托吡酯联合丙戊酸钠治疗难治性癫痫临床研究.docVIP

托吡酯联合丙戊酸钠治疗难治性癫痫临床研究 　　[摘要] 目的 探?托吡酯（topiramate，TPM）联合丙戊酸钠（valproatesodium，VPA）治疗难治性癫痫的临床疗效。 方法 选择2015年12月～2016年12月来我院住院治疗的成年癫痫患者100例作为观察对象，采用随机数字表法随机分为两组，每组50例，对照组予托吡酯，起始剂量25 mg/d口服，每天1次，观察组同时联合丙戊酸钠治疗，起始剂量200 mg/d口服，每天3次，根据患者发作情况及药物不良反应调整剂量，最佳或最终剂量范围，托吡酯50～300 mg/d，丙戊酸钠200～1500 mg/d，治疗 1 个月后进行临床疗效评价；并比较两组患者的癫痫发作次数，并对比分析两组患者治疗前后神经心理学检查结果。 结果 观察组患者治疗后的临床总有效率90.0%，显著高于对照组治疗后的总有效率78.0%，组间疗效对比差异具有显著性（P0.05）。观察组患者治疗后的发作频率（2.1±0.7）次/月，明显低于治疗前及对照组，组间对比差异具有显著性（P0.05）。经神经心理学检查，结果显示，观察组患者治疗后词语流畅性测试中的重复、数字广度测试中的顺背、倒背及Stroop 字色干扰试验中的读色纠正数分别较治疗前及对照组显著降低，组间对比差异具有显著性（P0.05）。 结论 托吡酯联合丙戊酸钠治疗难治性癫痫可以显著提高临床疗效，降低发作频率，改善患者的临床症状。 　　[关键词] 难治性癫痫；托吡酯；联合；丙戊酸钠 　　[中图分类号] R742.1 [文献标识码] B [文章编号] 1673-9701（2017）11-0078-03 　　Clinical study of topiramate combined with valproatesodium in the treatment of refractory epilepsy 　　ZHANG Yu1 YANG Xuezhi2 　　1.Department of Neurology， Shaoxing Central Hospital， Shaoxing 312030， China； 2.Department of Neurology， the First Affiliated Hospital of Wenzhou Medical University， Wenzhou 325200， China 　　[Abstract] Objective To explore the clinical efficacy of topiramate（TPM） combined with valproatesodium （VPA） in the treatment of refractory epilepsy. Methods 100 adult patients with epilepsy who were hospitalized from December 2015 to December 2016 were selected as the subjects. They were randomly divided into two groups according to the random number table， with 50 cases in each group. The control group was orally given topiramate at the starting dose of 25 mg/d， po， once a day. The observation group was further orally given valproatesodium at a dose of 200 mg/d， three times a day. According to the patients attacks and adverse drug reactions， the dose was adjusted. The optimal or final dose range： topiramate 50～300 mg/d， sodium valproate 200～1500 mg/d. The clinical efficacy evaluation was carried out 1 month after the treatment； the frequency of epilepsy was compared between the two groups of patients， and the neuropsychological examination results were comp