卡马西平与托吡酯联合左乙拉西坦治疗创伤性难治性癫痫临床研究

Clinical study of carbamazepine combined with topiramate and levetiracetam in the treatment of traumatic refractory epilepsy

目的探讨托吡酯、卡马西平及左乙拉西坦联合治疗创伤性难治性癫痫患者的疗效及对其认知功能的影响。方法选取2014-01—2016-06平煤神马医疗集团总医院收治的74例难治性癫痫患者,依据建档顺序分为2组,各37例。对照组采用卡马西平联合托吡酯治疗,研究组联合采用卡马西平、托吡酯及左乙拉西坦治疗;2组均持续治疗4个月。统计对比2组临床疗效、入院时及疗程结束后认知功能评分(MoCA)及癫痫发作次数。结果研究组总有效率89.19%(33例)高于对照组70.27%(26例),差异有统计学意义(P<0.05);治疗前2组癫痫发作次数及MoCA评分比较,差异无统计学意义(P>0.05),治疗后研究组癫痫发作次数少于对照组,MoCA评分高于对照组,差异有统计学意义(P<0.05)。结论托吡酯联合卡马西平及左乙拉西坦治疗创伤性难治性癫痫效果显著,可有效减少癫痫发作次数,提高患者认知功能。

Objective To investigate the efficacy of topiramate,carbamazepineand levetiracetamin the treatment of patients with traumatic refractory epilepsy and its cognitive function. Methods Seventy four patients with refractory epilepsy admitted to the General Hospital of Pingmei Shenma Medical Group from January 2014 to June2016 were divided into two groups according to the order of establishment,37 cases in each group. The control group was treated with carbamazepine plus topiramate. The study group was treated with carbamazepine,topiramate and levetiracetam. Both groups were treated for 4 months. The clinical efficacy of the two groups,the cognitive function score （MoCA） and the number of seizures at the time of admission and after the treat ment were compared statistically. Results The total effective rate of the study group was 89.19% （33 cases） higher than that of the control group （70.27% （26 cases）） ,the difference was statistically significant （P〈0.05）. There was no significant difference in the number of seizures and MoCA scores between the two groups before treatment（P〉0.05）, the number of seizures in the study group was lower than that in the control group after treatment, and the MoCA score was higher than that in the control group, the difference was statistically significant （P〈0.05）. Conclusion Topiramate combined with carbamazepine and levetirace tam is effective in the treatment of traumatic refractory epilepsy,which can effectively reduce the number of seizures and improve cognitive function.