针刺联合中药治疗儿童癫痫的疗效观察及对脑电图和智力水平的影响

Observation on the efficacy of acupuncture combined with Chinese herbal medicines in the treatment of epilepsy in children and its effect on EEG and intelligence level

目的观察针刺联合癫痫促效方治疗儿童癫痫的临床疗效及对患者脑电图和智力水平的影响。方法将80例儿童癫痫患者随机分为对照组(40例)和研究组(40例)。对照组予常规抗癫痫治疗,研究组在对照组治疗基础上予针刺联合癫痫促效方治疗。比较两组临床疗效、脑电图改善率和不良反应发生率,观察两组治疗前后癫痫发作情况(发作频次和症状持续时间)、中医证候积分、简易精神状态检查量表(mini-mental state examination,MMSE)评分和韦氏儿童智力量表中文修订版(Wechsler intelligence scale for children-revised in China,WLSC-CR)评分的变化,观察两组治疗前后血清炎症因子和认知功能损害相关指标水平的变化。结果研究组总有效率高于对照组(P<0.05),脑电图改善率高于对照组(P<0.05)。治疗1个月后和治疗后,研究组癫痫发作频次低于对照组(P<0.05),症状持续时间短于对照组(P<0.05),中医证候积分低于对照组(P<0.05),WLSC-CR评分中总智商、语言智商和操作智商评分均高于对照组(P<0.05),MMSE评分高于对照组(P<0.05)。治疗1个月后和治疗后,研究组血清丙二醛(malondialdehyde,MDA)、白介素-1β(interleukin-1β,IL-1β)、白介素-6(interleukin-6,IL-6)、高迁移率族蛋白B1(high mobility group box-1,HMGB1)和基质金属蛋白酶-9(matrix metalloprotein-9,MMP-9)水平均低于对照组(P<0.05),血清超氧化物歧化酶(superoxide dismutase,SOD)和水通道蛋白4(aquaporin 4,AQP4)水平高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在常规抗癫痫治疗基础上,针刺联合癫痫促效方治疗儿童癫痫可提高临床疗效,降低癫痫发作频率,缩短癫痫发作时间,改善脑电图,提高患者智力水平,下调炎症反应和应激反应。

Objective To observe the clinical efficacy of acupuncture combined with Dian Xian Cu Xiao formula in the treatment of childhood epilepsy and its effect on patients’EEG and intelligence level.Method A total of 80 pediatric epilepsy patients were randomly divided into a control group(40 cases)and a study group(40 cases).The control group was treated with conventional antiepileptic therapy,while the study group was treated with acupuncture combined with Dian Xian Cu Xiao formula on the basis of the treatment in the control group.The clinical efficacy,improvement rate of electroencephalogram(EEG)and incidence of adverse effects were compared between the two groups,and the seizure situation(seizure frequency and symptom duration),traditional Chinese medicine(TCM)syndrome score,mini-mental state examination(MMSE)score and Wechsler intelligence scale for children-revised in China(WLSC-CR)were observed before and after the treatment in both groups,and the changes of serum inflammatory factors and cognitive impairment related indexes were observed before and after treatment in the two groups.Result The total effective rate of the study group was higher than that of the control group(P<0.05),and the improvement rate of EEG was higher than that of the control group(P<0.05).After 1-month treatment and after treatment,the frequency of seizures in the study group was lower than that of the control group(P<0.05),the duration of symptoms was shorter than that of the control group(P<0.05),the TCM syndrome score was lower than that of the control group(P<0.05),and the total,verbal,and operative intelligence scores in the WLSC-CR scores were higher than that of the control group(P<0.05),and the MMSE scores were higher than that of the control group(P<0.05).After 1-month treatment and after treatment,serum malondialdehyde(MDA),interleukin-1β(IL-1β),interleukin-6(IL-6),high mobility group box-1(HMGB1)and matrix metalloprotein-9(MMP-9)levels were lower than those of the control group(P<0.05),and the levels of serum superoxide dismutase(SOD)and aquaporin 4(AQP4)were higher than those of the control group(P<0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion On the basis of conventional antiepileptic treatment,acupuncture combined with Dian Xian Cu Xiao formula for the treatment of epilepsy in children can improve the clinical efficacy,reduce the frequency of epileptic seizures,shorten the duration of epileptic seizures,improve the EEG,improve the intellectual level of the patients,and down-regulate inflammatory response and stress response.