目的 探討化風(fēng)丹聯(lián)合丙戊酸鈉治療癲癇的臨床療效。方法 選取2020年10月—2021年10月在鄭州市第一人民醫(yī)院神經(jīng)內(nèi)科收治的80例癲癇患者，按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各40例。對(duì)照組患者口服丙戊酸鈉緩釋片(I)，20～30 mg/kg，1次/d。治療組在對(duì)照組治療基礎(chǔ)上口服化風(fēng)丹，8～10丸/次，3次/d。兩組連續(xù)用藥18 d。觀察兩組的臨床療效、臨床癥狀改善時(shí)間、癲癇發(fā)作次數(shù)與持續(xù)時(shí)間。比較兩組治療前后蒙特利爾認(rèn)知評(píng)估量表（MoCA）評(píng)分及血清高遷移率族蛋白（HMGB-1）、白細(xì)胞介素-1β（IL-1β）、腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-6（IL-6）水平的變化情況。結(jié)果 治療后，治療組總有效率是97.50%，顯著高于對(duì)照組的77.50%（P＜0.05）。治療過程中，治療組出現(xiàn)頭痛、疲倦、肌肉陣攣、全身肌肉痛好轉(zhuǎn)時(shí)間均短于對(duì)照組（P＜0.05）。治療后，兩組癲癇發(fā)作次數(shù)和發(fā)作持續(xù)時(shí)間均較治療前顯著降低（P＜0.05）；且治療后，治療組癲癇發(fā)作次數(shù)和發(fā)作持續(xù)時(shí)間低于對(duì)照組（P＜0.05）。治療后，兩組患者M(jìn)oCA評(píng)分較治療前均顯著提高（P＜0.05），且治療后，治療組MoCA評(píng)分高于對(duì)照組（P＜0.05）。治療后，兩組IL-6、IL-1β、TNF-α、HMGB-1水平均較治療前顯著降低（P＜0.05）；且治療后，治療組血清因子水平低于對(duì)照組（P＜0.05）。結(jié)論 化風(fēng)丹聯(lián)合丙戊酸鈉治療癲癇具有較好的臨床療效，能提高患者的認(rèn)知功能，降低癲癇發(fā)作頻率和炎性反應(yīng)，具有一定的臨床應(yīng)用價(jià)值

Objective To investigate the therapeutic effect of Huafengdan combined with sodium valproate in treatment of epilepsy. Methods A total of 80 epilepsy patients admitted to Department of Neurology of First People’s Hospital of Zhengzhou from October 2020 to October 2021 were selected and divided into control group and treatment group according to random number table method, with 40 cases in each group. Patients in the control group were po administered with Sodium Valproate Sustained-release Tablets (I), 20 — 30 mg/kg, once daily. Patients in the treatment group were po administered with Huafengdan on the basis of the control group, 8 — 10 pills/time, three times daily. Both groups were treated for 18 d. After treatment, clinical efficacy and improvement time of clinical symptoms, number and duration of seizures were observed. The changes of Montreal Cognitive Assessment Scale (MoCA) score, high mobility group protein (HMGB-1), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 97.50%, significantly higher than that of the control group (77.50%) (P < 0.05). During the treatment, the improvement time of clinical symptoms such as headache, fatigue, muscle clonus, and systemic muscle pain in the treatment group was shorter than that in the control group (P < 0.05). After treatment, the number and duration of seizures in both groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the number and duration of epileptic seizures in the treatment group were lower than those in the control group (P < 0.05). After treatment, MoCA score in both groups was significantly higher than that before treatment (P < 0.05), and MoCA score in treatment group was higher than that in control group (P < 0.05). After treatment, the levels of IL-6, IL-1β, TNF-α, and HMGB-1 in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the serum factor level in the treatment group was lower than that in the control group (P < 0.05). Conclusion Huafengdan combined with sodium valproate has good clinical effect in treatment of epilepsy, and can improve the cognitive function of patients, reduce the frequency of seizures and inflammatory response, which has certain clinical application value.

R971

河南省科技攻關(guān)計(jì)劃項(xiàng)目(LHGJ20200701)