丙戊酸钠合用氯硝西泮治疗难治性癫痫的临床疗效及不良反应

Clinical Efficacy and Adverse Reactions of Sodium Valproate Combined with Clonazepam in the Treatment of Refractory Epilepsy

目的研究丙戊酸钠联合氯硝西泮治疗难治性癫痫的临床疗效及不良反应。方法选取2021年1月-2023年1月上高县中医院精神科收治的60例难治性癫痫患者,行随机数字表法分为对照组(30例)与观察组(30例),对照组给予丙戊酸钠治疗,观察组应用丙戊酸钠联合氯硝西泮治疗,比较两组癫痫控制疗效、脑电图放电改善情况、国立医院癫痫发作严重程度量表(NHS3)、癫痫患者生活质量评定量表(QOLIE-31)评分及不良反应。结果观察组控制有效率大于对照组(P<0.05);观察组放电改善率大于对照组(P<0.05);两组治疗后NHS3分数低于治疗前,QOLIE-31分数高于治疗前,且观察组NHS3分数低于对照组,QOLIE-31分数高于对照组(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)。结论丙戊酸钠联合氯硝西泮对难治性癫痫具有确切疗效,可提高其癫痫控制效果,减少痫性放电,有助于患者病情严重程度及生活质量的改善,且用药安全性高。

Objective To study the clinical efficacy and adverse reactions of sodium valproate combined with clonazepam in the treatment of refractory epilepsy.Methods A total of 60 patients with refractory epilepsy admitted to the Department of Psychiatry,Shanggao County Hospital of Traditional Chinese Medicine from January 2021 to January 2023 were randomly divided into control group(30 patients)and observation group(30 patients).The control group was treated with sodium valproate,and the observation group was treated with sodium valproate combined with clonazepam.The efficacy of epilepsy control,improvement of EEG discharge,National Hospital Epilepsy Severity Scale(NHS3),Quality of Life Scale for Epilepsy Patients(QOLIE-31)score and adverse reactions were compared between the two groups.Results The effective rate of control in the observation group was higher than that in the control group(P<0.05).The improvement rate of discharge in the observation group was higher than that in the control group(P<0.05).After treatment,the NHS3 score of the two groups was lower than that before treatment,the QOLIE-31 score was higher than that before treatment,and the NHS3 score of the observation group was lower than that of the control group,the QOLIE-31 score was higher than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Sodium valproate combined with clonazepam has a definite effect on refractory epilepsy,which can improve the control effect of epilepsy and reduce epileptic discharge.Meanwhile,it is helpful to improve the severity and quality of life of patients,and the safety of medication is high.