目的 探究乌灵胶囊联合左乙拉西坦治疗老年癫痫的临床疗效。方法 选取2018年3月-2019年5月中国人民解放军联勤保障部队第988医院收治的老年癫痫患者103例，随机分为对照组（51例）和治疗组（52例）。对照组口服左乙拉西坦片，初始剂量为5 mg/（kg·次），2次/d，连续治疗1周，第2周增加至10 mg/（kg·次），第3周增加至25 mg/（kg·次），后维持该剂量。治疗组在对照组基础上口服乌灵胶囊，3粒/次，3次/d。两组患者均连续治疗12周。结果 治疗后，治疗组总有效率94.23%显著高于对照组80.39%，两组比较差异有统计学意义（P<0.05）。治疗后，两组阵挛发作频率、强直发作频率均较治疗前显著下降（P<0.05），且治疗后治疗组癫痫发作频率显著低于对照组（P<0.05）。治疗后，两组MMSE评分均较治疗前显著升高（P<0.05），治疗后治疗组MMSE评分显著高于对照组（P<0.05）。治疗后，两组血尿酸较治疗前均显著升高，但胱抑素C（Cystatin C）水平较治疗前显著下降（P<0.05）；治疗后，治疗组血尿酸高于对照组，而Cystatin C低于对照组（P<0.05）。治疗后，两组同型半胱氨酸（Hcy）、不对称二甲基精氨酸（ADMA）水平均较治疗前显著升高（P<0.05）；但治疗后Hcy、ADMA水平组间比较差异无统计学意义。结论 乌灵胶囊联合左乙拉西坦治疗老年癫痫具有较好的临床疗效，改善患者认知功能，但对降低Hcy、ADMA水平无明显作用，具有一定的临床推广应用价值。

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

河南省科技研发专项项目（162102310201）