复方丹参滴丸联合西药治疗外伤性癫痫59例临床观察

Clinical Observation on Compound Danshen Dripping Pill for 59 Cases of Posttraumatic Epilepsy

目的探讨复方丹参滴丸治疗外伤性癫痫(PTE)的疗效及作用机制。方法将118例PTE患者随机分为治疗组和对照组各59例。对照组予常规抗癫痫对症治疗;治疗组在此基础上加服复方丹参滴丸,每次10粒,每日3次。两组均30天为1个疗程,治疗3个疗程。观察治疗前30min、发作时及治疗后患者血清肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)含量,脑电图(EEG)变化和临床疗效。结果治疗组总有效率为91.5%,对照组为80.0%,治疗组明显优于对照组(P<0.05);两组患者各时间点EEG变化差异均无统计学意义(P>0.05);治疗组治疗后血清TNF-α、IL-6和CRP水平明显低于治疗前30min和发作时,且明显低于对照组(P<0.05);对照组治疗前30min、发作时及治疗后的血清TNF-α、IL-6与CRP水平之间均呈正相关(P<0.05),治疗组治疗前30min、发作时及治疗后的血清TNF-α、IL-6与CRP水平之间无明显相关性(P>0.05)。结论复方丹参滴丸治疗PTE疗效确切,但针对EEG表现为尖波、慢波和尖慢波者疗效无明显特异性,其作用机制可能与其降低血清TNF-α、IL-6与CRP值有关,但TNF-α、IL-6和CRP对其的敏感性不尽相同。

Objective To observe the efficacy and mechanism of Compound Danshen （Salvia） Dripping Pill on posttraumatic epilepsy（PTE）.Methods Totally 118cases of PTE were randomized into treatment group and control group with 59in each. The control group was given anti-epilepsy routine therapy and the treatment group was added with Compound Danshen Dripping Pill,10pills each time,three times daily.One treatment course lasted for 30days and the observation lasted for 3 courses.The therapeutic effect,tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6）and C-reactive protein（CRP）and electroencephalogram （EEG） were observed 30min before treatment,real onset,and after treatment.Results The total effective rate of the treatment group and control group was 91.5% and 80.0% respectively,with significant difference between groups （P0.05）.There was no significant difference between groups in EEG at all time phases（P0.05）.Compared with the level of 30min before treatment and real onset,the serum level of TNF-α,IL-6 and CRP was significantly decreased after treatment in the treatment group,with significant difference between groups（P0.05）.The serum levels of TNF-α,IL-6and CRP were positively correlated before and after treatment and during epilepsy seizure in the control group（P0.05）.There was no obvious correlation in the serum levels of TNF-α,IL-6 and CRP in the treatment group（P0.05）.Conclusion Compound Danshen Dripping Pill is effective for PTE,but it has no obvious effect on the sharp wave,slow wave and sharp-slow complex wave in EEG.Its curative effect may be related to reducing the serum levels of TNF-α,IL-6and CRP,but with vary sensitivity to TNF-α,IL-6 and CRP.