生酮饮食联合抗癫痫药物对难治性癫痫的疗效评价  

Evaluation of curative effect of Ketogenic diet combined with antiepileptic drugs on refractory epilepsy

作　　者：吴春风[1] 金波[1] 卢孝鹏[1] 梁超[1] 

机构地区：[1]南京医科大学附属南京儿童医院神经内科,210008

出　　处：《临床神经病学杂志》2016年第5期326-328,共3页Journal of Clinical Neurology

基　　金：南京市卫生局课题(YKK14121)

摘　　要：目的评价生酮饮食(KD)联合抗癫痫药物对难治性癫痫的疗效。方法对77例难治性癫痫患者在原有药物不变的基础上添加KD治疗3个月。观察癫痫临床发作频率的改变,判断疗效。比较有效组和无效组患者的临床资料,分析影响KD疗效的因素。结果在KD治疗后,完全控制16例(20.8%),显著有效14例(18.2%),有效12例(15.6%),无效35例(45.5%);KD添加治疗的总有效率为54.5%,保留率为76.6%。KD添加治疗无效组合用药物种类、智能障碍比例及睡眠障碍比例均明显高于有效组;而痉挛发作比例则明显低于有效组(均P<0.05)。结论 KD联合抗癫痫药物治疗难治性癫痫总体有效,尤其是痉挛发作类;对伴有智能障碍、睡眠障碍及合用药物种类偏多者疗效欠佳。Objective To evaluate the curative effect of Ketogenic diet（ KD） combined with antiepileptic drugs on refractory epilepsy（ RE）. Methods Seventy-seven RE patients were treated with KD and antiepileptic drugs for 3months. The changes of clinical epilepsy seizure frequency were observed,and judged the curative effect. The clinical data of patients with effective group and invalid group were compared,and the influence factors of curative effect were analyzed. Results After the KD therapy,there were 16 cases（ 20. 8%） with complete control,14 cases（ 18. 2%） with significantly effective,12 cases（ 15. 6%） with effective,35 cases（ 45. 5%） with invalid; the effective rate was 54. 5% and the retention rate was 76. 6%. The number of combined drugs and the rates of mental retardation and sleep disorders in invalid group were significantly higher than effective group,but the rate of spasms was significantly lower than effective group（ all P〈0. 05）. Conclusions KD combined with antiepileptic drugs is effective for RE patients,especially for spasm type. The curative effect is not very good for patients with mental retardation,sleep disorder or more combined drugs.

关 键 词：生酮饮食 难治性癫痫 疗效 

分 类 号：R742.1[医药卫生—神经病学与精神病学]