复方丹参滴丸治疗颅脑外伤伴发间脑癫痫的临床研究

Treatment of craniocerebral trauma accompanied by diencephalic epilepsy with Fu Fang Dan Shen Di Wan

目的探讨复方丹参滴丸治疗颅脑外伤伴发间脑癫痫的作用机制。方法 90例颅脑外伤伴发间脑癫痫的患者,随机分为对照组41例,予常规抗癫痫对症治疗;治疗组49例,在常规治疗基础上,另加服复方丹参滴丸1,0粒/次3,次/d,3个月后观察疗效并复查脑电图,同时监测治疗前后及癫痫发作时的血浆一氧化氮(NO)含量水平。结果临床疗效除癫痫症状无改善者外,将满意、显著改善、良好及效差均列为有效,治疗组总有效率达89.8%,对照组为73.2%(P<0.05);两组治疗前后脑电图表现为棘波、慢波和棘慢波综合者或弥漫性放电者疗效比较,差异无统计学意义(P>0.05);治疗组治疗后血浆NO水平高于治疗前,低于发作时,高于对照组水平(均P<0.05)。结论复方丹参滴丸治疗颅脑外伤伴发的间脑癫痫,疗效确切;但针对脑电图表现为棘波、慢波和棘慢波综合者或弥漫性放电者疗效无明显特异性。临床疗效可能与其改善脑部血液循环障碍、促进血脑屏障(blood brain barrier,BBB)生理性开放及调节血浆NO水平有关。

Objective To study the effective mechanism of Fu Fang Dan Shen Di Wan in the treatment of craniocerebral trauma accompanied by diencephalic epilepsy. Methods The patients with craniocerebral trauma accompanied by diencephalic epilepsy （ n = 90 ） were randomly divided into the control group （n =41 ） treated with anti-epilepsy routine therapy, and the treatment group （n =49）, with routine therapy and Fu Fang Dan Shen Di Wan （10 pieces once and three times a day）. The curative effect and electroencephalogram （EEG） was observed after 3 months, and the level of nitric oxide （NO） was monitored before and after the treatment and during epilepsy seizure. Results Except of the non-ameliorated symptoms of epilepsy, satisfactory, significant, good and poor effects were all taken as curative effective in clinic. The total effective rate was 89. 8% in the treatment group and 73.2% in the control group （P 〈 O. 05）. The comparison of effect in EEG showed spike wave, slow wave, spike-slow complex and diffuse discharge was not statistically different （ P 〉 O. 05 ） between two groups before and after the treatment. In the treatment group the level of NO was higher after the treatment than that before the treatment, and lower than that during epilepsy seizure. The level of NO was higher in the treatment group than that in the control group after the treatment （ all P 〈 0.05 ）. Conclusion Fu Fang Dan Shen Di Wan has a reliable curative effect on craniocerebral trauma accompanied by diencephalic epilepsy, but is not targeted to the patients with spike wave, slow wave, spike-slow complex and diffuse discharge in EEG. The curative effect of Fu Fang Dan Shen Di Wan may be related to the amelioration of cerebral blood circulation, improvement of physical open of blood brain barrier and regulation of level of plasma NO.