目的 探讨化风丹联合丙戊酸钠治疗癫痫的临床疗效。方法 选取2020年10月—2021年10月在郑州市第一人民医院神经内科收治的80例癫痫患者，按照随机数字表法分为对照组和治疗组，每组各40例。对照组患者口服丙戊酸钠缓释片(I)，20～30 mg/kg，1次/d。治疗组在对照组治疗基础上口服化风丹，8～10丸/次，3次/d。两组连续用药18 d。观察两组的临床疗效、临床症状改善时间、癫痫发作次数与持续时间。比较两组治疗前后蒙特利尔认知评估量表（MoCA）评分及血清高迁移率族蛋白（HMGB-1）、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平的变化情况。结果 治疗后，治疗组总有效率是97.50%，显著高于对照组的77.50%（P＜0.05）。治疗过程中，治疗组出现头痛、疲倦、肌肉阵挛、全身肌肉痛好转时间均短于对照组（P＜0.05）。治疗后，两组癫痫发作次数和发作持续时间均较治疗前显著降低（P＜0.05）；且治疗后，治疗组癫痫发作次数和发作持续时间低于对照组（P＜0.05）。治疗后，两组患者MoCA评分较治疗前均显著提高（P＜0.05），且治疗后，治疗组MoCA评分高于对照组（P＜0.05）。治疗后，两组IL-6、IL-1β、TNF-α、HMGB-1水平均较治疗前显著降低（P＜0.05）；且治疗后，治疗组血清因子水平低于对照组（P＜0.05）。结论 化风丹联合丙戊酸钠治疗癫痫具有较好的临床疗效，能提高患者的认知功能，降低癫痫发作频率和炎性反应，具有一定的临床应用价值

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

河南省科技攻关计划项目(LHGJ20200701)