Theoretical And Experimental Study On The Treatment Of Epilepsy Using The Methods Of Regulating Pivot And Mediating Ying (Nutrient) And Wei (Defensive)

Epilepsy is one of the common and difficult diseases of neurology. At present the pathogenesis of this disease has not yet entirely clear, clinical manifestations complex, longer course, treatment difficult. Existing anti-epileptic drugs can not completely control all seizures, and with a variety of adverse reactions which leading to the decline in the quality of life. So many patients can not tolerate long-term drug treatment. Therefore, the current focus of the work of the epilepsy study is seeking to some therapy and medicines that can improve the cure rate, control seizures effectively and improve the quality of life of patients. And traditional Chinese medicine has the characteristic of the holistic concept and syndrome differentiation and treatment,show that the unique advantages and clinical vitality in the treatment of difficult diseases.Especially the classic prescriptions are very strict,so the treatment of epilepsy applicated with the classic prescriptions obtained good results. Therefore, it has important clinical significance that strengthening theoretical research, applying the theory in clinical,grasping the consistency of theory, methods,prescriptions and drugs of traditional Chinese medicine, better playing the role of the classic prescriptions,and improving the treatment of epilepsy with TCM.And using the methods of regulating pivot and mediating ying(nutrient) and wei(defensive) in EP is the successful practice of treating epilepsy using the theory of TCM and the classic prescriptions.Through the study on《Treatise on febrile diseases》and the clinical experience in 40 years,Professor Zhang hengliu considered that the pathogenesis of EP is deficiency on the primary(ben) and excess on the secondary(biao).The primary(ben) is the disorder of pivot,the disharmony of ying(nutrient) and wei(defensive),and the spleen-qi deficiency.The secondary(biao) is wind and phlegm,followed blood stasis.The treatment of EP should mainly using the methods of regulating pivot,mediating ying(nutrient) and wei(defensive) and tonifying spleen-qi,and applying the methods of calming wind,eliminating phlegm and resolving stasis.Therefore,Pro.Zhang selected Chaihu-Guizhi soup to be the basis prescription,which is the representative prescription of the methods of regulating pivot and mediating ying(nutrient) and wei(defensive) in《Treatise on febrile diseases》.Based this prescription,he originated the Xianning tablets prescription with increasing and reducing the drugs,and achieved satisfactory clinical efficacy.The research team led by Pro.Zhang researched the application of the methods of regulating pivot and mediating ying(nutrient) and wei(defensive) and Xianning tablets in EP,from theory to clinical efficacy, pharmacology, and other mechanisms.Earlier studies of clinical efficacy and pharmacology achieved gratifying results,proved the clinical efficacy was exact and side effects was minor,worthed further research and development.Through theoretical and experiment research,this study systematically summed up the theoretical foundation and the law of syndrome differentiation and treatment of using the methods of regulating pivot and mediating ying(nutrient) and wei(defensive) in the treatment of EP,and explored its possible mechanism of anti-EP from different angles.This study could have a certain significance on the clinical treatment of epilepsy by TCM.Theoretical study used the methods of the prescription-syndrome research,with the literature and information,to explore the theoretical foundation and the law of syndrome differentiation and treatment of the treatment of EP applied the methods of regulating pivot and mediating ying(nutrient) and wei(defensive).(1)To summarize the origins,etiology,pathogenesis,and the laws of syndrome differentiation and treatment.(2)To explore the epileptic pathogenesis and the law of syndrome differentiation and treatment of EP according to the theory of six meridians,through Shaoyang pivot theory, the ying-wei doctrine, the spleen-stomach doctrine, Syncope theory of《Treatise on febrile diseases》, and so on.《Treatise on febrile diseases》has not yet established a chapter on EP, but has many description of epileptic similar symptoms in it.The theory of six meridians could also be applied to the syndrome differentiation and treatment of EP.(3)To expounded the theoretical foundation and the law of syndrome differentiation and treatment of using the methods of regulating pivot and mediating ying(nutrient) and wei(defensive) in the treatment of EP. As EP had the pathogenesis of the disorder of pivot,the disharmony of ying(nutrient) and wei(defensive),we could treate EP by the methods of regulating pivot and mediating ying(nutrient) and wei(defensive). Chaihu-Guizhi soup could treate Tai-Shao syndrome,and its mechanism was regulating pivot, mediating ying(nutrient) and wei(defensive) and regulating the body fluid.It reflected the methods of regulating pivot and mediating ying(nutrient) and wei(defensive),and was the representative prescription of the methods of regulating pivot and mediating ying(nutrient) and wei(defensive).So we could selected Chaihu-Guizhi soup to be the basis prescription to treat EP. Analysised and finishing the interpretation and application of Chaihu-Guizhi soup in ancient and modern, summed up the clinical and experimental Research of Chaihu-Guizhi soup,compiled statistics and analysed the reports of Chaihu-Guizhi soup on the treatment of EP in the literature,it was considered that EP could be treated by Chaihu-Guizhi soup if it accorded with the syndrome of Chaihu-Guizhi soup.(4)To arrange the instructor's clinical experiences on treatment of EP, analyse the law of syndrome differentiation and treatment and composition of the methods of regulating pivot and mediating ying(nutrient) and wei(defensive) in the treatment of EP. Epileptic pathogenesis is deficiency on the primary(ben) and excess on the secondary(biao).The primary(ben) is the disorder of pivot,the disharmony of ying(nutrient) and wei(defensive),and the spleen-qi deficiency.The secondary(biao) is wind and phlegm,followed blood stasis.The treatment of EP should mainly using the methods of regulating pivot,mediating ying(nutrient) and wei(defensive) and tonifying spleen-qi,and applying the methods of calming wind,eliminating phlegm and resolving stasis. Xianning tablets produced by the methods of regulating pivot and mediating ying(nutrient) and wei(defensive),seized the key pathogenesis of "the disorder of pivot,the disharmony of ying(nutrient) and wei(defensive)"and strengthened vital qi and dispelled pathogens.Then it was valid for all types of seizures.Experimental study explored the possible mechanism of anti-EP of Xianning tablets,which produced by the methods of regulating pivot and mediating ying(nutrient) and wei(defensive).This part included four experiments.(1)Experiment I :To research the anti-convulsive role of Xianning tablets on mice through pentylenetetrazol convulsion experiment and electroconvulsion experiment.The study found that Xianning tablets could extended the incubation period of the convulsion induced by PTZ,have antagonistic role on the convulsion induced by PTZ or electro,reducing the extent of electroconvulsion.(2) Experiment II :To observe the sedative effect of Xianning tablets on mice through under pentobarbital sodium threshold experiment and up pentobarbital sodium threshold experiment.Research shows that Xianning tablets had synergies with pentobarbital sodium ,could enhance the sleep role of pentobarbital sodium on mice,could shorten the sleep latency induced by pentobarbital sodium, extended sleep time induced by pentobarbital sodium,had sedative effect.(3)Experiment III: The chronic epileptic rat model was induced by lithium-pilocarpine,respectively took Xianning tablets and and sodium valproate,The neuron damage was observed by normal pathological means,and the expression of c-fos, GAD₆₅, and GFAP in rats'brain was observed by immunohistochemical tachniques.The results showed that Xianning tablets can obviously light the neuron damage in epileptic rats induced by lithium-pilocarpine,reduce the expression of c-fos in rats'brain,and protect the brain. Comparing than sodium valproate,the difference had not statistically significant.It's a satisfied antiepileptic prepared Chinese medicine.Its anti-epileptic mechanism might be to reduce the activation of the NMDA receptor,preventing the Ca²⁺ influx,reducing c-fos expression,interrupted apoptosis signal transduction,thereby reducing brain injury,played anti-epileptic effect.At present,there is no evidence to show that the anti-epileptic role of Xianning tablets regulated with GAD₆₅ and GFAP,which still needs to be studied further.(4)Experiment IV: The chronic epileptic rat model was induced by lithium-pilocarpine,respectively took Xianning tablets and and sodium valproate. Assessed spleen-qi deficiency syndrome of the rats before and after made model, and after took drugs,and observed the influence of Xianning tablets on spleen-qi deficiency syndrome.Research shows that,after made model,rats appeared spleen-qi deficiency symptoms,repeated epileptic seizures could affect the rat spleen and stomach function,thereby induce systemic function decline.Then,using the method of tonifying spleen-qi in the treatment of EP accorded with the clinical actual situation.Xianning tablets had good tonifying spleen-qi effectiveness,could significantly improve spleen-deficiency symptoms of epilepsy rats.It had advantages on the improvement of spleen-deficiency symptoms,which could not compared by sodium valproate.