拉莫三嗪治疗癫痫伴抑郁的临床疗效及对认知功能的影响

The Clinical Efficacy of Lamotrigine in the Treatment of Epilepsy with Depression and the Influence on Cognitive Function

目的:观察拉莫三嗪治疗癫痫伴抑郁的临床疗效及对患者认知功能的影响。方法:将我院收治的68例癫痫伴抑郁患者随机分为观察组和对照组两组,每组病例数均为34例。对照组患者行托吡酯治疗,观察组患者行拉莫三嗪治疗。治疗12周后,分别对两组患者的临床治疗效果进行评价;两组患者治疗前后采用汉密尔顿抑郁量表(HAMD)分别评价抑郁症状积分;采用简明智能精神状况检查量表(MMSE)分别评价患者的认知功能。结果:观察组患者临床治疗总有效率为91.17%,对照组为88.24%,两组比较,差异无统计学意义(P>0.05);在平均HAMD评分上,组间比较,治疗前两组比较,差异无统计学意义(P>0.05);治疗8周后及12周后,观察组HAMD评分均较对照组低(P<0.05)。组内比较,两组患者治疗8周后及12周后较治疗前降低(P<0.05)。治疗12周后,两组患者平均MMSE评分较治疗前均升高(P<0.05),但观察组患者平均MMSE评分均高于对照组(P<0.05)。结论:拉莫三嗪治疗癫痫伴抑郁的临床疗效显著,对患者抑郁症状及认知功能的改善效果良好。

Objective： To observe the clinical effect of lamotrigine in the treatment of epilepsy with depression and the influence on the cognitive function of the patients. Methods： 68 patients with epilepsy and depression in our hospital were randomly divided into observation group（n = 34） and control group（n = 34）. The control group patients were treated with topiramate. The observation group was treated with lamotrigine. After 12 weeks of treatment,therapeutic effect of 2 groups were evaluated. Depressive symptom score was evaluated in 2 groups of patients before and after treatment using Hamilton Depression Scale（HAMD） respectively,and patients＇ cognitive function were evaluated with concise mental state examination scale（MMSE）. Results： The clinical total effective rate was 91. 17% in observation group,and 88. 24% in the control group. There was no statistically significant difference（P〈0. 05）. On the average HAMD score,there was no significant difference between the two groups before the treatment（P〉0. 05）. After 8 weeks and 12 weeks,the HAMD scores of the observation group were lower than that of the control group（P〈0. 05）. In group comparison,the 2 groups decreased after treatment 8 weeks and 12 weeks after treatment（P〈0. 05）. After 12 weeks of treatment,the average MMSE score of the patients in both groups was higher than that before treatment（P〈0. 05）,and the average MMSE score of the observation group was higher than that of the control group（P〈0. 05）. Conclusion： The clinical curative effect of lamotrigine in the treatment of epilepsy with depression is significant,and can effectively improve the symptoms of depression and cognitive dysfunction.