目的 探讨二十五味珊瑚丸联合拉莫三嗪治疗强直-阵挛发作型癫痫的临床疗效。方法 选取2021年5月—2024年1月上海健康医学院附属崇明医院收治的强直–阵挛发作型癫痫患者106例，依据随机数字法分为对照组（53例）和治疗组（53例）。对照组患者口服拉莫三嗪片，50 mg/次，1次/d。在对照组的基础上，治疗组口服二十五味珊瑚丸，1 g/次，1次/d。两组用药8周。观察两组患者临床疗效，比较治疗前后两组患者发作频次、持续时间，蒙特利尔认知评估量表（MoCA）和简易精神状态检查量表（MMSE）评分，及胰岛素样生长因子-1（IGF-1）、高迁移蛋白1（HMGB1）、脑源性神经营养因子（BDNF）和神经特异性烯醇化酶（NSE）水平。结果 治疗后，治疗组总有效率为96.23%，明显高于对照组有效率（83.02%，P＜0.05）。治疗后，治疗组患者MoCA评分、MMSE评分比治疗前明显升高（P＜0.05），且治疗后治疗组评分均明显高于对照组（P＜0.05）。治疗后，两组患者HMGB1、NSE水平明显降低，而IGF-1和BDNF水平明显升高（P＜0.05），且治疗后治疗组患者HMGB1、NSE、IGF-1和BDNF水平明显好于对照组（P＜0.05）。结论 二十五味珊瑚丸与拉莫三嗪协同治疗强直–阵挛发作型癫痫效果明显，可明显改善癫痫患者的认知功能状态，减少癫痫发作的频次及时间，能调节神经递质因子水平。

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

上海市崇明区"可持续发展科技创新行动计划"项目(CKY2023-12)