
浏览全部资源
扫码关注微信
1.广州中医药大学 第一附属医院, 广州 510405
2.柳州市妇幼保健院, 广西 柳州 545001
黄晓利,在读博士,副主任医师,从事中西医结合儿科工作,E-mail:hxlceleste@163.com
龙易勤,副主任医师,从事小儿神经系统疾病工作,Tel:0772-2205049,E-mail:longyiqin31@163.com
网络出版日期:2020-04-14,
纸质出版日期:2020-06-20
移动端阅览
黄晓利,龙易勤,余宾.涤痰汤对痰浊阻窍型强直-阵孪性发作小儿癫痫的临床疗效及对免疫球蛋白、外周血Th17细胞及相关因子的影响[J].中国实验方剂学杂志,2020,26(12):114-120.
HUANG Xiao-li,LONG Yi-qin,YU Bin.Clinical Efficacy of Ditantang on Pediatric Epilepsy with Phlegm and Stasis-type Tonic-clonic Seizure and Its Effect on Immunoglobulin, Peripheral Blood Th17 Cells and Relevant Factors[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(12):114-120.
黄晓利,龙易勤,余宾.涤痰汤对痰浊阻窍型强直-阵孪性发作小儿癫痫的临床疗效及对免疫球蛋白、外周血Th17细胞及相关因子的影响[J].中国实验方剂学杂志,2020,26(12):114-120. DOI: 10.13422/j.cnki.syfjx.20201223.
HUANG Xiao-li,LONG Yi-qin,YU Bin.Clinical Efficacy of Ditantang on Pediatric Epilepsy with Phlegm and Stasis-type Tonic-clonic Seizure and Its Effect on Immunoglobulin, Peripheral Blood Th17 Cells and Relevant Factors[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(12):114-120. DOI: 10.13422/j.cnki.syfjx.20201223.
目的
2
观察涤痰汤治疗痰浊阻窍型强直-阵孪性发作癫痫患儿的临床疗效及对癫痫患儿免疫球蛋白、外周血辅助性T细胞17(Th17),白细胞介素-6(IL-6),白细胞介素-17A(IL-17A)的影响。
方法
2
将100例患儿按随机数字表法产生的随机分配序列放入密封的信封中,按顺序拆开信封并将受试对象分配入相应的对照组和观察组。对照组给予丙戊酸钠口服溶液治疗,观察组在对照组的基础上给予涤痰汤治疗。总疗程3个月,检测治疗前后两组患儿免疫球蛋白M(IgM),免疫球蛋白A(IgA),免疫球蛋白G(IgG)及Th17,IL-6,IL-17A,C-反应蛋白(hs-CRP),血同型半胱氨酸(Hcy)的变化,不良反应发生情况。比较两组患儿治疗前和治疗后3个月,癫痫发作次数、发作持续时间、脑电图的变化。
结果
2
涤痰汤联合丙戊酸钠治疗痰浊阻窍型强直-阵孪发作癫痫患儿3个月后,观察组临床总有效率优于对照组(
P
<
0.05)。治疗后,观察组在癫痫计分减少上面均优于对照组(
P
<
0.05)。与本组治疗前比较,观察组IgG,IgA水平升高(
P
<
0.05),外周血Th17,IL-6,IL-17A,hs-CRP,Hcy水平下降(
P
<
0.05)。与对照组治疗后比较,外周血Th17,IL-6,IL-17A,hs-CRP,Hcy水平下降更明显(
P
<
0.05)。对照组不良反应发生率高于观察组(
P
<
0.05)。
结论
2
涤痰汤加减治疗痰浊阻窍型癫痫(强直-阵孪发作)患儿疗效确切且安全
能够改善患儿临床症状和改善脑电图。能提高患儿免疫球蛋白水平,降低患儿外周血中Th17,IL-6,IL-17A水平,调节机体免疫功能,降低不良反应发生率。
Objective
2
To observe the clinical efficacy of Ditantang on phlegm turbid-blocked obstruction type tetan-burst twins in children with epilepsy and its effect on immunoglobulin
Peripheral blood helper T cells 17(Th17), interleukin-6 (IL-6) and interleukin-17A(IL-17A)in children with epilepsy.
Method
2
The random distribution sequences of 100 children generated by the random number table method were placed in sealed envelopes
and the subjects were divided into the corresponding experimental group and treatment group. Control group was treated with sodium valproate oral solution
and treatment group was also treated with Ditantang in addition to the therapy of control group. The total course of treatment was 3 months. The changes of immunoglobulin M(IgM), immunoglobulin A(IgA),immunoglobulin G(IgG)
peripheral blood Th17 cells,IL-6,IL-17A
C-reactive protein (hs-CRP)
blood homocysteine (Hcy) and the adverse reactions were detected before and after treatment in two groups. The changes in the number of seizures
duration of seizures and EEG before treatment and 3 months after treatment were compared between the two groups.
Result
2
Three months after the treatment of phlegm-blocking obstruction type tetan-burst twin epilepsy with Ditantang combined with sodium valproate
the results showed that the total effective rate of treatment group was superior to that of control group
with statistically significant differences (
P
<
0.05). After treatment
treatment group was superior to control group in the reduction of epilepsy score (
P
<
0.05). Compared with before treatment
the levels of IgG,IgA and IgM in treatment group were significantly increased (
P
<
0.05)
while the levels of Th17,IL-6,IL-17A,hs-CRP and Hcy in peripheral blood were significantly decreased. Compared with control group
the levels of Th17,IL-6,IL-17A,hs-CRP and Hcy in peripheral blood decreased significantly after treatment (
P
<
0.05). The incidence of adverse reactions in control group was significantly higher than that in treatment group (
P
<
0.05).
Conclusion
2
Ditantang is effective and safe in treating phlegm turbidness and obstruction type epilepsy (tetan-episode twin)
and can improve the clinical symptoms of children and electroencephalogram. Besides
it can improve the level of immunoglobulin in children
significantly reduce the levels of Th17,IL-6 and IL-17A in their peripheral blood
regulate the immune function of the body
and reduce the incidence of adverse reactions.
中国抗癫痫协会 . 临床诊疗指南·癫痫病分册 [M]. 2015修订版.北京 : 人民卫生出版社 , 2015 : 11 - 12 .
常琳 , 王小姗 . 中国癫痫流行病学调査研究进展 [J]. 国际神经病学神经外科学杂志 , 2012 , 39 ( 2 ): 161 - 164 .
孟欣 , 张晓敏 , 代卫峰 , 等 . 贾六金分期治疗儿童癫痫经验 [J]. 中医杂志 , 2019 , 60 ( 12 ): 1015 - 1017 .
王亚雷 . 马融教授治疗小儿癫痫验案举隅 [J]. 长春中医药大学学报 , 2008 , 24 ( 4 ): 363 .
贺小梅 . 自拟涤痰定痫汤治疗小儿癫痫29例观察 [J]. 当代医学 , 2016 , 22 ( 12 ): 158 - 159 .
周莲芝 , 李静 , 陈春鹏 , 等 . 涤痰汤加味治疗全面强直阵挛发作癫痫伴发认知功能障碍43例 [J]. 实用医学杂志 , 2018 , 34 ( 20 ): 3474 - 3477 .
李东海 . 涤痰汤联合奥卡西平治疗癫痫46例 [J]. 河南中医杂志 , 2014 , 34 ( 8 ): 1594 .
吴西志 , 吴运畴 . 星香涤痰汤治疗癫痫痰痫证临床疗效研究 [J]. 中医临床研究 , 2015 , 7 ( 19 ): 89 - 90 .
汪受传 , 虞坚儿 . 中医儿科学 [M]. 9版 . 北京 : 中国中医药出版社 , 2012 : 156 - 158 .
马融 , 刘振寰 , 张喜莲 , 等 . 中医儿科临床诊疗指南·小儿癫痫(修订) [J]. 中医儿科杂志 , 2017 , 13 ( 6 ): 1 - 6 .
田洪亮 , 朱万青 , 黄伟 , 等 . 王雪峰教授豁痰健脾论治小儿癫痫 [J]. 中国中西医结合儿科学 , 2012 , 4 ( 6 ): 485 - 486 .
于雪妮 , 冯小刚 , 张建民 , 等 . 人参化学成分与药理作用研究新进展 [J]. 人参研究 , 2019 , 14 ( 1 ): 47 - 50 .
张翼轸 , 张文驹 , 穆青 , 等 . 人参化学成分的药理活性及其含量积累的研究进展 [J]. 安徽农业科学 , 2011 , 39 ( 20 ): 12158 - 12160,12163 .
陆地 , 边立功 , 艾青龙 , 等 . 人参皂苷Rg 1 抑制癫痫大鼠大脑胼胝体区小胶质细胞激活和炎性因子表达的作用 [J]. 神经解剖学杂志 , 2016 , 32 ( 4 ): 452 - 458 .
陈伟 . 人参皂苷Rb 1 (G-rb 1 )对实验性自身免疫性重症肌无力的影响 [D]. 济南 : 山东中医药大学 , 2016 .
蒋征奎 , 李晓 , 陈卓 . 石菖蒲挥发油对链脲佐菌素致大鼠痴呆模型学习记忆能力的影响 [J]. 中国老年学杂志 , 2018 , 38 ( 2 ): 263 - 265 .
吁诚铭 , 李金平 , 胡先明 . 茯苓皮提取物抑制癫痫活性作用 [J]. 中成药 , 2017 , 39 ( 6 ): 1288 - 1290 .
DE LANEROLLE N C , LEE T S , SPENCER D D , et a1 . Astrocytes and epilepsy [J]. Neurotherapeutics, 2010 , 7 ( 4 ): 424 - 438 .
LIIMATAINEN S , LEHTIMAKI K , PALMIO J , et a1 . Immunological perspectives oftemporal lobe seizures [J]. J Neuroimmunol, 2013 , 263 ( 1/2 ): 1 - 7 .
PALACE J , LANG B . Epilepsy: an autoimmune disease? [J]. J Neurol Neurosurg Psych , 2000 , 69 ( 6 ): 711 - 714 .
罗向阳 , 李平甘 , 李栋方 , 等 . 免疫球蛋白治疗儿童癫痫的疗效及机制分析 [J]. 中华神经医学杂志 , 2010 , 9 ( 3 ): 299 - 303 .
陈芳 , 孙素真 , 王丽丽 , 等 , 新型抗癫痫药物唑尼沙胺治疗癫痫儿童免疫功能的变化 [J]. 中国综合临床杂志 , 2015 , 31 ( 6 ): 506 - 508 .
KORN T , BETTELLI E , OUKKA M , et al . IL-17 and Th17 cells [J]. Annu Rev Immunol , 2009 , 27 : 485 - 517 .
MAO L Y , DING J , MA Y , et al . Interictal interleukin-17A levels are elevated and correlate with seizure severity of epilepsy patients [J]. Epilepsia , 2013 , 54 ( 9 ): 142 - 145 .
0
浏览量
17
下载量
2
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621