目的:探讨坦度螺酮联合奥卡西平对癫痫合并焦虑抑郁患者的症状改善,以及对患者血清5-HT1A受体及额叶皮质水平的影响。方法:癫痫合并焦虑、抑郁患者80例随机分为对照组和观察组各40例,对照组常规给予奥卡西平片治疗;观察组在对照组基础上加用坦度螺酮胶囊治疗。治疗8周后,比较两组患者治疗前后汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、血清5-HT1A受体水平、额叶皮质水平及药品不良反应发生率。结果:治疗8周后,两组患者HAMA、HAMD评分均较治疗前明显降低(P<0.05),且观察组显著低于对照组(P<0.05)。两组男、女患者血清5-HT1A水平均较治疗前明显升高(P<0.05),且观察组男、女患者血清5-HT1A水平均高于对照组(P<0.05)。对照组患者左额叶谷氨酸复合物(Glx)/肌酸(Cr)治疗前后比较差异无统计学意义(P>0.05),其他指标治疗前后比较差异均有统计学意义(P<0.05);观察组患者各项指标治疗前后比较差异均有统计学意义(P<0.05)。且治疗后对照组患者左额叶Glx/Cr、胆碱复合物(Cho)/Cr及右额叶Cho/Cr、N-乙酰天门冬氨酸(NAA)/Cr水平低于观察组,右额叶Glx/Cr及左额叶NAA/Cr水平高于观察组(P<0.05)。两组药品不良反应发生率比较,差异无统计学意义(P>0.05)。结论:坦度螺酮联合奥卡西平对癫痫合并焦虑抑郁患者疗效肯定,安全性高,能有效改善患者血清5-HT1A受体及额叶皮质水平,减轻焦虑及抑郁症状,提高患者生活质量。 Objective: To investigate the clinical effects of tandospirone combined with oxcarbazepine on the symptoms of epilepsy with anxiety and depression, as well as the effects on serum 5-HT1A receptor and frontal cortex. Methods: 80 cases of epilepsy with anxiety and depression were randomly divided into control group and observation group of 40 cases. The control group was given oxcarbazepine tablets routinely. The observation group was treated with tandospirone capsules on the basis of the control group. After 8 weeks of treatment, Hamilton Anxiety Scale (HAMA), Hamilton Depression Rating Scale (HAMD), serum 5-HT1A receptor level, frontal cortex level and adverse drug reactions were compared before and after treatment. Results: After 8 weeks of treatment, HAMA and HAMD scores of both groups were significantly lower than those before treatment (P <0.05), and the observation group was significantly lower than the control group (P <0.05). The levels of serum 5-HT1A in both groups were significantly higher than those before treatment (P <0.05), and the levels of serum 5-HT1A in the male and female patients in the observation group were significantly higher than those in the control group (P <0.05). There were no significant differences in Glx / Cr before and after treatment in the control group (P> 0.05). The other indexes had statistical significance before and after treatment (P <0.05). The observation group patients with various indicators before and after treatment were statistically significant differences (P <0.05). After treatment, the levels of Glx / Cr, Cho / Cr and Cho / Cr and NAA / Cr in the left frontal lobe in the control group were lower than those in the observation group The levels of Glx / Cr and NAA / Cr in the left frontal lobe were higher than those in the observation group (P <0.05). There was no significant difference between the two groups in the incidence of adverse drug reactions (P> 0.05). Conclusion: Tandospirone combined with oxcarbazepine has certain effect on patients with epilepsy and anxiety and depression. It has high safety and can effectively improve the level of serum 5-HT1A receptor and frontal cortex, relieve the anxiety and depression, and improve the quality of life.