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目的:探讨天麻素联合卡马西平治疗脑梗死后继发癫痫的临床疗效。方法:选取2011年4月—2016年9月该院收治的脑梗死后继发癫痫的患者86例为研究对象,采用随机数字表法分为治疗组与对照组,对照组患者给予卡马西平治疗,治疗组患者给予天麻素联合卡马西平治疗的基础上加用中医辨证治疗,对比两组患者的临床疗效、脑电图改善情况,在治疗前后检测患者白细胞介素-1β(IL-1β)、D-二聚体(D-D)及肿瘤坏死因子-α(TNF-α)的水平变化,并观察两组患者不良反应发生情况。结果:治疗组与对照组的总有效率分别为93.02%、76.74%,两组相比,治疗组总有效率明显升高(P<0.05);治疗组与对照组脑电图改善率分别为90.70%、81.39%,两组相比,治疗组脑电图改善率明显升高(P<0.05);与治疗前对比,治疗后治疗组与对照组患者的IL-1β、D-D、TNF-α水平均明显降低(P<0.05),且治疗组患者IL-1β、D-D、TNF-α水平改善程度优于对照组(P<0.05);治疗组与对照组的不良反应发生率分别11.63%、13.95%,两组不良反应发生率对比无显著差异(P>0.05)。结论:天麻素联合卡西马平治疗的基础上加用中医辨证治疗脑梗后继发癫痫可显著提高临床疗效,改善脑电图状况,值得推广应用。
Objective: To investigate the clinical efficacy of gastrodin combined with carbamazepine in the treatment of secondary epilepsy after cerebral infarction. Methods: Totally 86 patients with secondary epilepsy after cerebral infarction admitted from April 2011 to September 2016 in our hospital were selected as the research object. The patients were divided into treatment group and control group by random number table. The patients in control group were given carbamazepine . The patients in the treatment group were treated with gastrodin combined with carbamazepine on the basis of TCM plus syndrome differentiation. The clinical efficacy and EEG improvement were compared between the two groups. The levels of interleukin-1β (IL-1β) , D-dimer (DD) and tumor necrosis factor-α (TNF-α) levels were observed and the incidence of adverse reactions in both groups were observed. Results: The total effective rates of the treatment group and the control group were 93.02% and 76.74% respectively. The total effective rate of the treatment group was significantly higher than that of the control group (P <0.05). The improvement rates of EEG in the treatment group and the control group were 90.70% and 81.39% respectively. Compared with the two groups, the improvement rate of EEG in the treatment group was significantly higher (P <0.05). Compared with those before treatment, the levels of IL-1β, DD and TNF- The levels of IL-1β, DD and TNF-α in treatment group were better than those in control group (P <0.05). The adverse reaction rates in treatment group and control group were 11.63% 13.95%. There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion: Based on the combination of gastrodin and CAS, the treatment of epilepsy secondary to cerebral infarction with TCM syndrome differentiation can significantly improve the clinical efficacy and improve the EEG status, which is worthy of promotion and application.