拉莫三嗪联合小剂量丙戊酸钠治疗新诊断癫痫的临床研究

Clinical effect of lamotrigine combined with small dose of valproic acid in the treatment of newly diagnosed epilepsy

目的分析拉莫三嗪联合小剂量丙戊酸钠治疗新诊断癫痫的临床效果。方法选取新诊断癫痫患者90例，采用随机数字表法分为对照组、观察组，每组45例。对照组给予小剂量丙戊酸钠治疗，观察组在对照组基础上加用拉莫三嗪治疗，观察两组临床指标及认知功能的变化，比较两组临床疗效。结果对照组总有效率为82．22％，观察组总有效率为91．11％，两组差异有统计学意义（Х^2=5．36，P〈0．05）。治疗后，对照组发作次数、发作持续时间、癫痫样放电、累及导联数分别为（1.29±0．55）次／年、（3。36±0．63）min、（11．69±1．26）180s／次、（5．69±1．52）180s／次，观察组分别为（0．51±0．22）次／年、（2．09±1．02）min、（7．56±1．34）180s／次、（3．54±1．48）180s／次，两组差异均有统计学意义（t=4．18、4．28、5．14、5．29，均P〈0．05）。两组治疗后与治疗前相比，简易智能精神状态检查量表（MMSE）、数字广度顺背测试及连线测试B评分均升高，观察组治疗后与对照组治疗后相比上述指标改善更显著，差异均有统计学意义（t=4．18、4．28、5．14，均P〈0．05）。结论拉莫三嗪联合小剂量丙戊酸钠治疗新诊断癫痫的疗效显著，能够缓解临床指标，改善认知功能。

Objective To explore the clinical effect of lamotrigine combined with small dose of valproic acid in the treatment of newly diagnosed epilepsy. Methods 90 patients with newly diagnosed epilepsy were selected, and they were randomly divided into control＇ group and observation group according to the digital table,45 cases in each group. The control group was only given small dose valproic acid treatment ,the observation group was given lamotrigine based on the control group. The curative effect, clinical indicators, and the change of cognitive function were compared between two groups. Results The total effective rate of the control group was 82.22%, which was significantly lower than 91.11% of the observation group （ Х^2 = 5.36, P 〈 0.05 ）. After treatment, the attack frequency, duration, the attack of epilepsy discharge,involving lead number of the control group were （ 1.29 ± 0.55 ） times per year, （3.36 ± 0. 63） min, （ 11.69 ± 1.26） 180s/time, （5.69 ± 1.52） 180s/time, which of the observation group were （0.51 ± 0. 22）times per year, （2.09 ±1.02 ） min, （7.56 ± 1.34 ） 180s/time, （3.54 - 1.48 ） 180s/time, the differences between the two groups were statistically significant （ t = 4.18,4.28,5.14,4.28, all P 〈 0. 05 ）. Compared with before treatment, the MMSE, digit span along the back test B scores after treatment in the two groups were increased, and the indicators of the observation group after treatment improved more significantly than those in the control group （t = 4. 18,4.28,5. 14, all P 〈 0.05 ）. Conclusion The therapeutic effect of lamotrigine combined with small dose of valproie acid in the treatment of newly diagnosed epilepsy is significant, which can reduce clinical indicators and improve cognitive function.