世界科学技术-中医药现代化
世界科學技術-中醫藥現代化
세계과학기술-중의약현대화
WORLD SCIENCE AND TECHNOLOGY-MODERNIZATION OF TRADITIONAL CHINESE MEDICINE
2013年
9期
2011-2020
,共10页
荣培晶%刘爱华%张建国%王玉平%杨岸超%贲卉%李亮%李丽萍%宋潞%刘焕光%何伟%黄凤%李霞%刘儒鹏%吴鹏%朱兵
榮培晶%劉愛華%張建國%王玉平%楊岸超%賁卉%李亮%李麗萍%宋潞%劉煥光%何偉%黃鳳%李霞%劉儒鵬%吳鵬%硃兵
영배정%류애화%장건국%왕옥평%양안초%분훼%리량%리려평%송로%류환광%하위%황봉%리하%류유붕%오붕%주병
难治性癫痫%迷走神经刺激%耳迷走神经分支%经耳甲腔刺激迷走神经
難治性癲癇%迷走神經刺激%耳迷走神經分支%經耳甲腔刺激迷走神經
난치성전간%미주신경자격%이미주신경분지%경이갑강자격미주신경
Refractory epilepsy%vagus nerve stimulation%auricular branch of the vagus nerve%auricular vagus nerve stimulation at auricular concha area
目的:本研究旨在探讨经皮(耳甲腔)电刺激耳迷走神经(ta-VNS)可否作为治疗难治性癫痫的一种有效方法。方法:采用经皮神经电刺激双盲法。首先,对50名难治性癫痫患者进行经皮电刺激耳迷走神经治疗(ta-VNS),初步观察治疗效果。然后,将另外144名癫痫患者随机分为:经皮电刺激耳迷走神经组(ta-VNS,n=98)和经皮电刺激非耳迷走神经组(tn-VNS,n =46)。每日治疗两次,共治疗24周。除了ta-VNS和tn-VNS组患者以外,其余同期入院患者均接受药物治疗。以校准恩格尔分级标准为疗效观察指标。在治疗后的第8周、第16周和第24周,对癫痫发作频率和严重程度进行评估。结果:前期研究中的50例癫痫患者,经过8周治疗后,6例无癫痫发作,12例发作频率分别减少了50%~89%。经过24周治疗后,8例无癫痫发作,2例癫痫发作频率减少≧90%,9例发作频率分别减少了50%~89%。在144例癫痫患者的研究中,经过8周治疗后,ta-VNS组的98例患者中10例无癫痫发作,6例发作频率减少≧90%,25例发作频率减少了50%~89%。经过24周的治疗后,15例无癫痫发作,6例发作频率减少≧90%,26例减少了50%~89%。经过前8周的治疗,tn-VNS对照组的46例患者重只有3例无癫痫发作,2例患者减少90%以上,9例发作频率减少了50%~89%。经过额外16周的ta-VNS治疗后,46例患者中有7例无癫痫发作,14例发作频率减少50%~89%。各组间发作频率减少百分比差异显著(P<0.05)。结论:ta-VNS与VNS作用相类似,能够抑制癫痫发作,是一个安全、有效、经济且广泛适用的治疗难治性癫痫方法。
目的:本研究旨在探討經皮(耳甲腔)電刺激耳迷走神經(ta-VNS)可否作為治療難治性癲癇的一種有效方法。方法:採用經皮神經電刺激雙盲法。首先,對50名難治性癲癇患者進行經皮電刺激耳迷走神經治療(ta-VNS),初步觀察治療效果。然後,將另外144名癲癇患者隨機分為:經皮電刺激耳迷走神經組(ta-VNS,n=98)和經皮電刺激非耳迷走神經組(tn-VNS,n =46)。每日治療兩次,共治療24週。除瞭ta-VNS和tn-VNS組患者以外,其餘同期入院患者均接受藥物治療。以校準恩格爾分級標準為療效觀察指標。在治療後的第8週、第16週和第24週,對癲癇髮作頻率和嚴重程度進行評估。結果:前期研究中的50例癲癇患者,經過8週治療後,6例無癲癇髮作,12例髮作頻率分彆減少瞭50%~89%。經過24週治療後,8例無癲癇髮作,2例癲癇髮作頻率減少≧90%,9例髮作頻率分彆減少瞭50%~89%。在144例癲癇患者的研究中,經過8週治療後,ta-VNS組的98例患者中10例無癲癇髮作,6例髮作頻率減少≧90%,25例髮作頻率減少瞭50%~89%。經過24週的治療後,15例無癲癇髮作,6例髮作頻率減少≧90%,26例減少瞭50%~89%。經過前8週的治療,tn-VNS對照組的46例患者重隻有3例無癲癇髮作,2例患者減少90%以上,9例髮作頻率減少瞭50%~89%。經過額外16週的ta-VNS治療後,46例患者中有7例無癲癇髮作,14例髮作頻率減少50%~89%。各組間髮作頻率減少百分比差異顯著(P<0.05)。結論:ta-VNS與VNS作用相類似,能夠抑製癲癇髮作,是一箇安全、有效、經濟且廣汎適用的治療難治性癲癇方法。
목적:본연구지재탐토경피(이갑강)전자격이미주신경(ta-VNS)가부작위치료난치성전간적일충유효방법。방법:채용경피신경전자격쌍맹법。수선,대50명난치성전간환자진행경피전자격이미주신경치료(ta-VNS),초보관찰치료효과。연후,장령외144명전간환자수궤분위:경피전자격이미주신경조(ta-VNS,n=98)화경피전자격비이미주신경조(tn-VNS,n =46)。매일치료량차,공치료24주。제료ta-VNS화tn-VNS조환자이외,기여동기입원환자균접수약물치료。이교준은격이분급표준위료효관찰지표。재치료후적제8주、제16주화제24주,대전간발작빈솔화엄중정도진행평고。결과:전기연구중적50례전간환자,경과8주치료후,6례무전간발작,12례발작빈솔분별감소료50%~89%。경과24주치료후,8례무전간발작,2례전간발작빈솔감소≧90%,9례발작빈솔분별감소료50%~89%。재144례전간환자적연구중,경과8주치료후,ta-VNS조적98례환자중10례무전간발작,6례발작빈솔감소≧90%,25례발작빈솔감소료50%~89%。경과24주적치료후,15례무전간발작,6례발작빈솔감소≧90%,26례감소료50%~89%。경과전8주적치료,tn-VNS대조조적46례환자중지유3례무전간발작,2례환자감소90%이상,9례발작빈솔감소료50%~89%。경과액외16주적ta-VNS치료후,46례환자중유7례무전간발작,14례발작빈솔감소50%~89%。각조간발작빈솔감소백분비차이현저(P<0.05)。결론:ta-VNS여VNS작용상유사,능구억제전간발작,시일개안전、유효、경제차엄범괄용적치료난치성전간방법。
This study was aimed to examine whether transcutaneous auricular vagus nerve electrical stimulation (ta-VNS) at auricular concha area was an effective approach for patients with refractory seizures. Double-blind transcu-taneous nerve electrical stimulation was applied in this study. A pilot study was conducted firstly on 50 patients with refractory seizures to preliminarily observe the therapeutic effect of ta-VNS. Then, a randomized controlled trial (RCT) was conducted on another 144 epilepsy patients who were randomly assigned to the ta-VNS group (n = 98), and the transcutaneous non-auricular vagus nerve electrical stimulation (tn-VNS) control group (n = 46). The treat-ment was performed twice a day for 24 weeks. Patients who were neither in the ta-VNS group nor the tn-VNS group accepted medication at the same time. The seizure frequency and severity were assessed in the 8-week, 16-week and 24-week of the treatment according to the modified Engel scale. The results showed that in the pilot study, after 8-week treatment, 6 out of 50 epilepsy patients were seizure free; and 12 cases had a 50%-89% reduction in seizure frequency. After 24-week treatment, 8 cases were seizure free; 2 cases had a more than 90% reduction in seizure frequency; and 9 cases had a 50%-89% reduction in seizure frequency. In the RCT study of 144 epilepsy patients, after 8-week treatment, 10 out of 98 patients in the ta-VNS group were seizure free; 6 cases had a more than 90% reduction in seizure frequency; and 25 cases had a 50%-89% reduction in seizure frequency. After 24-week treatment, 15 cases were seizure free; 6 cases had a more than 90% reduction in seizure frequency; and 26 cases had a 50%-89% reduction in seizure frequency. After 8-week treatment, in the tn-VNS control group, only 3 out of 46 patients were seizure free; 2 cases had a more than 90% reduction in seizure frequency; and 9 cases had a 50%-89% reduction in seizure frequency. After an additional 16-week treatment of ta-VNS, 7 out of 46 patients were seizure free; 14 had a 50%-89% reduction in seizure frequency. There were significant differences in seizure frequency reduction among groups (P< 0.05). It was concluded that ta-VNS, which had similar therapeutic effect as VNS, was able to suppress epileptic seizures. It is a safe, effective, economic, and applicable treatment option for the treatment of refractory epilepsy.