摘要
目的探究丙戊酸镁联合拉莫三嗪治疗癫痫的效果及安全性。方法选取2012年4月至2015年2月来佳木斯大学附属第一医院就诊的癫痫患者124例,依据随机数字法将患者分为研究组和对照组,各62例。对照组患者给予丙戊酸镁缓释片治疗,每次250 mg,每日2次;研究组在对照组治疗的基础上给予拉莫三嗪片治疗,每次25 mg,每2日1次,14 d后增加至25 mg/d。记录两组患者治疗前3个月、治疗开始后3个月及治疗开始后4~6个月的癫痫月平均发作情况及治疗6个月疾病控制情况、生活质量评分及不良反应发生情况。结果治疗6个月研究组患者的总有效率显著高于对照组[91.94%(57/62)比79.04%(49/62)](P<0.05)。两组患者治疗开始3个月、治疗开始4~6个月的月平均癫痫发作次数均较治疗前3个月呈下降趋势,且研究组下降速度更快[研究组:(8.1±2.2)次/月、(3.3±0.7)次/月比(13.9±3.9)次/月;对照组:(9.8±2.4)次/月、(5.8±1.1)次/月比(14.1±4.3)次/月],两组在组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。两组治疗3个月、治疗6个月生活质量评分均较治疗前呈升高趋势,且研究组升高速度更快[研究组:(78±12)分、(94±13)分、(64±10)分;对照组:(72±11)分、(84±15)分比(66±11)分],两组在组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。研究组患者在治疗6个月过程中累计出现皮疹、腹泻及嗜睡率与对照组比较差异无统计学意义[11.29%(7/62)比12.91%(8/62),14.52%(9/62)比12.91%(8/62),17.75%(11/62)比11.29%(7/62),P>0.05]。结论丙戊酸镁联合拉莫三嗪治疗癫痫可明显提高疗效,降低发作频率,提高生活质量,且不良反应发生率无明显升高。
Objective To explore the effect and the safety of treatment of magnesium valprote（VPA） and lamotrigine（LTG） to the patients with epilepsy. Methods From Apr. 2012 to Feb. 2015,124 cases of epilepsy in the First Affiliated Hospital of Jiamusi University were included in the study,and were divided into a research group and a control group according to random number method,62 cases each. The control group was given magnesium valprote（VPA） 250 mg/times,2 times/d for treatment; the research group was given LTG 25 mg/time,1 time/2 days,14 d later increased to 25 mg/d on the basis of the control group’ s regimen. The seizure situation,disease control situation,quality of life scores and adverse reactions were detected 3 months before treatment,3 months and 4-6 months after treatment. Results The total effective rate of the research group was higher than that of the control group[91. 94%（57/62） vs 79. 04%（49/62）,P 〈 0. 05].The average of epilepsy monthly episodes of the two groups after 3 months of treatment and 4-6 months of treatment started to show a downward trend than after 3 months of treatment,and the research group decreased faster[research group：（8. 1 ±2. 2） times/month,（3. 3 ± 0. 7） times/month vs（13. 9 ± 3. 9） times/month; control group：（9. 8 ± 2. 4） times/month,（5. 8 ± 1. 1） times/month vs（14. 1 ± 4. 3） times/month],the differences between the two different time points,groups,and groups · time point interaction were statistically significant（P 〈 0. 05）. The treatment quality of life scores of the two group 3 months and 6 months after treatment showed an increase tend than before treatment,and the research group increased faster[research group：（78 ± 12） score,（94 ± 13） score vs（64 ± 10） score; control group：（72 ± 11） score,（84 ± 15） score vs（66 ± 11） score],the differences between time points,groups,group·time point interaction were statistically significant（P 〈 0. 05）. During the 6 months of treatment,there were no statistically significant differences in the accumulated incidence of rash,diarrhea and lethargy between the two groups[11. 29%（7/62） vs 12. 91%（8/62）,14. 52%（9/62） vs 12. 91%（8/62）,17. 75%（11/62） vs 11. 29%（7/62）,P 〉 0. 05]. Conclusion VPA and LTG can significantly improve the treatment of epilepsy and reduce seizure frequency,improve the quality of life,without significant increase of the adverse reactions.
出处
《医学综述》
2017年第6期1231-1234,共4页
Medical Recapitulate
关键词
癫痫
拉莫三嗪
丙戊酸镁
生活质量
Epilepsy
Lamotrigine
Magnesium valproate
Quality of life
