丙戊酸钠片联合托吡酯治疗脑梗死后继发癫痫的临床效果

Clinical Efficacy of Sodium Valproate Tablets Combined with Topiramate on Epilepsy Secondary to Cerebral Infarction

目的分析丙戊酸钠片联合托吡酯治疗脑梗死(CI)后继发癫痫患者的临床效果。方法选择2017年1月至2020年1月在温县人民医院接受治疗的92例CI后继发癫痫的患者。根据选择的治疗药物分为丙戊酸钠片组(n=46)和丙戊酸钠片及托吡酯组(n=46)。丙戊酸钠片组患者接受丙戊酸钠片治疗,丙戊酸钠片及托吡酯组患者接受丙戊酸钠片联合托吡酯治疗。比较两组疗效、不良反应,以及治疗前和治疗3个月后脑电图异常、中国卒中量表(CSS)评分、蒙特利尔认知评估量表(MoCA)评分、生活质量综合评定问卷-74(GQOLI-74)评分。结果与丙戊酸钠片组相比,丙戊酸钠片及托吡酯组总有效率升高(P<0.05)。治疗3个月后,与丙戊酸钠片组对比,丙戊酸钠片及托吡酯组脑电图异常率降低(P<0.05)。与治疗前比较,两组患者治疗3个月后的CSS评分降低(P<0.05);治疗3个月后,丙戊酸钠片及托吡酯组CSS评分低于丙戊酸钠片组(P<0.05)。与治疗前比较,两组患者治疗3个月后的MoCA评分和GQOLI-74评分升高;治疗3个月后,丙戊酸钠片及托吡酯组MoCA评分和GQOLI-74评分高于丙戊酸钠片组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论采用丙戊酸钠片及托吡酯药物治疗CI后继发癫痫患者具有较好的临床疗效,能有效降低脑电图异常率,改善神经功能和认知功能,提升患者生活质量。

Objective To analyze the clinical efficacy of sodium valproate tablets combined with topiramate on epilepsy secondary to cerebral infarction(CI).Methods A total of 92 patients with secondary epilepsy after CI in Wenxian People’s Hospital from January 2017 to January 2020 were selected as the research objects.According to therapeutic drugs,they were divided into sodium valproate tablets group(n=46)and sodium valproate tablets and topiramate group(n=46).The patients in sodium valproate tablets group received sodium valproate tablets,while the patients in sodium valproate tablets and topiramate group received sodium valproate tablets combined with topiramate.The efficacy,adverse reactions,abnormal rate of electroencephalogram,scores of Chinese stroke scale(CSS),Montreal cognitive assessment(MoCA)and generic quality of life inventory-74(GQOLI-74)before and after 3 months of treatment were compared between the two groups.Results Compared with sodium valproate tablets group,the total effective rate in sodium valproate tablets and topiramate group was higher(P<0.05).After 3 months of treatment,compared with sodium valproate tablets group,the abnormal rate of electroencephalogram in sodium valproate tablets and topiramate group was lower(P<0.05).Compared with before treatment,the CSS scores of the two groups after 3 months of treatment were lower,after 3 months of treatment,the CSS score in sodium valproate tablets and topiramate group was lower than that in sodium valproate tablets group(P<0.05).Compared with before treatment,the scores of MoCA and GQOLI-74 of the two groups after 3 months of treatment were higher,after 3 months of treatment,the scores of MoCA and GQOLI-74 in sodium valproate tablets and topiramate group were higher than those in sodium valproate tablets group(P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Sodium valproate tablets combined with topiramate are effective in the treatment of epilepsy secondary to CI patients,which can effectively reduce the abnormal rate of electroencephalogram,improve neurological function and cognitive function,and improve the quality of life of patients.