多药物联合治疗难治性癫痫疗效分析

Comparison of the efficacy of multi-drug combination therapy for refractory epilepsy

目的探讨多药联合治疗难治性癫痫的疗效对比,以求更好的为临床治疗提供参考。方法对难治性癫痫患者分别给予丙戊酸钠(VPA)联合拉莫三嗪(LTG)或托吡酯(TPM)或奥卡西平(OXC)口服,通过电话随访、门诊随访212例难治性癫痫患者,对癫痫发作次数、副作用进行记录,分析癫痫控制率及副作用发生率。结果 189例患者联合治疗后每月发作(12.41±3.07)次,明显低于治疗前3个月每月发作(47.82±8.93)次;3组临床总有效率分别为76.19%、77.78%、82.54%,与治疗前相比均发生明显变化(P<0.05),且加用LTG组不良反应最少。3组治疗后,脑电图检查结果显示均有好转,但是组间对比差异无统计学意义(P>0.05)。结论 VPA+LTG、VPA+OXC或VPA+TPM治疗难治性癫痫均取得满意疗效,且LTG+VPA疗法不良反应最低,具有临床应用优势。

Objective: To explore the efficacy of multi-drug combination therapy for refractory epilepsy in order to provide a reference for clinical treatment.Methods: Patients with refractory epilepsy were treated with sodium valproate combined with lamotrigine or topiramate or oxcarbazepine.The number of seizures and side effects of 212 patients with refractory epilepsy were recorded by telephone follow-up and outpatient follow-up.Rate of incidence and side effects were recorded.Results: 1.189 patients had a monthly onset (12.41±3.07) after treatment,which was significantly lower than that (47.82±8.93) before treatment.The total clinical effective rate of the 2.3 group was 76.19%,77.78%,and 82.54%,respectively.Significant changes were observed compared with before treatment ( P <0.05),and the least adverse reactions were added in the LTG group.After 3 groups of treatment,the results of EEG showed improvement,but there was no significant difference between the groups ( P >0.05).Conclusion: In this study,VPA+LTG,VPA+OXC or VPA+TPM has satisfactory results,and LTG+VPA therapy has the lowest adverse reactions and clinical application advantages.