[1]张俊华,于 明,祁英杰,等.醒脑静注射液联合丙戊酸钠治疗脑卒中后癫痫疗效观察[J].新乡医学院学报,2020,37(9):852-855.[doi:10.7683/xxyxyxb.2020.09.010]
 ZHANG Junhua,YU Ming,QI Yingjie,et al.Effect of Xingnaojing injection combined with sodium valproate in the treatment of post-stroke epilepsy[J].Journal of Xinxiang Medical University,2020,37(9):852-855.[doi:10.7683/xxyxyxb.2020.09.010]
点击复制

醒脑静注射液联合丙戊酸钠治疗脑卒中后癫痫疗效观察
分享到:

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年9
页码:
852-855
栏目:
临床研究
出版日期:
2020-09-05

文章信息/Info

Title:
Effect of Xingnaojing injection combined with sodium valproate in the treatment of post-stroke epilepsy
作者:
张俊华1于 明2祁英杰1耿瑜睿1孙亚云1苏建华1
(1.江苏大学附属金坛医院神经内科,江苏 金坛 213200;2.江苏大学附属医院神经内科,江苏 镇江 212001)
Author(s):
ZHANG Junhua1YU Ming2QI YingjieGENG Yurui1SUN Yayun1SU Jianhua1
(1.Department of Neurology,Jintan Hospital Affiliated to Jiangsu University,Jintan 213200,Jiangsu Province,China;2.Department of Neurology,the Affiliated Hospital of Jiangsu University,Zhenjiang 212001,Jiangsu Province,China)
关键词:
卒中后癫痫醒脑静注射液丙戊酸钠安全性
Keywords:
post-stroke epilepsyXingnaojing injectionsodium valproatesafety
分类号:
R742.1
DOI:
10.7683/xxyxyxb.2020.09.010
文献标志码:
A
摘要:
目的 观察醒脑静注射液联合丙戊酸钠治疗脑卒中后癫痫的疗效和安全性。方法 选择2017年10月至2019年10月江苏大学附属金坛医院收治的86例脑卒中后癫痫患者为研究对象,采用随机数字表法将患者分为对照组和观察组,每组43例,剔除中途终止和随访脱落者,最终纳入疗效评估者对照组42例、观察组41例。2组患者均给予丙戊酸钠缓释片500 mg,口服,每日2次,治疗4周;在此基础上,观察组患者给予醒脑静注射液20 mL,静脉滴注,每日1次,治疗4周。比较2组患者总有效率、治疗期间不良反应发生率及治疗前后累及导联数和痫样放电情况;分别于治疗前后采用双抗体夹心酶联免疫吸附法检测2组患者血清神经元特异性烯醇化酶(NSE)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,采用酶联免疫吸附法检测血清细胞间黏附分子-1(ICAM-1)水平。结果 观察组和对照组患者总有效率分别为95.12%(39/41)、73.81%(31/42),观察组患者总有效率显著高于对照组(χ2=8.765,P<0.05)。 治疗前2组患者累及导联数和痫样放电次数比较差异无统计学意义(P>0.05)。2组患者治疗后累及导联数和痫样放电次数均低于治疗前(P<0.01);治疗后,观察组患者累及导联数和痫样放电次数均低于对照组(P<0.01)。治疗前2组患者血清NSE、TNF-α、IL-6、ICAM-1水平比较差异无统计学意义(P>0.05)。2组患者治疗后血清NSE、TNF-α、IL-6、ICAM-1水平均低于治疗前(P<0.01);治疗后,观察组患者血清NSE、TNF-α、IL-6、ICAM-1水平低于对照组(P<0.01)。 对照组和观察组患者不良反应发生率分别为9.52%(4/42)、12.20%(5/41),2组患者不良反应发生率比较差异无统计学意义(χ2=1.037,P>0.05)。结论 醒脑静注射液联合丙戊酸钠治疗能降低脑卒中后癫痫患者血清NSE、TNF-α、IL-6和ICAM-1水平,治疗效果优于单用丙戊酸钠,且不增加不良反应发生率。
Abstract:
Objective To observe the efficacy and safety of Xingnaojing injection combined with sodium valproatein in the treatment of post-stroke epilepsy.Methods Eighty-six post-stroke epilepsy patients in Jintan Hospital Affiliated to Jiangsu University from October 2017 to October 2019 were selected as the research objects.The patients were divided into control group(n=43) and observation group(n=43) by using the random number table.The patients who withdrawal from the study or loss of follow-up were eliminated.Finally,42 patients were assigned to the control group and 41 patients were assigned to the observation group.All patients took orally sustained-release tablets 500 mg,twice a day for 4 weeks;on this basis,the patiens in the observation group were given Xingnaojing injection 20 mL for 4 weeks.The total effective rate and adverse reactions of patients were compared between the two groups.The number of involved lead and epileptiform discharge of patients were compared between the two groups before and after treatment.The serum levels of neuron specific enolase (NSE),tumor necrosis factor- α (TNF-α) and interleukin-6 (IL-6) of patients were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA),and the serum levels of intercellular adhesion molecule-1 (ICAM-1) of patients were detected by ELISA.Results The total effective rate of patients in the observation group and control group was 95.12%(39/41),73.81%(31/42),respectively;the total effective rate of patients in the observation group was significantly higher than that in the control group(χ2=8.765,P<0.05).There was no significant difference in the number of involved lead and epileptiform discharge of patients between the two groups before treatment (P>0.05).The number of involved lead and epileptiform discharge of patients after treatment was significantly lower than that before treatment in the two groups(P<0.01);after treatment,the number of involved lead and epileptiform discharge of patients in the observation group were lower than those in the control group(P<0.01).There was no significant difference in serum NSE,TNF-α,IL-6 and ICAM-1 levels of patients between the two groups before treatment (P>0.05).The serum NSE,TNF-α,IL-6 and ICAM-1 levels of patients in the two groups after treatment were significantly lower than those before treatment(P<0.01);the serum NSE,TNF-α,IL-6 and ICAM-1 levels of patients in the observation group were significantly lower than those in the control group after treatment(P<0.01).The incidence of adverse reactions in the control group and observation group was 9.52% (4/42),12.20% (5/41),respectively;there was no significant difference in the incidence of adverse reactions between the two groups(χ2=1.037,P>0.05).Conclusion Xingnaojing injection combined with sodium valproate can reduce the serum levels of NSE,TNF-α,IL-6 and ICAM-1 of patients with post-stroke epilepsy.The therapeutic effect is better than sodium valproate alone,and does not increase the occurrence of adverse reactions.

参考文献/References:

[1] 孙海欣,王文志.中国脑卒中患病率、发病率和死亡率调查结果发表[J].中华神经科杂志,2017,50(5):337.
[2] 陈巧风.艾灸联合护理程序干预对脑卒中患者吞咽困难症状康复的影响[J].新乡医学院学报,2020,37(3):291-295.
[3] 刘晓蔓,王军,李诗梦,等.针刺配合语言训练治疗脑卒中后构音障碍患者的临床效果[J].世界中医药,2020,15(15):2312-2316.
[4] HSIEH C Y,LAI E C,YANG Y H,et al.Comparative stroke risk of antiepileptic drugs in patients with epilepsy[J].Epilepsia,2013,54(1):172-180.
[5] 魏兴海.第五届全国脑血管病学术会议简介[J].现代康复,2000,4(3):357.
[6] LAFRANCE W C J R,BAKER G A,DUNCAN R,et al.Minimum requirements for the diagnosis of psychogenic nonepileptic seizures:a staged approach:a report from the International League Against Epilepsy Nonepileptic Seizures Task Force[J].Epilepsia,2013,54(11):2005-2018.
[7] 梁晓霞.醒脑静辅助卡马西平治疗脑卒中后继发性癫痫的临床疗效与安全性分析[J].临床合理用药,2016,9(11C):45-47.
[8] 刘丹青,杨文明,董文,等.脑卒中后癫痫的研究概况[J].中医药临床杂志,2015,27(2):155-157.
[9] 李梦雪,张之毓,王倩.通督调神针法治疗脑卒中后失眠的疗效及其对神经递质水平的影响[J].世界中医药,2020,15(1):112-115.
[10] 左菁,宋慧杰,郑乃智.卒中后癫痫研究及治疗进展[J].国际神经病学神经外科学杂志,2019,46(2):198-202.
[11] RHONEY D H,TIPPS L B,MURRY K R,et al.Anticonvulsantprophylaxis and timing of seizures after aneurysmal subarachnoidhemorrhage[J].Neurology,2000,55(2):258-265.
[12] KOSHAL P,KUMAR P.Effect of liraglutide on corneal kindlingepilepsy induced depression and cognitive impairment in mice[J].Neurochem Res,2016,41(7):1-10.
[13] 王艳,赵新利,吴新艳,等.奥卡西平与卡马西平治疗脑卒中后继发性癫痫疗效比较[J].新乡医学院学报,2014,31(4):312-314.
[14] 王艳,张晓鑫,杨清成.脑卒中后癫痫的临床治疗及效果研究[J].北方药学,2018,15(4):38-39.
[15] XIE W J,DONG M,LIU Q,et al.Early predictors and prevention for post-stroke epilepsy:changes in neurotransmitter levels[J].Transl Neurosci,2016,7(1):1-5.
[16] MYINT P K,STAUFENBERG E F,SABANATHAN K.Post-stroke seizure and post-stroke epilepsy[J].Postgrad Med J,2006,82(971):568-572.
[17] 王智,田博,黄渝侃,等.丙戊酸钠对体外培养的人晶状体上皮细胞增生的抑制作用[J].眼科新进展,2009,29(5):345-347.
[18] 王静,马瑞莲,邓长林.小剂量丙戊酸联合拉莫三嗪治疗癫痫的疗效及安全性[J].中国老年学杂志,2016,36(10):2486-2488.
[19] 汪顺贵,刁丽梅,玉倩,等.醒脑静注射液治疗癫痫的研究进展[J].广西医学,2019,41(2):100-102.
[20] 刘梅.醒脑静联合拉莫三嗪、丙戊酸钠治疗老年脑卒中继发性癫痫患者的疗效观察[J].辽宁中医杂志,2017(3):109-111.
[21] 陈芳,崔亚杰,宋春兰,等.左卡尼汀对肠道病毒71型感染重症手足口病的神经保护作用[J].中华实用儿科临床杂志,2019,34(10):753-758.
[22] MORAIS N M,RANZAN J,RIESGO R S.Predictors of epilepsyin children with cerebrovascular disease[J].J Child Neurol,2013,28(11):1387.
[23] 林岚,王晓燕,杨淑,等.丙戊酸钠联合左乙拉西坦治疗脑卒中后癫痫的临床观察[J].临床合理用药杂志,2016,27(33):4634-4637.
[24] NOVOTNY L A,BAKALETZ L O.Intercellular adhesion molecule 1 serves as a primary cognate receptor for the type IV pilus of nontypeable Haemophilus influenzae[J].Cell Microbiol,2016,18(8):1043-1055.
[25] 郭留芹.醒脑静注射液联合奥卡西平对癫痫患者T淋巴细胞亚群及血清ALP ICAM-I水平变化影响[J].中国实用神经疾病杂志,2017,20(12):88-90.

相似文献/References:

[1]李爱琳,商怀玉.醒脑静注射液穴位注射对智力低下脑性瘫痪患儿智力发育及血液流变学的影响[J].新乡医学院学报,2017,34(9):840.[doi:10.7683/xxyxyxb.2017.09.016]
 LI Ai-lin,SHANG Huai-yu.Effect of acupoint injection of Xingnaojing injection on the intelligence development and hemorheology in children with mental retarded cerebral palsy[J].Journal of Xinxiang Medical University,2017,34(9):840.[doi:10.7683/xxyxyxb.2017.09.016]

更新日期/Last Update: 2020-09-05