生酮饮食对难治性癫痫患儿情绪和社会行为的影响

Impact of ketogenic diet on emotional and social behavior in children with intractable epilepsy

目的了解生酮饮食(ketogenic diet,KD)对难治性癫痫患儿情绪和社会行为的影响。方法采用前瞻性病例对照研究,对66例难治性癫痫患儿,在告知相关生酮治疗疗效和不良反应后由家长选择入组,加用生酮饮食治疗的35例为生酮组,继续单用抗癫痫药物治疗的31例为对照组。研究启动前对两组患儿进行情绪和社会行为评估,生酮饮食治疗启动后,分别在第3、6、12个月再进行情绪和社会行为的评估,将评分结果转化成T分进行分析,比较生酮组和对照组之间,以及生酮组自身治疗前后患儿情绪和社会行为的改变情况。结果生酮组生酮饮食治疗后第3、6、12个月,患儿的问题维度(忧郁、焦虑、冲动性、攻击性)较对照组明显下降(P<0.05);能力维度(注意力、依从性、模仿)较对照组有明显提高(P<0.05),其中在治疗初3个月改善最为明显。结论生酮饮食能明显改善难治性癫痫患儿的情绪和社会行为,较为安全。

Objective To understand the impact of the ketogenic diet ( ketogenic diet, KD) on the emotional and social behavior in children with refractory epilepsy. Methods A prospective case-control study was performed in 66 cases of children with intractable epilepsy from June 2011 to December 2014 treated in the hospital. After the relevant ketogenic diet efficacy and adverse reactions were informed, the groups were selected by the parents(35 cases in the patient group received completely fasting ketogenic diet treatment regimen, and 31 cases in the control group continued to receive the antiepileptic drug treatment) . Before the onset of study, the motional and social behavior of two groups of children was assessed, and after the ketogenic diet treatment, the emotional and social behavior in the following 3, 6, 12 months was assessed again, then the results of the assessment were transformed into T points scoring and compared, and the changes in the children′s emotional and social behavior before and after the ketogenic diet were analysed. Results 3, 6, 12 months after the ketogenic diet therapy, the issue dimensions of children ( depression, anxiety, impulsivity, aggression) in the treatment group were decreased markedly compared to those of the control group (P<0. 05), ability dimensions (attention, compliance, imitation) were increased significantly compared to those of the control group (P<0. 05), and the improvement in the early three months of treatment was more obvious. Conclusion The ketogenic diet can significantly improve the emotional and social behavior in children with intractable epilepsy, and it is comparatively safer.