低频重复经颅磁刺激联合丙戊酸钠治疗癫痫效果及对氧化-抗氧化系统的调节效应

Effect of low frequency repetitive transcranial magnetic stimulation combined with sodium valproate on epilepsy and its regulatory effect on oxidation and antioxidation system

目的观察低频重复经颅磁刺激(LF-rTMS)联合丙戊酸钠治疗癫痫效果及对氧化-抗氧化系统的影响。方法选取2019年12月至2021年12月齐鲁医药学院附属成武医院收治的癫痫患者102例,采用随机数字表法分为联合组(n=51)、药物组(n=51)。药物组给予丙戊酸钠治疗,联合组在药物组基础上联用LF-rTMS,均治疗4 w。比较两组治疗前后血清丙二醛(MDA)、总抗氧化能力(TAC)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、S-100β、神经元特异性烯醇化酶(NSE)、胶质酸性纤维蛋白(GFAP)水平;统计治疗期间不良反应;治疗后随访6个月,观察两组临床疗效与治疗前、治疗后6个月癫痫发作次数、持续时间。结果两组治疗后血清MDA、S-100β、NSE、GFAP水平均降低,TAC、SOD、GSH-Px水平均增高,且联合组治疗后血清MDA、S-100β、NSE、GFAP水平下降幅度更大,TAC、SOD、GSH-Px水平增高幅度更大(P<0.05);联合组治疗期间不良反应发生率5.88%与药物组11.76%,比较差异无统计学意义(P>0.05);治疗后随访6个月显示,联合组总有效率86.27%高于药物组68.63%(P<0.05);两组治疗后6个月癫痫发作次数、持续时间均减少,且联合组治疗后6个月癫痫发作次数、持续时间减少更明显(P<0.05)。结论LF-rTMS联合丙戊酸钠可调节氧化-抗氧化系统,减轻脑损伤,控制癫痫发作,疗效肯定且安全可靠。

Objective To observe the effect of low frequency repetitive transcranial magnetic stimulation(LF-rTMS)combined with sodium valproate in the treatment of epilepsy and its influence on oxidation and antioxidation system.Methods 102 patients with epilepsy admitted to the Chengwu Hospital Affiliated to Qilu College of Medicine from December 2019 to December 2021 were randomly divided into the combination group(n=51)and the drug group(n=51).The drug group was treated with sodium valproate,and the combination group was treated with LF-rTMS on the basis of the drug group for 4 weeks.The indexes of serum malondialdehyde(MDA),total antioxidant capacity(TAC),superoxide dismutase(SOD),glutathione peroxidase(GSH Px),S-100β,Neuron specific enolase(NSE),glial acidic fibrin(GFAP)level were compared between the two groups before and after treatment;adverse reactions during treatment were counted;follow up for 6 months after treatment to observe the clinical efficacy of the two groups and the number and duration of epileptic before treatment and after treatment for6 months.Results After the treatment of both groups,serum MDA,S-100β,NSE and GFAP levels decreased,and the levels of TAC,SOD and GSH-Px increased,after the combination group treatment,the serum MDA,S-100β,NSE and GFAP levels decreased greater,and the levels of TAC,SOD and GSH-Px increased more(P<0.05);the incidence of adverse reactions during treatment in the combination group was 5.88%and 11.76%in the drug group,with no significant difference(P>0.05);Follow up for 6 months after treatment showed that the total effective rate of the combination group was 86.27%higher than that of the drug group 68.63%(P<0.05);The number and duration of epileptic seizures in the two groups decreased 6 months after treatment,and the number and duration of epileptic seizures in the combination group decreased more significantly 6 months after treatment(P<0.05).Conclusion LFrTMS combined with sodium valproate can regulate the oxidation and antioxidation system,reduce brain injury,and control epileptic seizures,with definite efficacy and safety.