丙戊酸钠联合生酮饮食治疗癫痫的疗效及安全性评价  

Efficacy and safety evaluation of sodium valproate combined with ketogenic diet in treatment for epilepsy

作　　者：王帆[1] 王莉[1] 刘凯[1] WANG Fan;WANG Li;LIU Kai(Department of Neurology,Children's Hospital Affiliated to Zhengzhou University(Children's Hospital of Henan Province,Children's Hospital of Zhengzhou),Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学附属儿童医院(河南省儿童医院、郑州儿童医院)神经内科,河南郑州450000

出　　处：《中国医学工程》2020年第3期37-39,共3页China Medical Engineering

摘　　要：目的探讨丙戊酸钠联合生酮饮食治疗癫痫的疗效及安全性。方法从该院选出92例癫痫患者,按照随机数字表法将患者分为两组,分别为常规组(n=46)和联合组(n=46),常规组使用丙戊酸钠治疗,在常规组基础上,联合组加用生酮饮食治疗,评估两组患者治疗前后癫痫发作频率和持续时间以及总二氧化碳(TCO2)、尿酸(UA)、丙氨酸转氨酶(ALT)、指尖血酮、天冬氨酸转氨酶(AST)等生化指标,并对疗效和不良反应进行评估。结果治疗后,两组患者癫痫发作频率和持续时间均显著降低,且联合组变化幅度大于常规组;治疗后常规组总有效率65.22%,联合组总有效率84.78%,联合组显著高于常规组(P<0.05);治疗后,两组患者UA和指尖血酮均显著升高(P<0.05),且联合组变化幅度大于常规组(P<0.05),而AST、ALT、TCO2含量组内组间差异均无统计学意义(P>0.05);治疗期间,联合组不良反应4例(8.70%),常规组不良反应5例(10.87%),联合组不良反应发生率低于常规组(P>0.05)。结论丙戊酸钠联合生酮饮食治疗癫痫疗效较好,不良反应发生率较低、值得推介。【Objective】To explore the efficacy and safety of sodium valproate combined with ketogenic diet in the treatment of epilepsy.【Methods】Ninety-two patients with epilepsy were selected from our hospital and were divided into two groups according to the random number table method,including routine group(n=46)and combined group(n=46).Routine group was given sodium valproate,and combined group was treated with ketogenic diet on the basis of routine group.The frequency and duration of epileptic seizures,and biochemical indicators of total carbon dioxide(TCO2),uric acid(UA),alanine aminotransferase(ALT),fingertip blood ketone and aspartate transaminase(AST)were evaluated in the two groups before and after treatment,and the efficacy and adverse reactions were evaluated.【Results】After treatment,the frequency and duration of epileptic seizures were significantly decreased in the two groups,and the changes in combined group were greater than those in routine group.The total effective rate after treatment was 65.22%in routine group and 84.78%in combined group,and the rate in combined group was significantly higher than that in routine group(P<0.05).After treatment,the UA and fingertip blood ketone in the two groups were significantly increased(P<0.05),and the changes in combined group were larger than those in routine group(P<0.05),and there were no significant differences in the AST,ALT and TCO2 within and between the groups(P>0.05).During treatment,there were 4 cases(8.70%)of adverse reactions in combined group and 5 cases(10.87%)in routine group,and the incidence rate of adverse reactions in combined group was lower than that in routine group(P>0.05).【Conclusion】Sodium valproate combined with ketogenic diet has good efficacy and low incidence rate of adverse reactions in the treatment of epilepsy,thus it is worth recommending.

关 键 词：丙戊酸钠 癫痫 生酮饮食 

分 类 号：R742.1[医药卫生—神经病学与精神病学]