Objective  To observe the effect of phenobarbital combined with sodium valproate and their effects on cysteine aspartate protease-3 (caspase-3) and myelin basic protein (MBP) in patients with reversible splenial lesion syndrome (RESLES).

Methods  A total of 60 patients with RESLES were selected as study objects, and were randomly divided into study group (30 cases) and control group(30 cases). Both groups received conventional treatment. The patients in the control group orally administered sodium valproate sustained-release tablets, and those in the study group received oral phenobarbital combined with sodium valproate sustained-release tablets for 3 weeks.The expressions of caspase-3, MBP, oxidative stress, the indicators of inflammatory factors were tested, and the number of attacks before and after treatment, Hospital Anxiety and Depression Scale (HAD) score, Montreal Cognitive Assessment Scale (MoCA) score, efficacy of treatment after treatment and the incidence of total adverse reactions were compared in the two groups.

Results  After treatment, caspase-3, MBP, superoxide dismutase (SOD), catalase (CAT), interleukin-2 (IL-2), tumor necrosis factor -α (TNF-α) and interferon-γ (IFN-γ) levels of the two groups were significantly lower than before treatment, and MDA was higher than before treatment(P < 0.05). After treatment, caspase-3, MBP, SOD, CAT and IL-2, TNF-α, IFN-γ in the study group were lower than those in the control group, and malondialdehyde (MDA) was higher than the control group (P < 0.05). After treatment, the levels of caspase-3, MBP, SOD, CAT, IL-2, TNF-α and IFN-γ in the study group were lower, while MDA level was higher than that in the control group (P < 0.05). After treatment, the number of attacks in the study group was less, HAD score was lower, and the MoCA score was higher than that in the control group (P < 0.05). The total effective rate in the study group was higher than that in the control group (P < 0.05). There was no significant difference in the incidence of total adverse reactions between two groups (P>0.05).

Conclusion  The treatment of phenobarbital combined with sodium valproate can effectively improve the levels of caspase-3 and MBP for RESLES patients, relieve inflammation and oxidative stress, and improve cognitive function. Therefore, their combination has better clinical effect.