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OBJECTIVE To clarify whether the thera-peutic effect of escitalopram on depression patients is cor-related with traditional Chinese medicine syndrome types,and to provide a basis for more accurate drug applica-tion.METHODS A total of 235 depression patients were recruited and classified according to traditional Chinese medicine syndrome differentiation into 5 types:liver and qi stagnation(45),liver stagnation and fire transformation(43),liver qi stagnation and spleen deficiency(79),heart and spleen deficiency(20),and liver and kidney deficiency(38).All patients were treated with escitalopram(10 mg·d-1)for eight weeks.The Montgomery Depression Rating Scale(MADRS)and the 17 Hamilton Depression Rating Scale(HAMD-17)were used to score before treatment and 2,4,and 8 weeks after treatment,respectively.RESULTS Compared with before treatment,the MADRS and HAMD-17 scores and remission rates of each syn-drome type significantly improved with increasing medica-tion duration.The MADRS score relief rate of liver and kidney deficiency type was the most significant(69.3%),significantly higher than the other four syndrome types(47.5%-52.6%,P<0.05);The remission rate of HAMD-17 score was significantly higher than that of heart and spleen deficiency(50.7%vs.28.5%,P＜0.05).The remis-sion rate of HAMD-17 score in liver and qi stagnation type(52.2%)was significantly higher than that in liver stagnation and spleen deficiency type(37.0%,P＜0.01)and heart spleen deficiency type(28.5%,P＜0.05).CON-CLUSION Escitalopram may have a more significant therapeutic effect on patients with liver and kidney defi-ciency and liver stagnation depression.This study pro-vides a new approach for the more effective and accu-rate application of traditional Chinese medicine syndrome differentiation in the selection of clinical antidepressants.
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Objective:To explore the effects of anterior temporal lobectomy on the mini-mental state examination (MMSE) score, memory of patients with intractable temporal lobe epilepsy.Methods:104 patients with refractory temporal lobe epilepsy admitted to our hospital from June 2013 to June 2019 were selected, of which 68 cases were treated surgically as the observation group and 36 cases were treated medically as the control group. MMSE score, memory and social functions were compared between the two groups.Results:The total effective rate of the observation group was 95.59%, which was significantly higher than 83.33% of the control group ( P<0.05). The MMSE score of the observation group was significantly higher than that of the control group at 1 month and 6 months after treatment ( P<0.05); the MMSE score of the control group at 6 months after treatment was significantly higher than that before treatment ( P<0.05). Six months after treatment, performance intelligence quotient (PIQ), verbal intelligence quotient (VIQ) and full intelligence quotient (FIQ) in the observation group were significantly higher than those in the control group ( P<0.05), and there was significant difference between the two groups ( P<0.05). The memory quotient (MQ) of observation group was lower than that of control group 1 month after treatment ( P<0.05), and higher than that of control group six months after treatment ( P<0.05). Six months after treatment, the scores of social function and comprehensive quality of life in the observation group were significantly higher than those in the control group ( P<0.05), and there were significant differences between the two groups ( P<0.05). There were 4 cases of complications in the observation group after treatment, all of them improved after drug treatment, without other serious complications. Conclusions:Anterior temporal lobectomy is effective in the treatment of refractory temporal lobe epilepsy, it can improve cognitive and memory functions and social behavior function of patients, and has less complications after operation, with certain clinical application value.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of slow anti-epileptic drug (AED) taper protocol and a rescue benzodiazepine protocol in video-electroencephalography (video-EEG) monitoring for presurgical evaluation of epilepsy.</p><p><b>METHODS</b>Sixty-two of 109 patients with refractory focal epilepsy underwent pre-surgical video-EEG monitoring with a slow AEDs taper protocol and a rescue benzodiazepine protocol. Seizures were recorded by video-EEG in 56 patients. The time to the first seizure, duration of monitoring, incidence of 4-h and 24-h seizure clustering, secondarily generalized tonic-clonic seizures (sGTCS), status epilepticus, falls and cardiac asystole were evaluated.</p><p><b>RESULTS</b>A total of 191 seizures were recorded in the 56 cases, and the diagnostic efficiency of video-EEG was 90.3%. The mean time to the first seizure was 2.4 days and the time to conclude video-EEG monitoring averaged 6.8 days. Eight (12.9%) patients had 4-h clusters and 24 (38.7%) had 24-h clusters. Seizure clusters were more frequent in extra temporal epilepsy than in temporal lobe epilepsy. While 19 sGTCS were recorded in 15 patients (26.8%), status epilepticus did not occur and no seizure was complicated by cardiac asystole. Epileptic falls with no significant injuries occurred in 4 patients.</p><p><b>CONCLUSION</b>Seizure clustering is common during presurgical video-EEG monitoring, but serious adverse events are rare with a slow AED tapering and a rescue benzodiazepine protocols. These two protocols are effective and save in presurgical video-EEG monitoring for refractory focal epilepsy.</p>