拉莫三嗪与丙戊酸钠治疗癫痫合并抑郁障碍患者的疗效比较

Epileptic Patients with Depression Disorder: Comparison of Effect between Lamotrigine and Sodium Valproate

目的：探讨拉莫三嗪和丙戊酸钠治疗癫痫合并抑郁障碍的疗效,为其临床治疗提供依据。方法：选择2011年2月～2015年2月在我院接受治疗的癫痫合并抑郁障碍患者60例,根据随机数字表法将患者分为观察组（30例）和对照组（30例）,观察组给予拉莫三嗪治疗,对照组给予丙戊酸钠治疗,于治疗前、治疗后8周末和16周末采用HAMD-17和MADRS量表进行评分,并比较两组患者的临床疗效和不良反应。结果：治疗8周末和16周末两组患者的HAMD-17和MADRS量表评分较治疗前均降低,且观察组降低幅度大于对照组,差异均有统计学意义（P〈0.05）。治疗16周末观察组患者的总有效率为86.67%显著高于对照组的63.33%,差异有统计学意义（P〈0.05）。两组患者的不良反应主要为皮疹、嗜睡、恶心呕吐等,发生率低,差异无统计学意义（P〉0.05）。结论：拉莫三嗪和丙戊酸钠均可改善抑郁状态,但拉莫三嗪的疗效优于丙戊酸钠,且不会增加患者不良反应,值得临床推广应用。

Objective： To study the effect of lamotrigine and sodium valproate in treatment of epilepsy patients with depression disorder, and to provide the basis for the clinical treatment. Methods： A total of 60 epileptic patients with depression disorder, who were treated in Enshi Central Hospital of Tujia and Miao Autonomous Prefecture from February 2011 to February 2015,were selected and randomly divided into observation group （n=30） and control group （n=30）. The observation group was treated with lamotrigine, and the control group was treated with sodium valproate. The two groups were scored by HAMD-17 and MADRS scale before treatment, 8 and 16 weekends after treatment. The clinical effect and adverse reactions of the two groups were compared. Results： The HAMD-17 and MADRS scale scores of two groups 8 and 16 weekends after treatment were lower than before treatment, and the observation group was significantly lower than control group, the difference was statistically significant （P〈0.05）. The total effective rate （86.67%） of the observation group was significantly higher than that （63.33%） of the control group, the difference was statistically significant（P〈0.05）. The adverse reactions were mainly erythra, drowsiness, nausea and vomiting, the incidence rate was low, the difference had no significance （P〉0.05）. Conclusion： Both lamotrigine and sodium valproate can improve the state of depression of the epileptic patients, but the effect of lamotrigine is better than that of sodium valproate, with less adverse reactions, which is worthy of clinical popularization and application.