| Background Epilepsy is a variety of reasons leading to the abnormal discharge of brain neurons abnormal clinical syndrome, the clinical manifestations are paroxysmal, transient, repetitive and stereotyped. At present, the treatment of epilepsy is still mainly based on drug therapy,New antiepileptic drugs(AEDs) in recent yearsare available for the effective treatment of epilepsy provided the conditions. Nearly 10 million people with epilepsy in China, despite the ongoing new AEDs into clinical applications, but some patients with epilepsy is not sensitive to AEDs, there is a difficult to control repeated attacks. If two(or more) appropriate antiepileptic drugs, reasonable and adequate treatment(either single or combination) more than 2 years, blood drug concentration within the normal range, every month there are still more than four times attack known as refractory epilepsy(IE). Refractory epilepsy patients at least in more than 150 million in China, refractory epilepsy poor prognosis and high disability and mortality rate, seriously affect the patient's quality of life and social function. Therefore, the study of refractory epilepsy resistant to AEDs found the new treatment, is of great significance. At present, the research on the relationship between multidrug resistance(MDR)gene expression P-glycoprotein(P-gp)and refractory epilepsy has become a hot spot, Combined with traditional Chinese medicine in the treatment of IE and explore P-gp and traditional Chinese medicine compound prescription in the treatment of IE, is a major trend in the treatment of epilepsy, can reduce the resistance and improve the patient's quality of life and survival.One part, The clinical observation on the treatment of Refractory epilepsy with Dingxian Decoction addObjective Through observation and summary the clinical curative effect of treatment of refractory epilepsy and evaluation Dingxian decoction add-on therapy in refractory epilepsy clinical effect than simple AEDs good curative effect, less adverse reactions and refractory epilepsy treatment provides a strong operability, good effect in combination of Chinese medicine and Western medicine treatment.Method Incorporated patients accord with refractory epilepsy, western medicine diagnosis and syndrome differentiation of traditional Chinese medicine for the wind phlegm obstruction collaterals syndrome,who see a doctor in wuhan first hospital neurology clinics during october 2013 to 0ctober 2014. Add Chinese traditional medicine prescription, dingxian decoction on the basis of maintaining the original AEDs treatment,200 ml each time, 2 times a day warm drinking. A month for a period of treatment, observation of six courses, a total of 6 months. Compare the different time points seizure frequency, total effective rate of treatment, and peripheral blood content of P-gp, adverse reaction conditions change before and after treatment.Result Among the 40 patients in this test, 2 cases fall off, 1 case lost to follow-up, 37 cases of complete the observation period.(1)Number of seizures begin the first 3 months compared with 3,6 months after treatment, there was very significant difference(P<0.01).(2)Total effective rate of dingxiantang add treatment for 4,6months was better than 2 months, there were significant differences(P<0.05).(3)ELISA method to detect the contents of peripheral blood P-gp, and compare to begin with, 2, 4, 6 months after treatment of peripheral blood P-gp average content is lower, the difference was statistically significant(P<0.05).(4) The adverse reactions after treatment is less than that before treatment.Conclusion Dingxian decoction add treatment IE is more effective than pure western medicine treatment, and adverse reaction is obviously reduced.Two part, effects of p-glycoprotein expression in refractory epilepsy rat model with Dingxian Decoction add-on therapyAbstrsct Explore dingxian decoction add-on therapy for refractory epilepsy effects of P-gp expression in rats, by comparing the changes in the seizure duration, attack level, the content of P-gp expression in hippocampus and temporal lobe cortex dingxian decoction add refractory epilepsy model in rats before and after.Method Preparation of refractory epilepsy model of rats were randomly divided into groups and compound Epilepsy Group, otherwise normal control group 10. Dingxian decoction boiling concentrated herbal 1g · ml-1, Dingxian decoction concentration is 2.58g·kg-1, Blank control group and model group were given saline blank 2 ml/time. Groups are lavage for 6 weeks, observe and record seizures in rats behavior results after dosing. Using Western blot method to detect each group rats P-gp express distribution in two parts of the temporal lobe cortex and hippocampus.Result Drug-resistant epilepsy rat model success rate was 35%.(1)After the treatment, the average onset time of evry epilepsy model group was reduced, Significant difference(P < 0.05), there are statistically significant.(2)Each level of epilepsy model group were lower, obvious difference(P < 0.05), with statistical significance.(3)Western blot detection rats P-gp expression of temporal lobe cortex and hippocampus, there are evry significant differences(P < 0.01),with statistically significant. Compared with the blank control group, model group P-gp expression level significantly higher than the blank control group(P<0.01). Compared with the blank model group, expression level of dingxian decoction group was obviously lower than blank model group(P<0.01).Conclusion Dingxian decoction add treatment resistant epilepsy can reduce the refractory epilepsy model temporal lobe cortex and hippocampus of rats P-gp expression leve. |
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