Abstract:

To observe the effect of Changpu Madan decoction combined with sodium valproate on the rehabilitation of neurological and motor function in patients with post-stroke epilepsy. Methods　This article was a prospective study. A total of 121 patients with post-stroke epilepsy in the First Affiliated Hospital of Nanyang Medical College from January 2021 to December 2022 were selected as the study objects, and were divided into a control group (60 cases) and a combination group (61 cases) by the random number table method. In the control group, 32 males and 28 females, aged (61.22±5.33) years, were treated with sodium valproate. In the combination group, 31 males and 30 females, aged (60.33±5.25) years, were treated with Changpu Madan decoction combined with sodium valproate. The seizure statuses of the two groups before and after treatment were compared, as well as improvement of brain nerve function and motor function, and medication safety. t test and χ² test were used. Results　Before treatment, there were no statistically significant differences in the seizure status, brain nerve function, and motor function between the two groups (all P>0.05).After treatment, the number of seizures [(2.15±0.27) times/month] and duration of symptoms [(1.25±0.36) min/time] in the combination group were lower than those in the control group [(3.31±0.42) times/month and (2.29±0.46) min/time], with statistically significant differences (t=18.102 and 13.862, both P<0.05). After treatment, the levels of neuron-specific enolase (NSE) [(35.25±10.61) μg/L] and neuro filament light chain (NF-L) [(1 033.46±200.27) μg/L] in the combination group were lower than those in the control group [(42.11±10.77) μg/L and (1 192.72±200.64) μg/L], while the score of Mini-Mental State Examination (MMSE) [(26.11±5.15) points] was higher than that in the control group [(23.32±5.19) points], with statistically significant differences (t=3.560, 4.370, and 2.968; all P<0.05). After treatment, the upper limb and lower limb scores of Fugl-Meyer Motor Function Assessment (FMA) in the combination group were higher than those in the control group [(58.44±10.33) points vs. (51.15±10.11) points, (28.72±5.31) points vs. (25.21±5.28) points], with statistically significant differences (t=3.923 and 3.643, both P<0.05). After treatment, there was no statistically significant difference in the incidence of drug-related adverse reactions between the combination group [6.56% (4/61)] and the control group [5.00% (3/60)] (χ²=0.223, P>0.05). Conclusions　The combination of Changpu Madan decoction and sodium valproate in the treatment of post-stroke epilepsy can effectively promote the recovery of epilepsy symptoms in patients, and has a positive significance in improving their brain nerve function and motor function. The combined medication method does not significantly increase the risk of drug-related adverse reactions, with high safety.

Key words:

Post-stroke epilepsy, Changpu Madan decoction, Sodium valproate, Neurological function, Motor function

摘要：

目的　观察菖蒲麻胆汤结合丙戊酸钠对卒中后癫痫患者神经及运动功能康复效果的影响。方法　本文为前瞻性研究。选取2021年1月至2022年12月南阳医学高等专科学校第一附属医院收治的121例卒中后癫痫患者为研究对象，采用随机数字表法分为对照组（60例）和联合组（61例）。对照组男32例、女28例，年龄（61.22±5.33）岁，采用丙戊酸钠治疗；联合组男31例、女30例，年龄（60.33±5.25）岁，采用菖蒲麻胆汤结合丙戊酸钠治疗。对比两组患者治疗前后癫痫发作情况，脑神经功能、运动功能改善情况及用药安全性。采用t检验、χ²检验。结果　治疗前，两组患者癫痫发作情况、脑神经功能、运动功能比较，差异均无统计学意义（均P>0.05）。治疗后，联合组癫痫发作次数［（2.15±0.27）次/月］低于对照组［（3.31±0.42）次/月］，症状持续时间［（1.25±0.36）min/次］短于对照组（2.29±0.46）min/次］，差异均有统计学意义（t=18.102、13.862，均P<0.05）。治疗后，联合组神经元特异性烯醇化酶（NSE）［（35.25±10.61）μg/L］、神经元轴突轻链（NF-L）［（1 033.46±200.27）μg/L］均低于对照组［（42.11±10.77）μg/L、（1 192.72±200.64）μg/L］，简易精神状态检查量表（MMSE）评分［（26.11±5.15）分］高于对照组［（23.32±5.19）分］，差异均有统计学意义（t=3.560、4.370、2.968，均P<0.05）。治疗后，联合组Fugl-Meyer运动功能评分（FMA）上肢评分［（58.44±10.33）分］、下肢评分［（28.72±5.31）分］均高于对照组［（51.15±10.11）分、（25.21±5.28）分］，差异均有统计学意义（t=3.923、3.643，均P<0.05）。治疗后，联合组药物相关不良反应发生率［6.56%（4/61）］与对照组［5.00%（3/60）］比较，差异无统计学意义（χ²=0.223，P>0.05）。结论　菖蒲麻胆汤结合丙戊酸钠治疗卒中后癫痫可有效促进患者癫痫症状恢复，对改善患者脑神经功能及运动功能均有积极意义，此联合用药方法未明显增加药物不良反应发生风险，安全性较高。

关键词:

卒中后癫痫, 菖蒲麻胆汤, 丙戊酸钠, 神经功能, 运动功能