目的 探討二十五味珊瑚丸聯(lián)合拉莫三嗪治療強(qiáng)直-陣攣發(fā)作型癲癇的臨床療效。方法 選取2021年5月—2024年1月上海健康醫(yī)學(xué)院附屬崇明醫(yī)院收治的強(qiáng)直–陣攣發(fā)作型癲癇患者106例，依據(jù)隨機(jī)數(shù)字法分為對照組（53例）和治療組（53例）。對照組患者口服拉莫三嗪片，50 mg/次，1次/d。在對照組的基礎(chǔ)上，治療組口服二十五味珊瑚丸，1 g/次，1次/d。兩組用藥8周。觀察兩組患者臨床療效，比較治療前后兩組患者發(fā)作頻次、持續(xù)時間，蒙特利爾認(rèn)知評估量表（MoCA）和簡易精神狀態(tài)檢查量表（MMSE）評分，及胰島素樣生長因子-1（IGF-1）、高遷移蛋白1（HMGB1）、腦源性神經(jīng)營養(yǎng)因子（BDNF）和神經(jīng)特異性烯醇化酶（NSE）水平。結(jié)果 治療后，治療組總有效率為96.23%，明顯高于對照組有效率（83.02%，P＜0.05）。治療后，治療組患者M(jìn)oCA評分、MMSE評分比治療前明顯升高（P＜0.05），且治療后治療組評分均明顯高于對照組（P＜0.05）。治療后，兩組患者HMGB1、NSE水平明顯降低，而IGF-1和BDNF水平明顯升高（P＜0.05），且治療后治療組患者HMGB1、NSE、IGF-1和BDNF水平明顯好于對照組（P＜0.05）。結(jié)論 二十五味珊瑚丸與拉莫三嗪協(xié)同治療強(qiáng)直–陣攣發(fā)作型癲癇效果明顯，可明顯改善癲癇患者的認(rèn)知功能狀態(tài)，減少癲癇發(fā)作的頻次及時間，能調(diào)節(jié)神經(jīng)遞質(zhì)因子水平。

Objective To explore the clinical effect of Ershiwuwei Shanhu Pills combined with lamotrigine in treatment of tonic-clonic epilepsy. Methods Patients (106 cases) with tonic-clonic epilepsy in Chongming Hospital Affiliated Shanghai University of Medicine & Health Sciences from May 2021 to January 2024 were divided into control (53 cases) and treatment (53 cases) group according to random number method. Patients in the control group were po administered with Lamotrigine Tablets, 50 mg/time, once daily. Patients in the treatment group were po administered with Ershiwuwei Shanhu Pills, 1 g/time, once daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, the seizure frequency and duration, the scores of MoCA and MMSE, and the levels of HMGB1, NSE, IGF-1 and BDNF in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was 96.23%, which was significantly higher than that in the control group (83.02%, P < 0.05). After treatment, the MoCA scores and MMSE scores in the treatment group were significantly higher than those before treatment (P < 0.05), and the scores in the treatment group were significantly higher than those in the control group after treatment (P < 0.05). After treatment, the levels of HMGB1 and NSE in two groups were significantly reduced, while the levels of IGF-1 and BDNF were significantly increased (P < 0.05). After treatment, the levels of HMGB1, NSE, IGF-1 and BDNF in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion The synergistic treatment effect of Ershiwuwei Shanhu Pills and lamotrigine in treatment of tonic-clonic epilepsy is significant, which can significantly improve the cognitive function of patients with epilepsy, reduce the frequency and duration of seizures, and regulate the level of neurotransmitter factors.

R971

上海市崇明區(qū)"可持續(xù)發(fā)展科技創(chuàng)新行動計劃"項目(CKY2023-12)