Clinical Efficacy of Modified Dingxian Decoction Combined with Levetiracetam in the Treatment of Refractory Epilepsy
Objective To observe the clinical efficacy of modified Dingxian Decoction combined with levetirace-tam in the treatment of patients with refractory epilepsy(RE).Methods Ninety patients with RE treated at the Depart-ment of Neurology of Nanyang First People's Hospital,Henan Province,from December 2020 to December 2021,were en-rolled and randomly divided into a control group and an observation group according to a random number table,with 45 pa-tients in each group.The control group was treated with sodium valproate and levetiracetam,while the observation group re-ceived oral modified Dingxian Decoction in addition to the control group's treatment.Both groups continued treatment for 12 weeks.The clinical efficacy,adverse reactions,cognitive function scores,quality of life scores,levels of peripheral blood neurotransmitters[5-hydroxytryptamine(5-HT),dopamine(DA),and brain-derived neurotrophic factor(BDNF)],and serum levels of neuron-specific enolase(NSE)and S-100β protein(S-100β)before and after treatment in the two groups were compared.Results After treatment,the Montreal Cognitive Assessment(MoCA)scale scores in various di-mensions were significantly higher in both groups than those before treatment(P<0.05),and the scores in the observation group were significantly higher than those in the control group(P<0.05).The Quality of Life in Epilepsy Inventory-89(QOLIE-89)scores were significantly higher in both groups post-treatment than those before treatment(P<0.05),with the observation group showing significantly higher scores than the control group(P<0.05).Post-treatment levels of 5-HT and DA were significantly elevated,while BDNF levels were significantly reduced in both groups compared to pre-treatment levels(P<0.05).The observation group had significantly higher 5-HT and DA levels and significantly lower BDNF levels than the control group(P<0.05).NSE and S-100β levels were significantly reduced post-treatment in both groups(P<0.05),with the observation group showing significantly lower levels than the control group(P<0.05).The overall effective rate was significantly higher in the observation group(91.11%,41/45)than the control group(77.78%,35/45)(P<0.05).During the treatment period,the total incidence of adverse reactions was not significantly different between the observation group(11.11%,5/45)and the control group(13.33%,6/45)(P>0.05).Conclu-sion Modified Dingxian Decoction combined with levetiracetam can effectively improve cognitive function and quality of life in RE patients,enhance clinical efficacy,and has high safety.Its mechanism of action may be related to regulating neu-rotransmitter levels and reducing neuronal damage in RE patients.