托吡酯、卡马西平与丙戊酸钠治疗脑炎继发癫痫的疗效比较  

Clinical Efficacy of Topiramate, Carbamazepine and Sodium Valproate in the Treatment of Epilepsy Secondary to Encephalitis

作　　者：袁婕[1] 陈丹[2] 李红[3] 张虹[1] 于叔麒[1] 

机构地区：[1]陕西省人民医院神经内一科,陕西西安710068 [2]重庆医科大学附属第一医院神经外科,重庆400042 [3]西安体育学院健康科学系运动医学教研室,陕西西安710068

出　　处：《现代生物医学进展》2017年第25期4956-4958,4989,共4页Progress in Modern Biomedicine

摘　　要：目的:观察和比较托吡酯、卡马西平与丙戊酸钠对治疗脑炎继发癫痫的临床疗效及安全性。方法:选择2013年1月~2015年9月在我院进行诊治的脑炎继发癫痫患者80例,随机分为托吡酯组、卡马西平组和丙戊酸钠组,分别采用托吡酯、卡马西平与丙戊酸钠治疗,比较三组的治疗有效率、执行能力与视空间、命名、抽象、注意、定向、语言以及延迟回忆等认知功能评分及不良反应的发生情况。结果:托吡酯组的有效率最高,为80.65%(25/31),卡马西平组的有效率最低,为70.00%(21/30),但三组间有效率相比差异无统计学意义(P>0.05)。治疗后,托吡酯组患者的执行能力与视空间、命名、抽象、注意、定向、语言以及延迟回忆等认知功能评分均明显高于卡马西平组和丙戊酸钠组(P<0.05);托吡酯组的不良反应发生率(12.90%)明显低于卡马西平组(36.67%)和丙戊酸钠组的(29.62%)(P<0.05)。结论:托吡酯、卡马西平以及丙戊酸钠治疗脑炎继发癫痫疗效相当,但托吡酯对患者认知功能损害最小,安全性最高。Objective：To observe and compare the clinical curative effect and safety of topiramate,carbamazepine and sodium valproate on the epilepsy secondary to encephalitis.Methods：80 cases of patients with epilepsy secondary to encephalitis who were treated in our hospital from January 2010 to September 2015 were selected and divided into the topiramate group,carbamazepine group and sodium valproate group,which were treated with topiramate,carbamazepine and sodium valproate respectively.The treatment effect,congnitive scores （including executive function and visual space,name,language,abstract,attention,delayed memory,directional）,adverse reaction rate of three groups were compared.Results：The effective rate oftopiramate group was the highest（80.65%,25/31）,carbamazepine was the lowest （70.00%,21/30）,but there was no significant difference between the three groups （P〉0.05）.After treatment,the scores of executive ability and visual spatial,naming,abstraction,attention,orientation,language in topiramate group were significantly higher than those of carbamazepine group and sodium valproate group （P〈0.05）;the incidence of adverse reactions of topiramate group was 12.90%,which was significantly lower than that of carbamazepine group （36.67%） and sodium valproate group （29.62%）（P 〈 0.05）.Conclusions：Topiramate,carbamazepine and sodium valproate have equal therapeutic effect on epilepsy secondary to encephalitis,but topiramate had less adverse reactions and best safety.

关 键 词：托吡酯 卡马西平 丙戊酸钠 脑炎继发癫痫 认知功能 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R512.3[医药卫生—临床医学]