拉莫三嗪联合丙戊酸钠治疗脑卒中继发癫痫患者的效果分析

Effect of Lamotrigine Combined with Sodium Valproate on Patients with Epilepsy Complicated by Stroke

目的研究拉莫三嗪联合丙戊酸钠应用在脑卒中继发癫痫治疗中的临床疗效。方法方便选取该院收治的86例脑卒中继发癫痫患者作为该次研究病例,研究对象的选取时间为2015年2月—2017年6月,按照治疗手段的不同对其进行分组治疗,分为研究与对照组,每组患者各43例,对照组患者应用丙戊酸钠治疗,研究组实施拉莫三嗪联合丙戊酸钠治疗,比较两组的临床疗效与不良反应发生情况,并观察两组患者的癫痫发作频率与发作持续时间。结果两组患者用药1年后,研究组临床总有效率为93.02%,与对照组(76.74%)比较,差异有统计学意义(χ2=4.440 5,P=0.035 0),治疗后研究组的发作时间(2.12±0.16)min/次与发作频率(0.34±0.07)次/年显著短于对照组,组间差异有统计学意义(t=18.869 7,P=0.000;t=38.638 9,P=0.000 0);研究组不良反应发生率为9.30%(包括:2例皮疹,1例胃肠道反应,1例感觉异常),与对照组(13.95%)比较差异无统计学意义(χ2=0.452 6,P=0.501 0)。结论与单独应用丙戊酸钠治疗比较,拉莫三嗪与丙戊酸钠联合治疗的效果较为显著,不仅能够提高临床总有效率,且具有控制病情发生与发作时间的作用,用药较为安全,值得临床推广应用。

Objective To study the clinical efficacy of lamotrigine combined with sodium valproate in the treatment of epilepsy with stroke relay.Methods 86 patients with stroke-recurrent epilepsy admitted to our hospital were enrolled in this study.The study subjects were selected from February 2015 to June 2017 and were convenient divided into groups according to different treatment methods,43 patients in each group,the control group was treated with sodium valproate.The study group was treated with lamotrigine and sodium valproate.The clinical efficacy and adverse reactions of the two groups were compared as well as the frequency of seizures and duration of seizures in the group.Results After 1 year of treatment,the total effective rate of the study group was 93.02%,compared with the control group (76.74%),the difference was significant (χ^2=4.440 5,P=0.035 0),and the attack time of the study group after treatment (2.12±0.16)min/time and seizure frequency (0.34±0.07)times/year were significantly shorter than the control group,and the difference between the groups was statistically significant (t=18.869 7,P=0.00 0;t=38.638 9,P=0.000 0);The reaction rate of the study group was 9.30%(including: 2 cases of rash,1 case of gastrointestinal reaction,1 case of paresthesia),and there was no statistically significant difference compared with the control group (13.95%)(χ^2=0.452 6,P=0.501 0).Conclusion Compared with the treatment with sodium valproate alone,the combination of lamotrigine and sodium valproate is effective,which not only improves the total clinical efficiency,but also has the effect of controlling the occurrence and time of onset,which is worthy of clinical application.