摘要
目的探讨托吡酯联合卡马西平治疗小儿癫痫的临床效果。方法选取2012年5月至2018年5月安阳地区医院收治的106例癫痫患儿,参照密封信封法的随机分配法将入选患儿分为对照组和观察组,每组53例。对照组给予卡马西平,观察组在对照组治疗基础上加予托吡酯治疗,评估两组患儿的临床疗效,观察两组患儿治疗前和治疗后1、3、6个月的癫痫发作次数,对比两组患儿治疗前及治疗后6个月的脑电波背景活动和血清生化指标,评价两组患儿的药物安全性。结果观察组临床总有效率(92.45%,49/53)高于对照组(75.47%,40/53),P<0.05。治疗后1、3、6个月,两组患儿的癫痫发作次数逐渐减少(P<0.05),组内不同时间点比较差异有统计学意义(P<0.05),且均少于治疗前(P<0.05),观察组少于对照组(P<0.05)。治疗后,两组患儿的α波减少>0.5 Hz发生率、θ波增加率及δ波增加率提高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,两组患儿的血清神经肽Y(NPY)、甘丙肽(GAL)、脑源性神经生长因子(BDNF)水平降低(P<0.05),且观察组变化幅度大于对照组(P<0.05)。观察组不良反应总发生率为15.09%(8/53),对照组为13.21%(7/53),两组比较差异未见统计学意义(P>0.05)。结论托吡酯联合卡马西平治疗小儿癫痫疗效显著,能明显减少癫痫发作次数,改善其脑电波背景活动,有效降低血清NPY、GAL及BDNF水平,药物不良反应少,临床应用安全性高。
Objective To investigate the efficacy of topiramate combined with carbamazepine on pediatric epilepsy.Methods A total of 106 children with epilepsy admitted to Anyang District Hospital from May 2012 to May 2018 were selected.And they were divided into control group and observation group according to random distribution method of sealed envelope method,with 53 cases in each group.Children in the control group were treated with carbamazepine,while children in the observation group were treated with topiramate based on the treatment of the control group.The clinical efficacy was evaluated in the two groups.The frequency of epilepsy seizure in the two groups was observed before treatment and 1,3 and 6 months after treatment.And the brain wave background activity and serum biochemical parameters before treatment and 6 months after treatment were compared between the two groups.Meanwhile,the drug safety was evaluated in the two groups.Results The total clinical effective rate in observation groups(92.45%,49/53)was significantly higher than that in the control group(75.47%,40/53),P<0.05.After 1,3 and 6 months of treatment,the frequencies of epilepsy seizure of the two groups decreased gradually(P<0.05),and the difference at different time points within groups was statistically significant(P<0.05).The postoperative frequencies in the two groups were significantly lower than preoperative frequencies(P<0.05).And the observation group had less onset times than control group(P<0.05).After treatment,the incidence ofαwave reduction>0.5 Hz,increase rate ofθwave and increase rate ofδwave were significantly promoted in the two groups(P<0.05),and these indexes in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the levels of serum neuropeptide Y(NPY),galanin(GAL),brain-derived nerve growth factor(BDNF)were significantly decreased in the two groups(P<0.05),and the changes in the observation group were significantly larger than those in the control group(P<0.05).The total inc
作者
张军利
郭爱萍
陈丹
Zhang Junli;Guo Aiping;Chen Dan(Department of Pediatrics,Anyang District Hospital,Anyang 455000,China)
出处
《中国实用医刊》
2020年第9期92-96,共5页
Chinese Journal of Practical Medicine
关键词
小儿癫痫
托吡酯
卡马西平
脑电图
Pediatric epilepsy
Topiramate
Carbamazepine
Electroencephalogram
