小剂量丙戊酸联合拉莫三嗪治疗年龄大于60岁癫痫患者的疗效及安全性分析

Efficacy and safety analysis of low-dose valproic acid combined with lamotrigine in the treatment of epilepsy patients older than 60 years

目的:探究小剂量丙戊酸联合拉莫三嗪治疗年龄>60岁癫痫患者的临床疗效及安全性。方法:选取2019年1月~2020年6月我院106例年龄>60岁癫痫患者,随机数字表法将其以每组53例均分为单药组、联合组,单药组采用拉莫三嗪治疗,联合组采用小剂量丙戊酸+拉莫三嗪治疗,两组均连续治疗6个月。比较两组疗效、癫痫发作频率、发作持续时间、血脂指标、血清炎性因子及不良反应发生情况。结果:联合组治疗总有效率高于单药组(P<0.05);治疗后联合组癫痫发作频率低于单药组,发作持续时间较单药组短(P<0.05);治疗后联合组TC、LDL-C、TG、IL-6、TNF-α、IL-2水平较单药组低,HDL-C水平较单药组高(P<0.05);治疗后联合组水平较单药组低(P<0.05);治疗后两组总不良反应发生率相比无差异(P>0.05)。结论:小剂量丙戊酸联合拉莫三嗪治疗年龄>60岁癫痫患者疗效显著,可有效控制患者血脂,缓解病症,降低炎性反应,且安全性高。

Objective:To explore the clinical efficacy and safety of low-dose valproic acid combined with lamotrigine in the treatment of epilepsy patients>60 years old.Methods:106 cases of epilepsy patients>60 years old in our hospital from January 2019 to June 2020 were selected,53 cases in each group were divided into single drug group and combined group by random number table method.The single drug group was treated with lamotrigine and the combined group was treated with low dose valproic acid+lamotrigine.Both groups were treated for 6 months.Efficacy,seizure frequency,seizure duration,blood lipid indexes,serum inflammatory factors and the occurrence of adverse reactions were compared between the two groups.Results:The total effective rate in combination group was higher than that in single drug group(P<0.05).After treatment,the seizure frequency of the combined group was lower than that of the single drug group,and the seizure duration was shorter than that of the single drug group(P<0.05).After treatment,the levels of TC,LDL-C,TG,IL-6,TNF-αand IL-2 in the combined group were lower than that in the single drug group,while the hdL-C level was higher than that in the single drug group(P<0.05).After treatment,there was no difference in the incidence of total adverse reactions between the two groups(P>0.05).Conclusion:Low-dose valproic acid combined with lamotrigine is effective in the treatment of epilepsy patients>60 years old,which can effectively control blood lipids,relieve symptoms and reduce inflammatory response,with high safety.