托吡酯、卡马西平与丙戊酸钠治疗不同类型脑炎继发癫痫疗效观察

Clinical effect observation of topiramate,carbamazepine and sodium valproate in the treatment of secondary epilepsy with different types of encephalitis

目的：探讨托吡酯、卡马西平与丙戊酸钠治疗不同类型脑炎继发癫痫的临床疗效。方法选择2013年7月至2016年7月90例脑炎继发癫痫患者，随机分为三组，A 组经托吡酯治疗，B 组经卡马西平治疗，C 组经丙戊酸钠治疗，对比三组疗效。结果治疗后 A 组总有效率为70.0%，B 组为76.7%，C 组为76.7%，差异未见统计学意义（P ﹥0.05）。A 组不良反应发生率为16.7%，显著低于 B 组、C 组，差异有统计学意义（P ﹤0.05）；B 组PS 型癫痫发作患者有效率为100%，显著高于 A 组、C 组，差异有统计学意义（P ﹤0.05）。结论脑炎继发癫痫经托吡酯、卡马西平、丙戊酸钠治疗疗效确切，其中采用托吡酯可有效控制不良反应发生率，值得临床推广采用。

Objective To investigate the clinical effects of topiramate,carbamazepine and sodi-um valproate on secondary epilepsy with different types of encephalitis. Methods From July 2013 to Ju-ly 2016,90 patients with secondary epilepsy with different types of encephalitis were randomly divided into three groups. The patients in group A were treated with topiramate,and the patients in group B were treated with carbamazepine,while the patients in group C were treated with sodium valproate. Then the clinical effects of three groups were compared. Results After treatment,the total effective rate in group＆amp;nbsp;A was 70. 0% ,and the total effective rate in group B was 76. 7% ,while the total effective rate in group C was 76. 7% ,and there was no significant difference among the three groups（P ﹥ 0. 05）. The incidence of adverse reactions in group A was 16. 7% ,which was significantly lower than that in group B and group C,there were significant differences（P ﹤ 0. 05）. The effective rate of the patients with type PS epilepsy in group B was 100% ,which was significantly higher than that in group A and group C,there were sig-nificant differences（P ﹤ 0. 05）. Conclusions The clinical effects of topiramate,carbamazepine and so-dium valproate on secondary epilepsy with different types of encephalitis are good,and topiramate can ef-fectively control the occurrence of adverse reactions,thus it is worthy of clinical use.