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(Z + Z ) (σ + σ ) (1.96 + 0.84) (23.11 + 20.52)
2
2
α
2
2
n = n = 1- 2 1-β 1 2 = = 38
1 2 (μ - μ ) (5 - 2)
2
2
1 2
were: (1) Death of the patient in the first 7 days; (2) Patients Table 1. Mean and standard deviation of age in both
undergoing brain surgery for treatment at the time of silymarin and control groups
referral; (3) Patient dissatisfaction; (4) Addicted patients;
and, (5) Having severe trauma in other parts of the body. Silymarin Control
Regarding the level of consciousness score and by comparing Mean ±SD Mean ±SD P Value
the formula of the average in the two groups with Age 08/16± 37/33 00/16± 50/33 87/0
99% confidence at least 38 subjects in each group and
76 samples in total should be taken. The number of samples No Significant Difference
in each group is considered to be 40 individuals because of
the drop, and the total numbers of samples were consequently Table 2. Frequency of sex in two groups of silymarin and
calculated as 80. control

RESULTS Variable group Number (%)
As shown in Table 1, 2, 3, 4, 5 and 6, there was no a Number (%) Silymarin Control P Value
significant difference between intervention group and control Women 6(20) 7(5/17) .5
in terms of demographic parameters as age (P = .87), gender Sex Men 34(85) 33(5/82)
(P = .5), residence of participants (P = .30), injury causes Total 40(100) 40(100)
(P = .23), detailed analysis of injury causes (P = .18), and the
incident site (P = .47). Both groups didn’t show significant There was no significant difference between the two groups.
difference as regards traumatic outcome as desirable
traumatic outcome (P = 0.40), undesirable traumatic outcome Table 3. Frequency of residence of participants in two
(P = .12), consciousness level (P = .13), hospitalization groups of silymarin and control
duration (P = .82), and GOS (P = .19), (Table 7,8, 10, 11, 13).
Regarding Table 9, there was a significant difference between Number (%)
the two groups (P = .002), where in the silymarin group there Variable group Silymarin Control P Value
were more normal cases in terms of CT scan results. As City 28(2/11) 31(4/12) .30
shown in Table 12, there was no significant difference Residential Village 12(8/4) 9(6/3)
between the two groups regarding the incidence time of location Total 40(100) 40(100)
accident to arrival at emergency unite (P = .06).
There was no significant difference between the two groups.
DISCUSSION
Silymarin is the active component of Silybum marianum L., Table 4. Frequency of injury causes in two groups of
a member of Carduus marianum family containing a mixture silymarin and control
of flavonolignans consisting silibinin (Type A and B),
isosilybinin (Type A and B), silycristin, silydianin, Number (%)
neosilyhermin and silyhermin. 25 Variable group Silymarin Control P Value
One of the important issues with silymarin is that it can be Machine 24(6/9) 31(4/12) .23
safe as a proper herbal product, since no risks to health or side Damage Engine 8(2/3) 5(2)
effects are associated with the suitable use of designed doses. mechanism Bullet fall 8(2/3) 4(6/1)
Several studies have also been conducted on silymarin against Total 40(100) 40(100)
oxidation of stress and inflammatory responses. Silymarin has
a significant antioxidant effect, which reduces free radicals, There was no significant difference between the two groups.
inhibits lipid peroxidation and increases the activity of
superoxide dismutase in erythrocytes. 26,27 Several studies have reported for Silymarin, studies have been conducted to
been conducted based upon the anti-oxidant properties of investigate the effect of silymarin on wound healing, whereas
Silymarin. Silymarin-treated diabetic groups have showed most studies have been performed upon use of animal models.
increased tissue levels of malondialdehyde, nitrite and nitrate The objectives of the current study were different from
in diabetic rats. Four weeks treatment of Silymarin Roghani et al. ; there was no significant association between
28
(100 mg/kg bw) was determined to be associated with the the two groups in our study, whereas the findings of CT scan
reduction of oxidative stress indexes in renal tissue of were better after trauma in the Silymarin group.
diabetic rats as previously reported by Roghani et al. Another study had evaluated the anti-inflammatory
28
Considering the antioxidant and anti-inflammatory properties effect of silymarin on the healing of acetic acid-induced

10 ALTERNATIVE THERAPIES, JUL/AUG 2020 VOL. 26 NO. 4 Nazemi Rafi—Silymarine Effects on Prognosis of TBI