卡马西平、托吡酯与丙戊酸钠治疗脑炎继发癫痫的效果观察

Effect of Carbamazepine, Topiramate and Sodium Valproate Treatment of Encephalitis Secondary to Epilepsy

目的探讨卡马西平、托吡酯与丙戊酸钠治疗脑炎继发癫痫的临床疗效。方法选取本院2006年3月至2011年4月收治的脑炎继发癫痫患者93例,随机分为三组,采用卡马西平(300mg/d)治疗患者31例为观察Ⅰ组,采用托吡酯(起始剂量为25mg/d,每周增加25mg/d,目标剂量为100mg/d)治疗患者31例为观察Ⅱ组,采用丙戊酸钠(500mg/d)治疗患者31例为观察Ⅲ组,疗程均为1年,比较三组患者治疗后的临床疗效及不良反应情况。结果治疗总有效率由高到低分别为观察Ⅲ组(77.4%)、观察Ⅱ组(74.2%)、观察Ⅰ组(67.7%),差异均无统计学意义(P>0.05)。不良反应发生率由高到低分别为观察Ⅰ组(38.7%)、观察Ⅲ组(22.6%)、观察Ⅱ组(9.7%),差异均有统计学意义(P<0.05)。结论卡马西平、托吡酯与丙戊酸钠治疗脑炎继发癫痫的临床疗效相当,托吡酯不良反应发生率最低更适合于临床应用。

Objective Carbamazepine, topiramate and sodium valproate treatment of encephalitis, the clinical efficacy of secondary epilepsy. Methods A hospital from March 2006 to April 2011 93 cases of encephalitis admitted patients with epilepsy secondary, were randomly divided into three groups, patients treated with carbamazepine （300mg/d） , 31 cases observed in group I topiramate （starting dose 25rag/d, weekly 25mg/d target dose of 100mg/d） treatment of 31 patients, the use of sodium valproate （500mg/d） to observe the group I：I patients treated with 31 cases observed Ⅲ group, the course of one year, the clinical efficacy and adverse effects compare three groups of patients after treatment. Results The overall efficiency from high to low were observed in group Ⅲ （77.4%） , observed in group Ⅱ （74.2%） observed in group I （67.7%） showed no significant difference （P〉 0.05） . The incidence of adverse reactions from high to low were observed in group I （38.7%） , observation of the III group （22.6%） , and observe the II group （9.7%） , the differences were statistically significant （P〈0.05） . Conclusion The clinical efficacy of carbamazepine, topiramate and sodium valproate in the treatment of epilepsy encephalitis secondary incidence of adverse events of topiramate minimum is more suitable for clinical application.