苯巴比妥药理作用及其治疗热性惊厥的效果评价

目的 探讨苯巴比妥的药理作用及其治疗热性惊厥的优势.方法 2013年1月至2015年12月在四川省泸州市人民医院治疗的380例热性惊厥患儿随机分成两组:观察组190例,采用“苯巴比妥(i.m)+地西泮(i.v)”治疗;对照组190例,仅给予地西泮(i.v)治疗.比较两组的疗效、惊厥症状控制时间、脑神经因子水平、复发率及不良反应情况.结果 观察组的总有效率93.68％(178/190)明显高于对照组的77.37％ (147/190),x2=20.430,P＜0.05;观察组的惊厥症状控制时间(11.30±2.45)明显少于对照组(15.02 ±4.50) min,t=10.008,P＜0.05];观察组治疗后的脑神经因子水平NSE(20.31±4.85) ng/mL、S-100β(0.14±0.03) μg/L、BDNF(6.71±1.48) μg/L均明显低于对照组的(28.35±5.77) ng/mL、(0.23±0.05) μg/L、(10.98±3.25)μg/L,t值分别为14.703、21.276、16.404,均P＜0.05;观察组的复发率(10.53％)和复发次数(2.03±1.15)均明显低于对照组的20.00％和(3.22±1.08)次,均P＜0.05;不良反应方面,组间比较无明显差异(P＞0.05).结论 苯巴比妥具有良好的镇静、抗惊厥、抗癫痫等药理作用,临床治疗热性惊厥疗效确切.

Pharmacological actions of phenobarbital and its effect on treatment of febrile convulsion

Objective To investigate the pharmacological action of phenobarbital and its advantage in treatment of febrile convulsion.Methods Altogether 380 children with febrile convulsion admitted to Luzhou People' s Hospital of Sichuan Province from January 2013 to December 2015 were randomly divided into observation group (n =190) and control group (n =190).Children in the observation group were treated with phenobarbital (i.m) + diazepam (i.v),and children in the control group were treated with diazepam (i.v).Clinical efficacy,control time of seizure symptoms,level of brain nerve factor,recurrence rate and adverse reactions in two groups were observed and compared.Results Total effective rate in the observation group was 93.68％ (178/190),which was significantly higher than that in the control group (77.37％) (147/190) (P ＜ 0.05).Control time of seizure symptoms in the observation group was significantly less than that in the control group (11.30 ± 2.45 min vs 15.02 ± 4.50 min,P ＜ 0.05).Brain nerve factor index levels of NSE,S-1003,BDNF after treatment in the observation group were significantly better than those in the control group 20.31 ± 4.85 ng/mL vs 28.35 ± 5.77 ng/mL,0.14 ± 0.03 μg/L vs 0.23 ± 0.05 μg/L,6.71 ± 1.48 μg/L vs 10.98 ± 3.25 μg/L,respectively,all P ＜ 0.05.Recurrence rate (10.53％) and number of recurrence (2.03 ± 1.15) in the observation group were significantly lower than those in the control group (20.00％,3.22 ± 1.08) (both P ＜ 0.05).There was no significant difference in adverse reactions between two groups (P ＞ 0.05).Conclusion Phenobarbital has good sedative,anti-convulsant and anti-epileptic effect and definite curative effect for febrile convulsion.