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ORIGINAL RESEARCH

Investigations of Silymarine Effects on

Prognosis of Patients With Severe and Moderate

Traumatic Brain Injury

Ali Nazemi Rafi, MD; Saeed Jafari, MD; Hassan Solhi, MD; Jila Mohseni, PhD; Alireza Kamali, MD

ABSTRACT
Objective • The purpose of this study was to evaluate accident and the incidence time of accident to arrival at
Silymarine effects on prognosis of patients with severe and emergency unite. Statistical analysis was conducted using
moderate traumatic brain injury. SPSS (SPSS version 18; Chicago, IL).
Study Design • This double blind, placebo-controlled Results • Our findings suggested that there was no a
clinical trial. significant difference between intervention group and
Setting • Valiasr hospital hospital in Arak, Iran. control in terms of parameters as GOS, GCS, age, gender,
Subjects and Methods • Research was performed among location, mechanism of trauma, and site of accident and
patients between 15 and 65 years of age with severe the incidence time of accident to arrival at emergency
moderate (Glasgow Coma Scale score 9 to 12) and unite (P > .05). Brain CT in two groups showed a significant
moderate (GCS 3 to 8) traumatic brain injury (TBI). difference (P = .002), where in the silymarin group there
Patients were divided into two groups (Each group: were more normal cases when comparing with control
40 patients). Patients assigned to the control groupwere group.
receiving all standard treatments. Patients in case groups Conclusions • Silymarin did not reveal a significant effect
were administered 140 mg of silymarin every 8 hours for for improving prognosis of patients with moderate and
7 days. We Checked the Glasgow Outcome Scale (GOS), severe TBI. (Altern Ther Health Med. 2020;26(4):8-13).
GCS, age, gender, location, mechanism of trauma, site of

Ali Nazemi Rafi, MD; and Saeed Jafari, MD, are in the patients with traumatic brain injury is estimated at
Department of Neurosurgery. Hassan Solhi, MD, is in the $76.5 billion in 2010. More than 700 researchers in the
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Department of Toxicology. Jila Mohseni, PhD, is in the world have studied traumatic brain injury on a full-time
Department of Pharmacology. Alireza Kamali, MD, is in the basis. Our knowledge of the field has increased dramatically
Department of Anesthesiology. All are located at Arak over the last 25 years. In 2008, the US military allocated
University of Medical Sciences, Arak, Iran $200 million to research projects in this field. 1
Many evidence-based guides have been developed in
Corresponding author: Saeed Jafari, MD recent years on how to treat and deal with adults and
E-mail address: saeedjafari1980@hotmail.com children, pre-hospital treatment and surgical treatments.
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Different tables have been presented for the classification of
post-traumatic injury, which are generally provided with a
INTRODUCTION therapeutic approach. The rest of the categorization was
Traumatic brain injury (TBI) is the most important based on the mechanism of trauma, prognosis and etc. In
1,5
cause of long-term mortality and disability word wide in the the history of dealing with trauma patients, different
under 45 years of age. Despite its decreasing incidence in therapeutic approaches have been tested and erroneous.
developed countries such as North America, Japan and Considering the pathophysiological prediction of post
Australia, developing countries are facing an increasing rate traumatic brain injury, different drugs have been used to
of TBI. The incidence ranges from 67 to 317 per 1 000 000 reduce or reverse traumatic brain injury. One of the theories
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people, where mortality is estimated to be between 4% and that have been considered in the study of the mechanism of
8% for the average type of trauma and about 50% for the brain damage is the theory of free radicals. It is suggested in
severe type. The cost of direct and indirect medical care for the theory that, oxidative substances accumulate in the
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8 ALTERNATIVE THERAPIES, JUL/AUG 2020 VOL. 26 NO. 4 Nazemi Rafi—Silymarine Effects on Prognosis of TBI