苯巴比妥与地西泮联合咪达唑仑治疗小儿惊厥的临床疗效

Clinical efficacy evaluation of phenobarbital and diazepam combined with midazolam in the treatment of children with convulsion

目的评价小儿惊厥用苯巴比妥与地西泮联合咪达唑仑治疗的效果。方法回顾性分析2020年5月至2021年7月于咸宁市第一人民医院治疗的66例惊厥患儿的临床资料,按照治疗方案的不同分为对照组与实验组,各33例。对照组采用地西泮联合苯巴比妥治疗,实验组采用苯巴比妥与地西泮联合咪达唑仑联合治疗。比较两组临床疗效、药物起效时间、惊厥控制时间、退热时间、住院时间、血清学指标[脑源性神经营养因子(brain-derived neurotrophic factor,BONF)、肌特异性烯醇化酶(recombinant enolase,muscle specific,MSE)、S-100β蛋白]、免疫功能指标(IgA、IgG、IgM)、T淋巴细胞亚群、不良反应发生情况。结果实验组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。实验组药物起效时间、惊厥控制时间、退热时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。实验组BONF、MSE、S-100β水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组IgA、IgG、IgM水平均高于治疗前,且实验组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组CD4^(+)水平及CD4^(+)/CD8^(+)均高于治疗前,CD8^(+)水平均低于治疗前,且实验组CD4^(+)水平及CD4^(+)/CD8^(+)均高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论苯巴比妥与地西泮联合咪达唑仑治疗小儿惊厥疗效显著,可缩短患儿相关症状缓解时间、住院时间,改善血清学指标,且安全性较高,值得临床推广应用。

Objective To evaluate the efficacy of phenobarbital,diazepam and midazolam in the treatment of children with convulsion.Methods The clinical data of 66 children with convulsion treated in the First People's Hospital of Xianning from May 2020 to July 2021 were retro-spectively analyzed,and they were divided into the control group and the experimental group according to the different treatment methods,with 33 cases in each group.The control group was treated with diazepam and phenobarbital,and the experimental group was treated with phenobarbital and diazepam combined with midazolam.The clinical efficacy,drug onset time,convulsive control time,fever reduction time,hospitalization time,serum indexes(brain-derived neurotrophic factor[BONF],recombinant Enolase,Muscle Specific[MSE]),immune function indexes(IgA,IgG,IgM),T lymphocyte subsets and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).The drug onset time,convulsion control time,fever reduction time and hospitalization time in the experimental group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The levels of BONF,MSE and S-100βin the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of IgA,IgG and IgM of the two groups were higher than before treatment,and the experimental group was higher than the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of CD4^(+)and CD4^(+)/CD8^(+)of the two groups were higher than before treatment,and the levels of CD8^(+)were lower than before treatment,and the levels of CD4^(+)and CD4^(+)/CD8^(+)in the experimental group were higher than those in the control group,and the levels of CD8^(+)was lower than that in the control group,and the differences werestatistically significant(P<0.05).There was no significant difference in the incidence of adverse reac-tions between the two groups.Conclusion The phenobarbital and diazepam combined with midazolam has significant therapeutic effects on pediat-ric convulsions,Can shorten the time for symptom relief and hospitalization,improve serum indexes,with high safety,which is worthy of clinical promotion and application.