| Background and Objective:Epilepsy is one of common neurological diseases.Now there are about 50 million epileptic all of the world,and 9 million in our country.About 25%of patients are refractory to treatment normally using more than one AEDs,which is called medically intractable epilepsy. It has poor prognosis with increased morbidity and mortality.Temporal lobe epilepsy(TLE) is one of common intractable epilepsy,and account for above 50%.Therefore TLE as starting point,it is important to develope new effective therapeutics for IE.With Traditional Chinese Medicine(TCM) to therapy epilepsy especially intractable epilepsy shows good therapeutic effect in clinical practice.But nowadays TCM syndrome of epilepsy research is seldom,there are some questions in clinical research of epilepsy,such as chaos of standard,pattern of syndrome and syndrome described disunity,the method of curative effect evaluation is irrational.so it's necessary to institute a new and popular standard of epileptic diagnosis and therapy,and the TCM syndrome research is a center in standardized of epileptic diagnosis and therapy.This study is beginning of the epileptic TCM research,and adoption factor analysis to analyse and sum up the distributing of TLE TCM main syndrome,to establish base for normalization of epileptic syndrome and setting up diagnosis and treatment standard of epilepsy.At the same time,by animal experiment to investigate the molecular mechanisms of the chai bei zhi xian tang anti-epilepsy.methods:clinical researchA prospectively cross-sectional investigation is carried out in this part.the questionnaire of the TLE clinical information was established by investigating the related literature and specialist opinion.The included TLE patients were all from Dongfang Hospital affiliated to Beijing university of Chinese Medicine and Beijing tiantan hospital of the study.The general conditions,four diagnostic information of TCM and relative information were collected. Adoption factor analysis to analyse and Sum up the distributing of TLE TCM main syndrome.experimental studyIn the first section,the model of medically TLE was established by PILO,and it's praxiology and brain tissue histomorphlogy was observed at 5 groups:the normal control group,the blank model group,the herbs and western medicine group,the herbs groups,the western medicine group.We observe the organism status of rats,the praxiology of rats,such as seizure frequency,time length,average time length,grade of epileptic seizure and body weight to analyses the curative effect.We observed the rats brain tissue histomorphlogy by campeachy-eosin staining and Nissl's staining.We investigate the change of neuron morphosis and the survivorship state of neuron and Nissl's body on the hippocampus and the cortex of temporal lobe.In the second section,the expression and distrbution of GABA_ARα1,NMDAR1 protein was observed in hippocampus and cortex of temporal lobe of rats by immunohistochemical method and Western blotting.We investigate the effect on GABA_ARα1 and NMDAR1 by the herbs of complex prescription of thai bei zhi xian tang and carbamazepine intervention,and partly intended to study the molecular mechanisms of the chai bei zhi xian tang anti-epilepsy.Result:clinical researchUsing the factor analysis method,5 TCM syndromes of TLE were summarised:wind phlegm with stagnation of liver-Qi type,phlegm fire type,deficiency in heart and spleen type, stagnation of blood stasis type,deficiency of yin in liver and kidney type.The wind phlegm with stagnation of liver-Qi type is the main TCM syndrome of TLE,and the second one is phlegm fire type.There was no significant difference in the sex,course of disease and seizure frequency over the distribution of the 5 TCM syndromes(P＞0.05).There was a significant difference in the age group and age of onset over the distribution of the 5 TCM syndromes (P＜0.05).experimental studyThe results of first section:1 The change of seizure frequency and time length of rats with TLEThe seizure frequency in the herbs and western medicine group,the herbs group and the western medicine group was significantly decreased compared with that of the blank model group(P＜0.05);Compared with that of the herbs and western medicine group,the seizure frequency in the herbs group was significantly increased(P＜0.05).The seizure time length in the herbs and western medicine group was significantly decreased compared with that of the blank model group(P＜0.05);Compared with that of the herbs and western medicine group,the seizure time length in the herbs group and the western medicine group was significantly increased(P＜0.05).2 The seizure average time length of rats with TLEAfter treatment,the seizure average time length in the herbs and western medicine group, the herbs group and the western medicine group was significantly decreased compared with that of the blank model group(P＜0.05);Compared with that of the herbs and western medicine group,the seizure average time length in the herbs group was significantly decreased(P＜0.05).Compared with that of pretherapy,the seizure average time length in the herbs and western medicine group was very significantly decreased(P＜0.01),and in the herbs group and the western medicine group was significantly decreased(P＜0.05).3 The seizure grade of rats with TLEAfter treatment,the seizure grade in the herbs and western medicine group,the western medicine group was significantly decreased compared with that of the blank model group (P<0.05).Compared with that of pretherapy,the seizure grade in the herbs and western medicine group was very significantly decreased(P<0.01),and in the western medicine group was signifycantly decreased(P<0.05).4 The change of body weight of rats with all groupsAfter treatment,the body weight in the blank model group,the herbs and western medicine group,the herbs group and the western medicine group was significantly decreased compared with that of the normal control group(P<0.05).Before treatment,compared with that of the normal control group,the body weight in the blank model group,the herbs and western medicine group,the herbs group and the western medicine group was significantly decreased(P<0.05);Compared with that of the blank model group,the body weight in the herbs and western medicine group was significantly increased (P<0.05).5 result of histomorphlogyThe neuron showed obviously damage on the district of CA1,CA2,CA3 and dentate band of hippocampus,cortex of temporal lobe in the model of TLE established by PILO.The most severe diseased region was the district of CA1 and CA3 of hippocampus,then is the district of CA2 and dentate band of hippocampus,the cortex of temporal lobe.The herbs of complex prescription of chai bei zhi xian tang and carbamazepine could relieve neuron damage on the district of CA1,CA2,CA3 and dentate band of hippocampus,cortex of temporal lobe in rats with temporal lobe,which hinted the two kinds of medicine could protect neuron.The results of second section:1 the expression of GABA_ARα1The expression of GABA_ARα1 in temporal lobe cortex and CA1,CA3 of hippocampus on rats with temporal lobe epilepsy of the herbs group,the herbs and western medicine group was very significantly increased compared with that of the blank model group(P<0.01).Compared with that of the normal control group,the expression of GABA_ARα1 in the western medicine group and the blank model group was very significantly increased(P<0.01).2 the expression of NMDAR1The expression of NMDAR1 in temporal lobe cortex and CA1,CA3 of hippocampus on rats with TLE of the herbs group,the herbs and western medicine group,the western medicine group and the blank model group was significantly increased compared with that of the normal control group(P<0.05).there was no significant difference among the herbs group,the herbs and western medicine group,the western medicine group and the blank model group (P>0.05).Conclusions:clinical researchWind phlegm with stagnation of liver-Qi type,phlegm fire type,deficiency in heart and spleen type,stagnation of blood stasis type,deficiency of yin in liver and kidney type are main TCM syndrome of TLE.The wind phlegm with stagnation of liver-Qi type is the common one,and the second one is phlegm fire type.TCM syndromes of TLE have no relation with the patient's sex,course of disease and seizure frequency.TCM syndromes are closely related to the age group and age of onset.The wind phlegm with stagnation of liver-Qi type and phlegm fire type are the main TCM syndromes among the young and middle aged patients,and deficiency of yin in liver and kidney type is common syndrome among middle and old aged patients.experimental studyThe manipulateion of the model of medically TLE established by PILO was simple and it's achievement ratio and stability was fine.The curative effect of the way of the herbs combined western medicine is greatest than the others.The herbs of complex prescription of chai bei zhi xian tang can increase expression of GABA_ARα1 and cann't decrease the expression of NMDAR1.The one of mechanism on the herbs of complex prescription of chai bei zhi xian tang healing epilepsy may be it's increasing expression of GABA_ARα1.
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