目的 评价银杏二萜内酯葡胺注射液（DGMI）联合依达拉奉右崁对急性缺血性脑卒中（AIS）的治疗效果。方法 回顾性分析我院2021年3月—2022年6月收治的86例AIS患者,根据治疗方法不同,分为单药组和联合组,每组43例,2组均予以DGMI治疗,联合组加用依达拉奉右崁醇。对比2组的治疗效果。结果 治疗后,联合组美国国立卫生研究院卒中量表（NIHSS）评分低于单药组（P<0.05）,简易智能精神状态检查量表（MMSE）和Barthel指数（BI）得分高于单药组（P<0.05）;联合组治疗后脑血流动力学指标（Q_min和V_min）高于单药组（P<0.05）,而全血还原黏度、血浆黏度和血小板聚集指数低于单药组（P<0.05）;联合组治疗后血清丙二醛（MDA）、超敏C-反应蛋白（hsCRP）和白细胞介素-6（IL-6）低于单药组（P<0.05）,而超氧化物歧化酶（SOD）高于单药组（P<0.05）;联合组治疗总有效率88.37%,高于单药组的67.44%（P<0.05）,且2组不良反应总发生率比较差异无统计学意义（P>0.05）。结论 DGMI联合依达拉奉右崁醇可有效提高AIS患者的神经功能、认知功能及日常生活能力,降低血液高凝状态,改善脑部血流,缓解机体氧化应激及炎症反应,且不良反应发生率较低,安全性良好。

Objective To evaluate the clinical efficacy of diterpene ginkgolides meglumine injection（DGMI）combined with edaravone dextracanthol in the treatment of acute ischemic stroke（AIS）．Methods A total of 86 patients with AIS admitted to our hospital from March 2021 to June 2022 were divided into single drug group and combination group according to different treatment methods,with 43 patients in each group．Both groups were treated with DGMI,and the combination group was added with edaravone dextracanthol．The therapeutic effect,neurological function and adverse reactions of the two groups were compared．Results After treatment,compared with the single drug group,the NIH Stroke Scale（NIHSS）score of the combination group was significantly lower（P<0.05）,and the Mini-Mental State Examination（MMSE）and Barthel index（BI）scores were significantly higher（P<0.05）．After treatment,the cerebral hemodynamic indexes（Q_min and V_min）in the combination group were significantly higher（P<0.05）,while the whole blood reducing viscosity,plasma viscosity and platelet aggregation index were significantly lower（P<0.05）．After treatment,compared with the single drug group,the serum malondialdehyde（MDA）,high sensitive C-reactive protein（hsCRP）and interleukin- 6（IL-6）levels in the combination group were significantly lower（P<0.05）,while the level of superoxide dismutase（SOD）was significantly higher（P<0.05）．The total effective rate of the combination group was 88.37%,which was significantly higher than 67.44% of the single drug group（P<0.05）．The incidence of adverse reaction between two groups was not significant（P>0.05）．Conclusions DGMI combined with edaravone dextracanthol can effectively improve the neurological function,cognitive function and daily living ability of patients with AIS,reduce blood hypercoagulability,improve cerebral blood flow,alleviate oxidative stress and inflammatory reaction,improve the therapeutic effect,without increasing the incidence of adverse reactions,which has good safety．

目的 探讨不同分期的子宫内膜异位症（EMs）患者行体外受精-胚胎移植（IVF-ET）助孕结局与成本效果分析。方法 回顾性分析2016年1月—2022年1月Ⅰ~Ⅱ期、Ⅲ~Ⅳ期EMs患者应用卵泡期长方案及同期因“输卵管因素”患者采用黄体期长方案行IVF-ET的助孕结局以及成本费用。结果 EMs各组的启动日LH、E₂以及hCG日E₂水平低于对照组（P<0.05）,Ⅲ~Ⅳ期EMs组的可利用胚胎数、着床率、临床妊娠率、活产率明显低于对照组及Ⅰ~Ⅱ期EMs组（P<0.05）,其流产率偏高,但组间比较差异无统计学差异（P>0.05）。各组间的Gn剂量、Gn天数、hCG日的LH水平、hCG日≥14 mm卵泡数、hCG日子宫内膜厚度、获卵数、受精率、卵裂率比较差异无统计学意义（P>0.05）。成本效果分析提示：各组平均周期总成本无明显差异,Ⅰ~Ⅱ期EMs组患者患者获得一例妊娠所花费的成本与对照组相当,而Ⅲ~Ⅳ期EMs组患者获得一例妊娠所花费的成本最高。结论 对于不同分期的EMs,Ⅰ~Ⅱ期患者应用卵泡期长方案的患者可获得良好的妊娠结局,其妊娠率及成本与传统方案相当,而Ⅲ-Ⅳ期的患者妊娠率偏低,获得妊娠的成本更高,可能与该疾病严重程度及方案选择有关。

Objective To analyze the outcome and cost-effectiveness of invitrofertilization-embryotransfer（IVF-ET）assisted pregnancy in endometriosis（EMs）patients with different stages．Methods The outcomes and costs of patients with stageⅠ-Ⅱ and Ⅲ-Ⅳ EMs treated with follicular phase long protocol and patients treated with luteal phase long protocol due to“tubal factors” during the same time from January 2016 to January 2022 were retrospectively analyzed．Results The levels of LH,E2 on initiation day and the levels of E2 on hCG day in EMs groups were lower than those in control group（P<0.05）,the number of available embryos,implantation rate,clinical pregnancy rate and live birth rate in stage Ⅲ-Ⅳ EMs group were significantly lower than those in control group and stageⅠ-Ⅱ EMs group（P<0.05）,and the abortion rate was higher．But there was no significant difference between groups（P>0.05）．There were no significant differences in the dosage of Gn,duration of Gn,the levels of LH on hCG day,the number of follicles with diamete≥14 mm on hCG day,endometrial thickness on hCG day,number of oocytes retrieved,fertilization rate and cleavage rate among the three groups（P>0.05）．Conclusions For different stages of endometriosis,patients in stageⅠ-Ⅱ who apply the follicular phase long protocol can achieve good pregnancy outcomes,and their pregnancy rate and cost are comparable to the traditional regimen,while patients in stage Ⅲ-Ⅳ have a low pregnancy rate,and the cost of pregnancy is higher,which should be related to the severity of the disease and the choice of regimen.

目的 探讨腰-硬联合阻滞分娩镇痛方式对初产妇在产程进展及产时发热的影响,为临床实践提供理论依据。方法 回顾性分析2020年12月—2021年12月在广州市某三甲医院产科分娩产妇535例的基本资料。观察组（285例）采用腰-硬联合阻滞麻醉分娩镇痛,对照组（250例）选择常规无干预分娩。结果 观察组中的产妇第一产程和第二产程的时间比对照组更长,且产后2 h出血量高于对照组,差异有统计学意义（P<0.05）,除此之外,2组产妇产时发热率比较差异也有统计学意义（P<0.01）。结论 腰硬联合阻滞分娩镇痛在一定程度上会延长产程,且产后2 h的出血量较多,同时也会增加产时发热的概率,存在一定不良反应,故需要密切观察,保证母儿安全。

Objective To investigate the effect of combined spinal-epidural block anesthesia on the progress of labor and intrapartum fever in primipara,and to provide a theoretical basis for clinical practice．Methods The basic data of 535 pregnant women who gave birth in the obstetrics department of a tertiary hospital in Guangzhou from December 2020 to December 2021 were retrospectively analyzed．The observation group（285 cases）was given labor analgesia,and the control group（250 cases）was given routine non-intervention delivery．Results The time of the first stage of labor and the second stage of labor in the observation group was significantly longer than that in the control group,and the bleeding volume 2 hours after delivery was higher than that in the control group,and the difference was statistically significant（P<0.05）．The maternal fever rate during delivery also had statistical significance（P<0.01）．Conclusions Combined spinal-epidural block anesthesia will prolong the labor process to a certain extent,and the amount of bleeding in 2 hours after delivery will be more,and it will also increase the probability of intrapartum fever,with certain adverse reactions．Therefore,close observation is needed to ensure the mother and child safety．

目的 探讨影响宫腔修复的因素,为不全流产妇女选择期待治疗提供理论依据。方法 2021年1月—12月在香港大学深圳医院招募早孕药流不全的患者534例,记录其人口学特征以及从排胎到流产后3周到月经复潮后的相关情况,通过多因素Logistic回归分析影响不全流产者宫腔修复的因素。结果 534例药流不全患者中,月经复潮后宫腔残留240例,残留率为44.9%;多因素Logistic回归分析显示,BMI（OR=0.888,95%CI：0.808~0.975）、子宫位置（OR=1.836,95%CI：1.139~2.958）、人工流产次数（OR=2.258,95%CI：1.078~4.728）、阴道流血时长（OR=0.344,95%CI：0.141~0.837）、残留物最大径线（OR=1.061,95%CI：1.031~1.092）、残留物血流信号2级/3级（OR=3.636,95%CI：1.790~7.394;OR=4.001,95%CI：1.561~10.256）是宫腔残留的影响因素。结论 宫腔残留的高危因素有子宫后位、残留物最大径线、1次以上的人工流产、2级及以上的残留物血流信号,且血流信号等级影响最大。BMI和阴道流血时长>3周是宫腔残留的保护因素。

Objective To investigate the factors affecting uterine cavity repair and to provide a theoretical basis for the choice of expectant treatment for women with incomplete abortion．Methods From January to December 2021,534 patients with incomplete abortions were recruited at University of Hong Kong-Shenzhen Hospital,and their demographic characteristics and correlations from expulsion of the gestational sac to 3 weeks after medication abortion and after menstrual resumption were recorded,and the factors affecting uterine cavity repair in incomplete abortions were analyzed by multifactorial logistic regression．Results In 534 women,there were 240 cases of uterine cavity remnants after menstrual return,with a remnant rate of 44.9%;the results of multifactorial logistic regression analysis showed that BMI（OR=0.888,95% CI：0.808-0.975）,uterine position（OR=1.836,95% CI：1.139-2.958）,number of abortions（OR=2.258,95% CI：1.078-4.728）,length of vaginal bleeding（OR=0.344,95% CI：0.141-0.837）,maximum diameter of residuals（OR=1.061,95% CI：1.031-1.092）,and residual blood flow signal grade 2/3（OR=3.636,95% CI：1.790-7.394;OR=4.001,95%CI：1.561-10.256）were influential factors for uterine residuals．Conclusions High-risk factors for uterine residuals are posterior uterus,the maximum diameter of residuals,more than one abortion,grade 2 or higher residual blood flow signal,and the grade of blood flow signal had the greatest effect．BMI and duration of vaginal bleeding >3 weeks are protective factors for uterine residuals．

目的 研究母代不同孕期巨细胞病毒（CMV）感染对自身精神及行为的影响。方法 72只BALB/c雌鼠随机分为12组（A1、A2、A3、B1、B2、B3、C1、C2、C3、D1、D2、D3,每组6只）,A为孕期再感染、B为既往感染、C为孕期原发感染、D为空白对照,1为孕早期、2为孕中期、3为孕晚期。母鼠腹腔注射小鼠CMV（murine CMV,MCMV）Smith株建立播散性感染模型,或注射无菌生理盐水建立对照模型。母鼠产仔后同笼合养,产后22 d分笼;母鼠做行为学试验。试验结束,每组随机处死3只母鼠;测量子宫、肝、脑脏器重量系数及唾液腺中MCMV含量。结果 A、B、C组母鼠产后次日体质量均低于D组（均P<0.05）,其中C2、C3组母鼠低体质量情况持续至产后22日（均P<0.05）。A、B、C组母鼠唾液腺组织均测出MCMV。与D组母鼠相比,A1、C1组母鼠活胎率降低（均P<0.05）,A、C组母鼠的子宫、肝、脑脏器系数升高（均P<0.05）且脑组织有病损表现。产后6天时,A3、B3、C组母鼠水平运动总距离和直立次数减少（均P<0.05）,糖水偏好量降低（均P<0.05）,悬尾不动时间延长（P<0.05）;其中,C2、C3组母鼠以上行为退缩情况至产后22天仍存在,且有逃避潜伏时间延长（均P<0.01）,穿越原平台位置次数减少（均P<0.01）情况。结论 孕期CMV感染损害母代身心健康,有可能增加子代不良抚养的风险。

Objective To investigate the effects of cytomegalovirus（CMV）infection in different stages of maternal pregnancy on its own spirit and behavior．Methods A total of 72 female BALB/c mice were randomly divided into 12 groups（each group had 6 mice）：A1-A3,B1-B3,C1-C3,D1-D3（group A had re-infection,group B had previous infection,group C had primary infection,group D was blank control,group 1 was in early pregnancy,group 2 was in middle pregnancy,group 3 was in late pregnancy）．The disseminative infection model was established by intraperitoneal inoculation of murine CMV（MCMV）Smith strain,and the blank control model was established by intraperitoneal inoculation of 0.9% sterile saline（NaCl）．After 21 days of parturition,the mothers and offspring were reared in separate cages,mothers were selected for the behavior experiments．At the end of all the behavior tests,3 mothers in each group were killed randomly．Weighed and calculated the organ coefficients of the uteri,livers and brains,and detected the expression levels of MCMV in salivary gland．Results On the first day after delivery,the weights of mothers in groups A,B and C were lower than those in group D（all P<0.05）,the low body weight of mice in C2 and C3 groups lasted to the 22th day（all P<0.05）．The MCMV in salivary gland tissue were found in groups A,B and C,but not in group D．The live fetus rates of groups A1 and C1 were significantly lower than that of group D．The organ coefficients of uteri,livers and brains in groups A and C were higher than those in group D（all P<0.05）．And the lesions of brain tissues in groups A and C were more serious than in the other groups．On the 6th day,compared with the other groups,the mothers of groups A3,B3 and C were significantly abnormal in the open field test,the tail suspension test and the sugar preference test（all P<0.05）．But on 22th day,only the mothers of groups C2 and C3 were significantly abnormal in those tests（all P<0.01）,and even in the water maze test（all P<0.01）．Conclusions Maternal CMV infection in different stages pregnancy have impacts on mother mice's physical and mental health．Those bad situations may bring poor parenting to the offspring．

目的 探讨与观察思维导图教育模式对肠造口患者生活质量与心理情绪的影响。方法 选择2021年5月—2022年4月本院胃肠外科收治的低位直肠癌术后患者80例为研究对象,按入院顺序随机编号,对应随机数字为偶数的分到思维导图组（n=40）,奇数的分到传统组（n=40）。传统组给予常规健康教育干预,思维导图组在传统组护理的基础上给予思维导图教育模式干预,思维导图组与传统组护理观察时间为3个月。结果 思维导图组护理期间的造口感染、坏死、水肿、出血、旁疝等并发症发生率与传统组相比都降低（P<0.05）。思维导图组与传统组护理后的焦虑与抑郁评分与护理前相比降低（P<0.05）,护理后思维导图组评分与传统组相比降低（P<0.05）。思维导图组的术后住院时间、术后排气时间、术后下床活动时间与传统组相比均减少（P<0.05）。思维导图组护理后的副作用、共性症状、尿路症状、特异躯体症状、特异心理、性功能、尿袋问题等生活质量评分与传统组相比都减少（P<0.05）。结论 思维导图教育模式在肠造口患者的应用能促进缓解心理负面情绪,促进患者康复,提高患者的生活质量,减少术后造口并发症的发生。

Objective To explore and observe the effects of mind map education mode on the quality of life and psychological emotions of patients with enterostomy．Methods From May 2021 to April 2022, 80 cases of patients with postoperative low rectal cancer who were admitted to the Gastrointestinal Surgery Department of our hospital were selected as the research subjects, and all the cases were numbered according to the random admission sequence, and those with even random numbers were assigned to the mind map group（n=40）, and odd numbers were assigned to the traditional group（n=40）．The traditional group was given routine health education intervention, the mind map group was given mind map education mode intervention additionally, and the nursing observation time of both groups was 3 months．Results The incidences of complications such as stoma bleeding, parastomal hernia, stoma necrosis, stoma edema and stoma infection during nursing in the mind map group were lower than that in the traditional group（P<0.05）．The anxiety and depression scores in both groups after nursing were significantly lower than those before nursing（P<0.05）, and the scores in the mind map group after nursing were also significantly lower than those in the traditional group（P<0.05）．The postoperative hospital stay, postoperative exhaust time, and postoperative ambulation time of the mind map group were significantly shorter than those of the traditional group（P<0.05）．The quality of life scores of common symptoms, side effects, urinary tract symptoms, specific somatic symptoms, specific psychology, urine bag problems and sexual function in the mind map group after nursing were significantly lower than those in the traditional group（P<0.05）．Conclusions The application of mind map education model in patients with enterostomy can promote the relief of psychological negative emotions, promote the recovery of patients, reduce the occurrence of postoperative complications, and improve the quality of life of patients．

目的 探讨苏黄止咳胶囊联合多索茶碱对慢性持续期支气管哮喘的疗效及对肺功能、呼出气一氧化氮（FeNO）的影响。方法 选择2020年3月—2022年3月70例慢性持续期支气管哮喘患者,随机分为2组各35例,对照组仅予以多索茶碱治疗,研究组在对照组基础上加服苏黄止咳胶囊治疗。治疗3个月,采用哮喘控制测试（ACT）对患者进行评估,记录哮喘急性加重、急救药物使用情况及急诊入院情况,测定肺功能和呼出FeNO。结果 2组治疗1月的ACT评分比较无统计学意义（P>0.05）,治疗2、3个月时研究组的ACT评分高于对照组（P<0.05）。研究组哮喘急性加重次数、急救药物使用次数均少于对照组（P<0.05）,而2组急诊入院次数比较差异无统计学意义（P>0.05）。与基线值相比,2组治疗3个月时的肺功能指标无改变（P>0.05）且组间比较差异亦无统计学意义（P>0.05）;2组治疗3个月时的FeNO无改变（P>0.05）,而研究组的FeNO低于对照组（P<0.05）。结论 苏黄止咳胶囊联合多索茶碱治疗慢性持续期支气管哮喘可降低FeNO,提高哮喘控制水平。

Objective To investigate the effect of Suhuang Zhike capsule combined with doxofylline on chronic persistent bronchial asthma, pulmonary function and exhaled nitric oxide（FeNO）．Methods Seventy patients with chronic persistent bronchial asthma from March 2020 to March 2022 were randomly divided into two groups, 35 cases in each group．The control group was only treated with doxofylline, and the study group was treated with Suhuang Zhike capsule additionally．After 3 months of treatment, the patients were evaluated by asthma control test（ACT）, the acute exacerbation of asthma was recorded, and the pulmonary function and exhaled FeNO were measured．Results There was no statistical significance in the ACT score of the two groups after one month of treatment（P>0.05）．The ACT scores of the study group after two months and three months of treatment were significantly higher than those of the control group（P<0.05）．The times of acute exacerbation of asthma and the use of emergency drugs in the study group were less than those in the control group（P<0.05）, but there was no significant difference in the number of emergency hospitalizations between the two groups（P>0.05）．Compared with the baseline value, there was no significant change in lung function indexes in the two groups after 3 months of treatment（P>0.05）．Compared with the baseline value, there was no significant change in FeNO in the two groups after 3 months of treatment（P<0.05）, while FeNO in the study group was lower than that in the control group（P<0.05）．Conclusions Suhuang Zhike capsule combined with doxofylline in the treatment of chronic persistent bronchial asthma can reduce FeNO and improve the level of asthma control．

目的 探讨与分析推拿联合补肾祛瘀针刺法治疗慢性腰肌劳损恢复期患者对腰部疼痛及表面肌电图的影响。方法 选择2019年9月—2022年4月我院收治的72例慢性腰肌劳损恢复期患者为研究对象,根据随机1∶1数字表法,分为联合组与对照组各36例。对照组给予推拿治疗,联合组在此基础上,给予补肾祛瘀针刺法治疗,2组均治疗并观察4周,评价腰部疼痛及表面肌电图变化情况。结果 治疗后联合组与对照组的总有效率分别为97.2%和75%,联合组高于对照组（P<0.05）;治疗前,2组患者的视觉类比疼痛评分法（VAPS）和下腰痛失能问卷（OPDG）评分比较差异无统计学意义,治疗后,2组患者的VAPS和OPDG评分均降低,且联合组低于对照组（P<0.05）;2组治疗后的腰椎前屈力度都高于治疗前（P<0.05）,且联合组更高（P<0.05）;2组治疗后的表面肌电图神经根振幅和潜伏期均低于治疗前（P<0.05）,且联合组更低（P<0.05）。联合组与对照组治疗后的血清5-HT含量均高于治疗前（P<0.05）,联合组更高（P<0.05）。结论 推拿联合补肾祛瘀针刺法在慢性腰肌劳损恢复期患者中的应用具有良好的安全性,有效改善患者的腰椎功能,缓解患者疼痛,提高整体治疗效果,也能改善患者的表面肌电图状况,促进血清5-HT的释放。

Objective To explore and analyze the effects of massage combined with kidney tonifying and blood stasis removing acupuncture on lumbar pain and surface electromyography in patients with chronic lumbar muscle strain in the recovery period．Methods From September 2019 to April 2022, 72 cases of patients in the recovery period of chronic lumbar muscle strain treated in our hospital were selected as the research objects, and were divided into the combined group and the control group with 36 cases in each group by the random 1∶1 number table method．The control group were given massage therapy, and the combination group were given kidney tonifying and stasis removing acupuncture additionally．Results After treatment, the total effective rates of combined group and control group were 97.2% and 75%, respectively, and the combined group was significantly higher than the control group（P<0.05）．Before treatment, there was no significant difference in the visual analogue pain scale（VAPS）and Oswestry low pain & disability questionnaire（OPDG）scores between the two groups, but after treatment, the scores of the two groups were significantly decreased, and the combined group was significantly lower than the control group（P<0.05）．The lumbar flexion intensity after treatment was significantly higher in both groups than before treatment（P<0.05）, and higher in combination group（P<0.05）．The amplitude and latency of surface electromyogram nerve roots after treatment were significantly lower in both groups than before treatment（P<0.05）, and even lower in combination group（P<0.05）．The serum 5-HT content in combination group and control group after treatment was significantly higher than that before treatment（P<0.05）, and that in combination group was higher（P<0.05）．Conclusions The application of massage combined with kidney tonifying and blood stasis removing acupuncture in patients recovering from chronic lumbar muscle strain has good safety, which can improve the lumbar function of patients, relieve the pain of patients, improve the overall therapeutic effect, improve the surface electromyography of patients and promote the release of serum 5-HT．

目的 探讨氢吗啡酮对大鼠脑缺血再灌注损伤的影响。方法 45只SD雄性大鼠随机分成3组：假手术组（Sham组）、脑缺血再灌注组（I/R组）和氢吗啡酮组（HM组）。采用Zea-Longa改良线拴法构建动物模型,再灌注24 h后,Zea-Longa评分法评价神经功能;TTC染色检测脑梗死体积;苏木精-伊红（HE）和Nissl染色观察海马神经元病理变化,Tunel染色观察细胞凋亡情况,Western blot、qPCR检测凋亡相关因子B淋巴细胞瘤（Bcl）-2、Bcl-2相关X蛋白（Bax）和半胱氨酸蛋白酶（Caspase）-3蛋白和mRNA表达量。结果 与I/R组相比,HM组神经功能评分下降和脑梗死面积减小（P<0.05）,Tunel阳性细胞数量减少（P<0.05）,Bax和Caspase-3蛋白mRNA表达量减少,而Bcl-2表达量显著增加（P<0.05）。结论 氢吗啡酮具有神经保护作用,可减轻大鼠脑缺血再灌注损伤。

Objective To investigate the effect of hydromorphone on cerebral ischemia-reperfusion injury in rats．Methods Forty-five SD male rats were randomly divided into three groups：sham-operated group（Sham group）, cerebral ischemia-reperfusion group（I/R group）and hydromorphone group（HM group）．The animal models were constructed using the Zea-Longa modified line tethering method, and neurological function was evaluated by the Zea-Longa score after 24 h of reperfusion．TTC staining was used to detect the volume of cerebral infarction, hematoxylin-eosin（HE）and Nissl staining were used to observe the pathological changes of hippocampal neurons, and Tunel staining was used to observe apoptosis, Western blot, qPCR were used to detect apoptosis Bcl-2, Bcl-2-associated X protein（Bax）and cysteine protease（Caspase）-3 protein and mRNA expression．Results Compared with the I/R group, the HM group showed lower neurological function scores and cerebral infarct area（P<0.05）, smaller number of Tunel-positive cells（P<0.05）, less mRNA expression of Bax and Caspase-3 proteins and significantly higher expression of Bcl-2（P<0.05）．Conclusions Hydromorphone has neuroprotective effects and can reduce cerebral ischemia-reperfusion injury in rats．

目的 探讨天麻止痫汤分别联合托吡酯和卡马西平治疗对癫痫患者记忆能力及甘丙肽、铁调节转运体1（IREG1）的影响。方法 选择我院2019年6月—2022年6月收治的85例癫痫患者,其中21例予天麻止痫汤联合托吡酯治疗（A组）,23例予天麻止痫汤联合卡马西平治疗（B组）,22例予托吡酯治疗（C组）,19例予卡马西平治疗（D组）。评价4组的治疗效果、记忆能力、甘丙肽和IREG1水平等指标,并进行统计比较。结果 4组治疗总有效率和完全控制率比较差异均无统计学意义（P>0.05）。两两比较,A组总有效率高于C组和D组（P<0.05）,B组总有效率高于C组和D组（P<0.05）,A组和B组总有效率比较差异无统计学意义（P>0.05）;A组患者治疗后中医症候积分、癫痫发作次数及发作持续时间均少于其他3组（P<0.05）;A组患者治疗后视觉再认、图片回忆、视觉再生、联想学习、理解、顺背和倒背数字和记忆商数（MQ）均较治疗前升高,且高于其他3组（P<0.05）;4组治疗后甘丙肽水平升高（P<0.05）,IREG1蛋白表达量降低（P<0.05）,A组治疗后甘丙肽水平高于其他3组,IREG1蛋白表达量低于其他3组（P<0.05）;4组不良反应发生率比较差异无统计学意义（P>0.05）。结论 天麻止痫汤联合托吡酯或卡马西平治疗癫痫的总有效率、安全性均较好,且对患者记忆能力影响较小;而天麻止痫汤在改善癫痫症状、减少癫痫发作次数及发作持续时间、抑制甘丙肽和IREG1异常表达方面更具优势。

Objective To investigate the effects of Tianma Zhixian Decoction combined with topiramate and carbamazepine on memory ability and galanin and iron exporter ferroportin 1（IREG1）in patients with epilepsy．Methods A total of 85 patients with epilepsy were admitted to our hospital from June 2019 to June 2022,including 21 patients treated with Tianma Zhixian Decoction combined with topiramate（Group A）,23 patients treated with Tianma Zhixian Decoction combined with carbamazepine（Group B）,22 patients treated with topiramate（Group C）,and 19 patients treated with carbamazepine（Group D）．The therapeutic effect,memory ability,galanin and IREG1 levels were compared among the four groups．Results There were no significant differences in the total treatment response rate and complete control rate between the four groups（P>0.05）．By pairwise comparison,the total response rate in Group A was significantly higher than those in Group C and Group D（P<0.05）,the rate in Group B was significantly higher than those in Group C and Group D（P<0.05）,there was no significant difference in the total response rate between group A and B（P>0.05）．In group A,the TCM syndrome score,seizure attacks and duration of seizure were significantly less than those of the other three groups（P<0.05）．In Group A,visual re-recognition,picture recall,visual regeneration,associative learning,understanding,numbers recitation forward or backward and MQ values were all significantly improved compared with those before treatment,which was significantly higher than that in the other three groups（P<0.05）．Galanin levels significantly increased in the four groups（P<0.05）after treatment,while IREG 1 protein expression decreased（P<0.05）．Galanin level in group A was significantly higher than the other three groups,IREG 1 protein expression was significantly lower than that in the other three groups（P<0.05）．There was no significant difference in the incidence of adverse reactions among the four groups（P>0.05）．Conclusions Tianma Zhixian Decoction combined with topiramate or carbamazepine is effective and safe in the treatment of epilepsy,with little effect on the memory ability of patients．Tianma Zhixian Decoction has more advantages in improving the complete control rate of epilepsy,improving epilepsy symptoms,reducing the number and duration of seizures,and inhibiting the abnormal expression of galanin and IREG1．