目的 探究烏靈膠囊聯合左乙拉西坦治療老年癲癇的臨床療效。方法 選取2018年3月-2019年5月中國人民解放軍聯勤保障部隊第988醫(yī)院收治的老年癲癇患者103例，隨機分為對照組（51例）和治療組（52例）。對照組口服左乙拉西坦片，初始劑量為5 mg/（kg·次），2次/d，連續(xù)治療1周，第2周增加至10 mg/（kg·次），第3周增加至25 mg/（kg·次），后維持該劑量。治療組在對照組基礎上口服烏靈膠囊，3粒/次，3次/d。兩組患者均連續(xù)治療12周。結果 治療后，治療組總有效率94.23%顯著高于對照組80.39%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組陣攣發(fā)作頻率、強直發(fā)作頻率均較治療前顯著下降（P<0.05），且治療后治療組癲癇發(fā)作頻率顯著低于對照組（P<0.05）。治療后，兩組MMSE評分均較治療前顯著升高（P<0.05），治療后治療組MMSE評分顯著高于對照組（P<0.05）。治療后，兩組血尿酸較治療前均顯著升高，但胱抑素C（Cystatin C）水平較治療前顯著下降（P<0.05）；治療后，治療組血尿酸高于對照組，而Cystatin C低于對照組（P<0.05）。治療后，兩組同型半胱氨酸（Hcy）、不對稱二甲基精氨酸（ADMA）水平均較治療前顯著升高（P<0.05）；但治療后Hcy、ADMA水平組間比較差異無統(tǒng)計學意義。結論 烏靈膠囊聯合左乙拉西坦治療老年癲癇具有較好的臨床療效，改善患者認知功能，但對降低Hcy、ADMA水平無明顯作用，具有一定的臨床推廣應用價值。

Objective To explore the clinical effect of Wuling Capsules combined with levetiracetam in treatment of elderly epilepsy. Methods Patients (103 cases) with elderly epilepsy in the 988th Hospital of the Chinese People's Liberation Army Joint Logistic Support Force from March 2018 to May 2019 were randomly divided into control group (51 cases) and treatment group (52 cases). Patients in the control group were po administered with Levetiracetam Tablets, the initial dosage was 5 mg/(kg·time), twice daily, followed by continuous treatment for 1 week, increasing to 10 mg/(kg·time) in the 2nd week, and 25 mg/(kg·time) in the 3rd week, followed by maintenance of the dosage. Patients in the treatment group were po administered with Wuling Capsules, 3 grains/time, three times daily. Patients in both groups were treated continuously for 12 weeks. Results After treatment, the total effective rate of 94.23% in the treatment group was significantly higher than 80.39% in the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the frequency of clonic seizures and tonic seizures in both groups decreased significantly compared with that before treatment (P<0.05), and the frequency of epileptic seizures in the treatment group was significantly lower than that in the control group (P<0.05). After treatment, MMSE score of both groups was significantly higher than that before treatment (P<0.05), and MMSE score of the treatment group was significantly higher than that of the control group (P<0.05). After treatment, the serum uric acid level in both groups was significantly higher than that before treatment, but the level of Cystatin C was significantly lower than that before treatment (P<0.05). After treatment, serum uric acid was higher than that in the control group, but Cystatin C was significantly lower than that in the control group (P<0.05). After treatment, the levels of homocysteine (Hcy) and asymmetric dimethyl-arginine (ADMA) in both groups were significantly higher than those before treatment (P<0.05). However, after treatment, there was no statistically significant difference in Hcy and ADMA levels between two groups. Conclusions Wuling Capsules combined with levetiracetam has good clinical effect in treatment of elderly epilepsy, and can improved cognitive function of patients, but had no significant effect on reducing Hcy and ADMA levels, which has certain clinical application value.

R971

河南省科技研發(fā)專項項目（162102310201）