长期生酮饮食疗法治疗儿童Lennox-Gastaut综合征的临床疗效及其对智力发育的影响研究

Clinical Effect of Long-term Ketogenic Diet Therapy in Treating Children with Lennox-Gastaut Syndrome and the Impact on Intelligence Development

目的分析长期生酮饮食疗法治疗儿童Lennox-Gastaut综合征的临床疗效及其对智力发育的影响。方法选取2013年8月—2016年5月唐山市妇幼保健院收治的Lennox-Gastaut综合征患儿78例,根据治疗方法分为对照组38例和观察组40例。对照组患儿予以常规药物治疗,观察组患儿在对照组基础上予以长期生酮饮食疗法;两组患儿均连续治疗3个月。比较两组患儿临床疗效,治疗前后癫痫发作频率、癫痫发作持续时间及韦氏儿童智力量表中国修订本(WISC-CR)评分,并观察两组患儿治疗期间不良反应发生情况。结果观察组患儿临床疗效优于对照组(P<0.05)。治疗前两组患儿癫痫发作频率及癫痫发作持续时间比较,差异无统计学意义(P>0.05);治疗后观察组患儿癫痫发作频率低于对照组,癫痫发作持续时间短于对照组(P<0.05)。治疗前两组患儿WISC-CR评分比较,差异无统计学意义(P>0.05);治疗后观察组患儿WISC-CR评分高于对照组(P<0.05)。观察组患儿治疗期间不良反应发生率低于对照组(P<0.05)。结论长期生酮饮食疗法治疗儿童Lennox-Gastaut综合征的临床疗效确切,可有效降低癫痫发作频率,缩短癫痫发作持续时间,促进患儿智力发育,且安全性较高。

Objective To analyze the clinical effect of long - term ketogenic diet therapy in treating children with Lennox-Gastaut syndrome and the impact on intelligence development. Methods A total of 78 children with Lennox-Gastaut syndrome were selected in Tangshan Maternal and Child Health Care Center from August 2013 to May 2016, and they were divided into control group （n = 38 ） and observation group （n = 40） according to therapeutic methods. Children of control group received conventional medical treatment, while children of observation group received extra long -term ketogenic diet therapy based on conventional medical treatment; both groups continuously treated for 3 months. Clinical effect, seizure frequency, duration of seizure and WISC - RC score before and after treatment were compared between the two groups, and incidence of adverse reactions during the treatment was observed. Results Clinical effect of observation group was statistically significantly better than that of control group （ P 〈 0.05 ）. No statistically significant differences of seizure frequency or duration of seizure was found between the two groups before treatment （ P 〉 0. 05 ） ; after treatment, seizure frequency of observation group was statistically significantly lower than that of control group, meanwhile duration of seizure of observation group was statistically significantly shorter than that of control group （ P 〈 0. 05 ）. No statistically significant differences of WISC - RC score was found between the two groups before treatment （ P 〉0. 05 ）, while WISC - RC score of observation group was statistically significantly higher than that of control group after treatment （ P 〈 0. 05）. Incidence of adverse reactions of observation group was statistically significantly lower than that of control group during the treatment （P 〈0. 05）. Conclusion Long - term ketogenic diet therapy has certain clinical effect in treating children with Lennox-Gastaut syndrome, can effectively reduce the seizure frequency, shorten the duration of seizure and promote the intelligence development, with relatively high safety.