than in the control(P<0.05).After 3-month treatments,the total effective rate was higher in the integration group than in the control group(P<0.05).Conclusion Xing Nao Kai Qiao acupuncture plus Chai Gui Wen Dan Ding Zhi decoction can improve the electroencephalogram,clinical symptoms,and neurological function,mitigate the disease condition,and strengthen the cognitive function in treating PSE patients,producing more significant efficacy than oral administration of the decoction alone.