目的 探讨丙戊酸钠联合奥卡西平治疗癫痫的疗效及其对患者炎性因子的影响。方法 选择2022年1月—2023年1月医院接收的100例癫痫患者进行研究,电脑随机编号奇偶数分为两组各50例,对照组采取丙戊酸钠治疗,观察组采取丙戊酸钠联合奥卡西平治疗,评价并比较两组治疗效果、神经因子、炎症因子、免疫功能、认知功能及生活质量,观察不良反应发生率。结果 观察组和对照组的治疗有效分别为47例（94.00%）、39例（78.00%）,观察组治疗有效率高于对照组（χ²=5.315,P=0.02）。治疗后,观察组的脑源性神经营养因子（195.33±18.29）pg/mL、神经生长因子（594.69±54.45）ng/mL水平高,肿瘤坏死因子-α（4.12±1.07）pg/mL、IL-1β（3.48±0.79）pg/mL、IL-6（53.44±3.63）pg/mL水平比对照组（150.68±15.27）pg/mL、（542.46±45.56）ng/mL、（6.35±1.27）pg/mL、（4.35±0.93）pg/mL、（63.02±3.81）pg/mL低（t=13.250、5.201、9.495、5.041、12.872,P<0.05）。治疗后,观察组的IgM（1.02±0.12）g/L、IgG（10.02±1.22）g/L、IgA（2.10±0.22）g/L比对照组（1.13±0.14）g/L、（11.68±1.57）g/L、（2.65±0.31）g/L更高（t=4.218、5.903、10.230,P<0.05）。治疗后,观察组的蒙特利尔认知量表（27.78±2.15）分、日常生活活动量表（71.88±6.45）分、癫痫患者生活质量评定量表-31（82.65±8.25）分比对照组（25.33±2.01）分、（65.65±5.54）分、（74.05±7.37）分更高（t=5.886、5.181、5.497,P<0.05）。观察组、对照组发生不良反应组间比较差异无统计学意义（χ²=1.010,0.343,1.010,1.010,1.010,P均>0.05）。结论 丙戊酸钠联合奥卡西平治疗癫痫患者可取得良好的疗效,控制癫痫症状,改善神经因子、认知功能,增强免疫功能,控制炎症因子,而且不良反应少,利于生活质量提高。

Objective To investigate the effect of sodium valproate combined with oxcarbazepine in the treatment of epilepsy and its influence on inflammatory factors．Methods From January 2022 to January 2023,100 patients with epilepsy admitted to our hospital were selected and randomly divided into two groups,50 cases in each group．The control group was treated with sodium valproate,and the observation group was treated with sodium valproate combined with oxcarbazepine．The therapeutic effect,neurological factors,inflammatory factors,immune function,cognitive function and quality of life were evaluated and compared between the two groups,and the incidence of adverse reactions was observed．Results The effective rate of the observation group and the control group were 94.00%（47 cases）and 78.00%（39 cases）,respectively．The effective rate of the observation group was higher than that of the control group（χ²=5.315,P=0.02）．After treatment,the levels of brain-derived neurotrophic factor（195.33±18.29）pg/mL and nerve growth factor（594.69±54.45）ng/mL in the observation group were higher than those in the control group．The levels of tumor necrosis factor-α（4.12±1.07）pg/mL,IL-1β（3.48±0.79）pg/mL,IL-6（53.44±3.63）pg/mL in the control group were（150.68±15.27）pg/mL,（542.46±45.56）ng/mL,（6.35±1.27）pg/mL,（4.35±0.93）pg/mL,（63.02±3.81）pg/mL（t=13.250,5.201,9.495,5.041,12.872,P<0.05）． After treatment,the IgM（1.02±0.12）g/L,IgG（10.02±1.22）g/L,IgA（2.10±0.22）g/L were higher than those in the control group（1.13±0.14）g/L,（11.68±1.57）g/L,（2.65±0.31）g/L（t=4.218,5.903,10.230,P<0.05）．After treatment,the scores of Montreal Cognitive Scale（27.78±2.15）,Activities of Daily Living Scale（71.88±6.45）and Quality of Life in Epilepsy Scale 31（82.65±8.25）in the observation group were higher than those in the control group（25.33±2.01）,（65.65±5.54）and（74.05±7.37）（t=5.886,5.181,5.497,P<0.05）．There was no significant difference in adverse reactions between the observation group and the control group（χ²=1.010,0.343,1.010,1.010,1.010,all P>0.05）．Conclusions Sodium valproate combined with oxcarbazepine in the treatment of patients with epilepsy can achieve good curative effect,control epilepsy symptoms,improve neurological factors,cognitive function,enhance immune function,control inflammatory factors,with less adverse reactions,conducive to improve the quality of life．

目的 观察营养指导联合预防护理在小儿癫痫意外预防中作用。方法 抽取焦作市妇幼保健院2021年1月—2023年1月收治的116例小儿癫痫患儿,按照护理方法分为两组,每组各58例。对照组行常规护理,联合组患儿在常规护理基础上给予营养指导联合预防护理干预,对比两组家属满意度、患儿依从率、蒙特利尔认知评估量表（MoCA）评分。结果 经过护理干预,联合组家属满意率98.28%,依从率96.55%,比对照组87.93%、82.76%高（P<0.05）;住院至出院居家三个月内,相较于对照组,联合组患儿外伤发生次数、发病持续时间、癫痫发作次数较少（P<0.05）;护理后,联合组MoCA评分高于对照组（P<0.05）。结论 在小儿癫痫意外预防中联合应用营养指导和预防护理可改善患儿遵医行为,优化小儿癫痫意外预防效果,减少患儿外伤、癫痫发生次数,缩短患儿发病持续时间,提升患儿生活质量和家属满意度。

Objective To observe the effect of nutritional guidance combined with preventive nursing on the prevention of epilepsy accidents in children．Methods A total of 116 cases of pediatric epilepsy admitted in Jiaozuo Maternal and Child Health Care Hospital from January 2021 to January 2023 were selected．They were divided into two groups according to the nursing method,with 58 cases in each group．The control group was given usual care,while the combined group was given nutritional guidance combined preventive nursing intervention．The satisfaction,the compliance rate and MoCA score were compared between two groups．Results After nursing intervention,the satisfaction rate of the combined group was 98.28%,and the compliance rate of the combined group was 96.55%,which were higher than 87.93% and 82.76% in the control group（P<0.05）．Within three months from hospitalization to discharge,compared with the control group,number of injuries,duration and frequency of seizures were less in the combined group（P<0.05）．After nursing,the MoCA score of the combined group was higher than that of the control group（P<0.05）．Conclusions The combined application of nutritional guidance and preventive nursing in the prevention of pediatric epileptic accidents can improve the compliance behavior of children,optimize the prevention effect of pediatric epileptic accidents,reduce the incidence of trauma and epilepsy in children,shorten the duration of illness,and improve the quality of life of children and family satisfaction．

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．

目的 观察单唾液酸四己糖神经节苷脂联合复方丹参片在治疗难治性癫痫的脑保护作用。方法 选取2010年1月—2015年10月于我院进行治疗的80例难治性癫痫患者为研究对象,随机分为对照组和治疗组。对照组患者给予常规抗癫痫药物治疗,而治疗组患者在对照组治疗基础上给予单唾液酸四己糖神经节苷脂联合复方丹参片治疗。治疗一疗程后,对两组患者进行疗效判定;并分别在治疗前后使用韦氏成人智力量表(WAIS-RC)和韦氏记忆量表(WMS-RC)对两组患者的智商和记忆商进行测评,并比较分析。结果 ①观察组患者的治疗总有效率为97.5%高于对照组的87.5%(P<0.05)。②治疗后,观察组患者的语言智商、操作智商、总智商和记忆商得分分别为(95.4±8.5)分、(94.8±12.5)分、(92.8±7.5)分和(93.5±8.2)分,均高于治疗前的(89.5±7.2)分、(91.5±10.1)分、(88.5±6.9)分和(82.5±10.0)分,且也均高于对照组治疗后的(75.4±6.8)分、(80.6±9.8)分、(80.1±5.9)分和(76.9±8.2)分,以上差异均有统计学意义(P<0.05)。治疗后,对照组患者的智商和记忆商均见的下降,均低于治疗前各分数,以上差异有统计学意义(P<0.05)。结论 神经节苷脂联合复方丹参片治疗难治性癫痫临床效果显著,且具有一定的脑保护效果,可为以后临床治疗难治性癫痫患者提供参考依据。

Objective To observe the cerebral protective effects of monomial four hexose ganglioside combined with compound salvia miltrorrhiza tablets (CSMT) in patients with refractory epilepsy. Methods 80 patients with refractory epilepsy patients treated in our hospital between January 2010 and October 2015 were randomly divided into control group and treatment group. The control group patients were treated with conventional antiepileptic drug therapy, and the treatment group patients were treated with monomial four hexose ganglioside, CSMT and conventional antiepileptic drug therapy. The efficacy in two groups' patients was determined after a course of treatment. The IQ and memory quotient in two groups' patients before and after treatment were evaluated by the Wechsler Adult Intelligence Scale (WAIS-RC) and the Wechsler Memory Scale (WMS-RC) respectively and comparative analysed. Results ①The total effective rate in the treatment group (97.5%) was significantly higher than that in the control group (87.5%) (P<0.05). ②The verbal IQ (95.4±8.5), performance IQ (94.8 ± 12.5), total IQ (92.8 ± 7.5) and memory quotient (93.5 ± 8.2) scores in the treatment group after treatment were significantly higher than those before treatment (89.5 ± 7.2), (91.5 ± 10.1), (88.5 ± 6.9), (82.5 ± 10.0) respectively, and also were significantly higher than those in the control group after treatment (75.4 ± 6.8), (80.6 ± 9.8), (80.1 ± 5.9) and (76.9 ± 8.2) respectively (P<0.05). The IQ and memory quotient in the control groups' patients after treatment were significantly decline and lower than before treatment, which had a statistically significant difference (P<0.05). Conclusion Ganglioside combined with CSMT in the treatment of refractory epilepsy can receive significant clinical effect and own a certain brain protective effect, which provide reference to the future clinical treatment of refractory epilepsy patients.