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目的观察拉莫三嗪联合丙戊酸钠治疗难治性癫痫部分性发作的临床疗效及安全性。方法将100例癫痫部分性发作患者随机分为对照组50例和试验组50例。对照组予以口服丙戊酸钠0.2 g·d~(-1),qd;试验组在对照组的基础上,加用口服拉莫三嗪,前两周12.5 mg·d~(-1),qd,两周后调整为25 mg·d~(-1),qd,若无用药不适感,增加剂量为100~200 mg·d~(-1)维持治疗。2组患者均需持续用药以保证对病情的控制。比较2组患者的临床疗效、发作频率、治疗后发作期时癫样放电变化和不良反应的发生率。结果治疗3,6个月后,试验组的总有效率均显著高于对照组[82.00%vs 66.00%,92.00%vs 76.00%,P<0.05]。治疗3,6个月后,试验组的发作频率均显著低于对照组[(7.64±1.28)vs(10.39±2.31),(1.98±0.52)vs(6.82±1.14),P<0.05]。治疗3,6个月后,试验组在发作期时癫样放电总减少率均明显低于对照组[78.00%vs 92.00%,64.00%vs 82.00%,P<0.05]。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论拉莫三嗪联合丙戊酸钠治疗难治性癫痫部分性发作的临床疗效显著,可减少癫痫发作频率,且不增加不良反应的发生率。
Objective To observe the clinical efficacy and safety of lamotrigine and valproate in the treatment of partial seizures of refractory epilepsy. Methods One hundred patients with partial epilepsy were randomly divided into control group (50 cases) and experimental group (50 cases). The control group was given sodium valproate 0.2 g · d ~ (-1) qd. On the basis of the control group, the rats in the control group were given oral lamotrigine 12.5 mg · d -1 for the first two weeks, qd, adjusted to 25 mg · d ~ (-1) two weeks later, qd, if no drug discomfort, increase the dose of 100 ~ 200 mg · d ~ (-1) maintenance treatment. 2 groups of patients need continuous medication to ensure that the disease control. The clinical efficacy, frequency of seizures, changes in epileptiform discharges and the incidence of adverse reactions after the treatment were compared between the two groups. Results After 3 and 6 months of treatment, the total effective rate in the experimental group was significantly higher than that in the control group [82.00% vs 66.00%, 92.00% vs 76.00%, P <0.05]. After 3 and 6 months of treatment, the seizure frequency in the experimental group was significantly lower than that in the control group [(7.64 ± 1.28 vs 10.39 ± 2.31, 1.98 ± 0.52 vs 6.82 ± 1.14, P <0.05]. After 3 and 6 months of treatment, the total rate of epileptiform discharge in the experimental group was significantly lower than that in the control group [78.00% vs 92.00%, 64.00% vs 82.00%, P <0.05]. There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion Lamotrigine combined with sodium valproate in treatment of partial seizures of refractory epilepsy has a significant clinical effect, can reduce the frequency of seizures, and does not increase the incidence of adverse reactions.