丙戊酸钠联合拉莫三嗪治疗成人及儿童癫痫的疗效及对认知功能的影响

Therapeutic effect and influence on cognitive function of VPA combined with LTG in the treatment for adults and children with epilepsy

目的观察丙戊酸钠(VPA)联合拉莫三嗪(LTG)治疗成人及儿童癫痫的疗效并进一步探讨其对认知功能的影响。方法以2013年8月至2015年12月收治的115例癫痫患者作为研究对象,根据患者的年龄进行分组,16岁以下患者为儿童,列为对照组,16岁及以上成人列为观察组。两组均接受VPA及LTG的联合用药治疗。治疗3个月后对联合用药的临床疗效及安全性进行评估比较,并通过简易精神状态检测量表(MMSE)对两组患者用药前、用药后3个月、6个月的认知功能进行测试评估。结果用药3个月后,对照组治疗总有效率为93.10%,观察组为94.74%,组间差异无显著统计学意义(P>0.05);安全性对比结果显示,观察组患者以17.54%的不良反应发生率显著低于对照组的36.21%(P<0.05);认知功能评估结果显示,对照组在用药治疗3个月及6个月后,MMSE评分相比治疗前明显下降(P<0.05),而观察组用药前后MMSE值均无显著差异(P>0.05)。结论 VPA与LTG联用对儿童及成人的癫痫均有良好的疗效,但对儿童患者出现不良反应及认知功能的影响较大。

Objective To investigate the therapeutic effect and influence on cognitive function of VPA combined with LTG in the treatment for adults and children with epilepsy. Methods 115 cases with epilepsy admitted in our hospital from Aug 2013 to Dec 2015 were selected as study subjects,and were divided into two groups according to age,control group（age16,children） and study group（age≥16,adults）.Both group accepted the treatment of VPA combined with LTG both for three months. The therapeutic effect and safety of medication were analyzed after treatment of three months,and the cognitive function was evaluated by MMSE before treatment and after three/six-month treatment. Results The total therapeutic efficacy of control group and study groups were 93.10% and 94.74% respectively after three-month treatment,and there was no significant difference（P〉0.05）. The study group showed significant lower incidence of adverse reactions than control group（17.54%vs. 36.21%） in the investigation of safety of medication,the difference was statistically significant（P〈0.05）. The MMSE scores of control group after three/six-month treatment decreased significantly than before（P〈0.05）. There was no significant change between three time points in study group（P〉0.05）. Conclusion The treatment of VPA combined with LTG for adults and children with epilepsy has good effect,but there shows more adverse reactions and cognitive dysfunction in children,which needs more attention.