丙戊酸钠、卡马西平单一及联合用药对额叶癫痫患者高级脑功能的影响

摘要

目的 研究丙戊酸钠、卡马西平单一及联合用药对额叶癫痫患者高级脑功能的影响.方法 选择2012年3月至2014年9月来本院就诊的90例额叶癫痫患者为研究对象,随机分为三组,每组30例.观察组丙戊酸钠联合卡马西平治疗,对照1组丙戊酸钠治疗,对照2组卡马西平治疗.治疗结束后随访1年,观察治疗效果、患者脑功能状态及不良反应发生情况.结果观察组治疗总有效率为90％,显著高于其他两组,差异均具有统计学意义(P＜0.05).治疗后,观察组蒙特利尔认知能力(MoCA)、简易智能精神状态(MMSE)、中国修订韦氏成人智力(WAIS-RC)及汉密尔顿抑郁(HAMD)评分分别为(25.84±4.02)分、(29.52±0.32)分、(84.87±5.35)分及(6.85±1.01)分,与其他两组比较,差异具有统计学意义(P＜0.05).三组不良反应发生率比较,差异无统计学意义(P＞0.05).结论丙戊酸钠联合卡马西平治疗额叶癫痫效果显著,有助于改善癫痫患者脑功能,与单一治疗方案相比,并不显著增加不良反应发生率.%Objective To study the influence of valproate,carbamazepine,or the combination of these two on the higher-level brain functions in patients with frontal lobe epilepsy.Methods 90 patients with frontal lobe epilepsy treated at our hospital from March,2012 to September,2014 were selected as study objects and were randomly divided into three groups,30 cases for each group.The observation group were treated with valproate and carbamazepine,the control group 1 valproate,and the control group 2 carbamazepine.After the treatment,the patients were followed up for 1 year and the curative effect,the patients' brain function state,and the incidence of adverse reactions were observed.Results The total effective rate was 90％ in the observation group,which was significantly higher than those in the other two groups,with statistical differences (P ＜ 0.05).After the treatment,the scores of Montreal cognitive ability (MoCA),mental state (MMSE),China revised Wechsler adult intelligence (WAIS RC),and Hamilton depression (HAMD) were (25.84±4.02),(29.52±0.32),(84.87±5.35),and (6.85±1.01)in the observation group,with statistical differences from those in the other two groups (P ＜ 0.05).There were no statistical differences in the incidence of adverse reactions between these three groups (P ＞ 0.05).Conclusions Valproate combined with carbamazepine in the treatment of frontal lobe epilepsy can achieve remarkable curative effect and improve brain function in patients with epilepsy and does not significantly increase the incidence of adverse reactions.