目的 探讨安宫牛黄丸与注射用苯巴比妥钠联合治疗继发性癫痫的临床疗效。方法 回顾性选取2023年6月—2025年10月南阳南石医院收治的86例继发性癫痫患者临床资料，按用药方案差异分为对照组和治疗组，每组各43例。对照组肌肉注射注射用苯巴比妥钠，0.1 g/次，3次/d。治疗组在对照组的基础上口服安宫牛黄丸，1丸/次，1～2次/d。两组用药7 d。观察两组疗效情况，比较两组癫痫持续状态指标、脑电图指标、蒙特利尔认知评估量表（MOCA）、简易精神状态量表（MMSE）、生活质量综合评定量表（GQOLI-74）、血清高迁移率族蛋白B1（HMGB1）、血清胰岛素样生长因子1（IGF-1）、肿瘤坏死因子-α（TNF-α）、胶质酸性纤维蛋白（GFAP）水平。结果 治疗后，治疗组总有效率93.02%，显著高于对照组74.42%（P＜0.05）。治疗后，治疗组癫痫发作频率及发作持续时间明显低于对照组（P＜0.05）。两组患者STESS评分均较治疗前降低（P＜0.05），且治疗后治疗组STESS评分低于对照组（P＜0.05）。治疗后，两组患者的MoCA评分、MMSE评分及GQOLI评分均高于治疗前（P＜0.05），且治疗组的MoCA评分、MMSE评分及GQOLI评分均高于对照组（P＜0.05）。治疗后，两组患者θ波频段、δ波频段、痫样放电次数均显著低于同组治疗前（P＜0.05），且治疗后治疗组脑电图的θ波频段、δ波频段、痫样放电次数均低于对照组（P＜0.05）。治疗后，两组患者的HMGB1、TNF-α、GFAP水平较治疗前下降水平较为明显，而IGF-1水平高于治疗前（P＜0.05），且治疗组的HMGB1、TNF-α、GFAP水平低于对照组，而IGF-1水平高于对照组（P＜0.05）。结论 安宫牛黄丸与苯巴比妥钠协同治疗继发性癫痫效果显著，可有效改善脑电图及癫痫持续状态，降低机体炎性水平，提高患者认知及生活质量，值得借鉴与应用。

Objective To explore the clinical efficacy of Angong Niuhuang Pills combined with phenobarbital sodium in treatment of secondary status epilepticus. Methods Retrospectively, the clinical data of 86 patients with secondary epilepsy who were admitted to Nanyang Nanshi Hospital from June 2023 to October 2025 were selected. They were divided into control group and treatment group based on differences in medication regimens, with 43 cases in each group. Patients in control group were im administered with Phenobarbital Sodium for injection, 0.1 g/time, three times daily. Patients in control group were given Angong Niuhuang Pills orally in addition to control group, 1 pill/time, 1 — 2 times daily. Both groups were administered the medication for 7 d. The therapeutic effects of two groups were observed, and the indicators of status epilepticus, electroencephalogram, Montreal Cognitive Assessment Scale (MOCA), Mini-Mental State Examination (MMSE), General Quality of Life Index-74 (GQOLI-74), serum high mobility group box 1 (HMGB1), serum insulin-like growth factor 1 (IGF-1), tumor necrosis factor-α (TNF-α), and glial acidic fibrillary protein (GFAP) levels were compared between two groups. Results After treatment, the total effective rate of the treatment group was 93.02%, significantly higher than that of the control group (74.42%) (P < 0.05). After treatment, the frequency of epileptic seizures and seizure duration of treatment group were significantly lower than those of control group (P < 0.05). The STESS scores of both groups decreased compared with those before treatment (P < 0.05), and the STESS score of the treatment group was lower than that of the control group after the treatment (P < 0.05). After treatment, the MoCA score, MMSE score and GQOLI score of both groups were higher than those before treatment (P < 0.05), and the MoCA score, MMSE score and GQOLI score of treatment group were higher than those of control group (P < 0.05). After treatment, the θ wave frequency band, δ wave frequency band and epileptic discharge frequency of both groups were significantly lower than those before treatment in same group (P < 0.05), and the θ wave frequency band, δ wave frequency band and epileptic discharge frequency of treatment group in the EEG were lower than those of control group after treatment (P < 0.05). After treatment, the HMGB1, TNF-α and GFAP levels of both groups decreased more significantly compared with those before treatment, but the IGF-1 level was higher than that before treatment (P< 0.05), and the HMGB1, TNF-α and GFAP levels of treatment group were lower than those of control group, but the IGF-1 level was higher than that of control group (P < 0.05). Conclusion The combined treatment of Angong Niuhuang Pills and phenobarbital sodium for secondary epilepsy has a remarkable effect, and can effectively improve electroencephalogram and status epilepticus, reduce the body’s inflammatory levels, enhance patients’ cognition and life quality, which is worthy of reference and application.

R971

河南医学科技攻关计划联合共建项目（LHGJ20230959）