托吡酯联合卡马西平治疗小儿癫痫临床效果及对脑电图参数、 神经因子、安全性的影响

Clinical Effect of Topiramate Combined with Carbamazepine in the Treatment of Epilepsy in Children and Its Impact on EEG Parameters, Neurological Factors and Safety

目的探讨托吡酯(TPM)联合卡马西平(CBZ)治疗小儿癫痫的效果及对脑电图参数、神经因子、安全性的影响。方法选取2018年1月—2021年12月收治的小儿癫痫78例,根据治疗方法的不同均分为观察组和对照组,观察组予TPM联合CBZ治疗,对照组仅予CBZ治疗,治疗后3个月比较2组治疗效果,治疗前后脑电图参数变化、血清神经因子水平,以及治疗期间不良反应发生情况。结果观察组治疗总有效率高于对照组(P<0.05)。治疗后3个月观察组α波减少>0.5 Hz、θ波增加、δ波增加患儿比例高于对照组(P<0.05)。治疗后3个月2组血清神经肽Y、胶质纤维酸性蛋白、脑源性神经生长因子水平均较治疗前降低,且观察组低于对照组(P<0.05,P<0.01)。2组患儿治疗期间不良反应总发生率比较差异无统计学意义(P>0.05)。结论TPM联合CBZ治疗小儿癫痫可以提高临床效果,改善患儿脑部异常放电状况,且安全性与单独使用CBZ相当。

Objective To investigate the effect of Topiramate(TPM)combined with Carbamazepine(CBZ)in the treatment of epilepsy in children and its impact on EEG parameters,neurological factors and safety.Methods A total of 78 children with epilepsy who were treated from January 2018 to December 2021 were selected and divided into observation group and control group according to different treatment methods.The observation group was treated with TPM combined with CBZ,and the control group was treated with CBZ alone.At 3 months after treatment,the therapeutic effects,the changes of EEG parameters and the levels of serum neurological factors before and after treatment,and the occurrence of adverse reactions during treatment were compared between the two groups.Results The total effective rate of treatment in observation group was higher than that in control group(P<0.05).At 3 months after treatment,the proportion of children withαwave reduction>0.5 Hz,θwave increase,andδwave increase in the observation group was higher than that in the control group(P<0.05).At 3 months after treatment,the levels of serum neuropeptide Y,glial fibrillary acidic protein and brain-derived nerve growth factor in the two groups were lower than those before treatment,and lower in the observation group than in the control group(P<0.05,P<0.01).There was no significant difference in the total incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion TPM combined with CBZ in the treatment of epilepsy in children can improve the clinical treatment effect and improve the abnormal discharge of children's brain,and the safety is equivalent to that of CBZ alone.