针灸联合天麻止痫汤加减对癫痫患者GAL、IREG1水平的影响

Effect of Acupuncture and Moxibustion Combined with Modified Tianma Zhixian Decoction(天麻止痫汤)on GAL,IREG1 Level of Epileptic Patients

目的探究针灸联合天麻止痫汤加减对癫痫患者甘丙肽(GAL)、铁调节转运体1(IREG1)水平的影响。方法选取2019年10月—2020年10月黑龙江中医药大学附属第二医院收治的癫痫患者128例,按照随机数字表法分为汤加减组和联合组各64例。两组患者均行常规抗癫痫治疗,汤加减组患者采用天麻止痫汤加减治疗,联合组在汤加减组的基础上采用针灸治疗。对比两组癫痫发作情况、认知功能、中医证候积分、血清脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、胰岛素样生长因子1(insulin-like growth factor 1,IGF-1)、谷氨酸脱羧酶抗体(glutamic acid decarboxylase antibody,GADA)水平、血浆GAL、神经肽(neuropeptide,NPY)水平、IREG1蛋白表达量、脑电活动及临床疗效。结果与汤加减组相比,联合组癫痫发作次数、癫痫发作持续时间、中医证候积分、BDNF、IGF-1、GADA水平、IREG1蛋白表达量、β频段相对功率、δ频段相对功率、θ频段相对功率降低(P<0.05)。与汤加减组相比,联合组认知功能评分、GAL、NPY水平、α频段相对功率升高(P<0.05)。与汤加减组相比,联合组治疗总有效率较高(P<0.05)。结论针灸联合天麻止痫汤加减可改善患者癫痫症状,改变脑电异常活动,抑制GAL、IREG1异常表达,减轻认知功能障碍,效果显著。

Objective To explore the effect of acupuncture and moxibustion combined with Modified Tianma Zhixian Decoction(天麻止痫汤)on the level of galanin(GAL)and iron regulatory transporter 1(IREG1)in epileptic patients.Methods A total of 128 epilepsy patients admitted to our hospital from October 2019 to October 2020 were selected,and they were divided into subtraction group and combined group with 64 cases in each group according to the random number table method.Patients in the two groups were treated with conventional anti-epileptic treatment,patients in the decoction group were treated with Modified Tianma Zhixian Decoction,and the combination group was treated with acupuncture and moxibustion on the basis of the decoction group.The epileptic seizures,cognitive function,TCM syndrome score,serum brain-derived neurotrophic factor(BDNF),and insulin-like growth factor 1(IGF-1)were compared between the two groups,Glutamic acid decarboxylase antibody(GADA)level,GAL,neuropeptide(NPY)level,IREG1 protein expression,brain electrical activity and clinical efficacy.Results Compared with the decoction group,the number of seizures,seizure duration,TCM syndrome score,BDNF,IGF-1,GADA level,IREG1 protein expression,β band,δ band,and the relative power of the θ band were reduced in the combined group(P<0.05).The cognitive function score,GAL,NPY level,and relative power in theαband increased in the combined group compared with the subtraction group(P<0.05).Compared with the decoction modified group,the combined group has a higher total effective rate of treatment(P<0.05).Conclusion Acupuncture and moxibustion combined with Modified Tianma Zhixian Decoction can improve epileptic symptoms,change abnormal EEG activity,inhibit abnormal expression of GAL,IREG1 and alleviate cognitive dysfunction.