生酮饮食对癫痫患儿的癫痫发作、脑电图及神经行为发育的影响  

Effect of ketogenic diet on seizures,electroencephalogram and neurobehavioral development in children with epilepsy

作　　者：王彦平[1] 闻公灵[1] 温昌明[1] 张保朝[1] 刘义锋[1] 孙军[1] 张义堂[2] Wang Yanping;Wen Gongling;Wen Changming;Zhang Baochao;Liu Yifeng;Sun Jun;Zhang Yitang(Department of Neurology,Nanyang Central Hospital,Nanyang 473009,Henan Province,China;Department of Pediatrics,Nanyang Central Hospital,Nanyang 473009,Henan Province,China)

机构地区：[1]南阳市中心医院神经内科,473009 [2]南阳市中心医院儿科,473009

出　　处：《中华实用儿科临床杂志》2020年第15期1177-1180,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨生酮饮食添加治疗对儿童癫痫发作、脑电图(EEG)变化及神经行为发育的影响。方法收集2016年3月至2019年3月南阳市中心医院诊断的癫痫患儿122例。采用随机数字表法分为观察组和对照组,每组各61例。对照组患儿采用常规治疗,观察组患儿在常规治疗基础上联合生酮饮食。对比2组患儿Gesell发育量表评分,评价癫痫发作控制情况和EEG改善情况。结果观察组患儿癫痫发作控制情况明显优于对照组[78.69%(48/61例)比54.10%(33/61例)],差异有统计学意义(χ2=12.114,P<0.05)。观察组患儿EEG控制情况明显优于对照组[81.97%(50/61例)比55.74%(34/61例)],差异有统计学意义(χ2=13.623,P<0.05)。治疗12个月,观察组患儿的适应性、大运动、精细动作、语言、个人社交5个能区及总发育商评分均明显高于对照组[(56.64±13.29)分比(46.04±12.86)分、(54.84±12.18)分比(47.62±11.91)分、(54.44±10.70)分比(44.31±11.56)分、(51.48±12.99)分比(42.04±11.18)分、(57.88±11.04)分比(47.42±13.16)分、(275.28±54.71)分比(227.42±55.79)分],差异均有统计学意义(t=5.997、5.887、6.003、5.889,6.007、6.010,均P<0.05)。结论生酮饮食可明显减少癫痫患儿的癫痫发作、改善EEG和神经行为发育。Objective To investigate the effects of ketogenic diet on seizures,electroencephalogram(EEG)changes and neurobehavioral development in children diagnosed with epilepsy.Methods A total of 122 children diagnosed with spastic epilepsy in Nanyang Central Hospital from March 2016 to March 2019 were enrolled.The patients were divided into the observation group and the control group,by the computerized random number table method with 61 cases in each group.The children in the control group were treated with conventional therapy,and the children in the observation group were combined with the ketogenic diet on the basis of conventional treatment.The Gesell developmental schedules scale scores were compared between the two groups to evaluate seizure control and EEG improvement.Results The seizure control in the observation group was significantly better than that in the control group[78.69%(48/61 cases)vs.54.10%(33/61 cases)],and the difference was statistically significant(χ2=12.114,P<0.05).The EEG improvement in the observation group was significantly better than that in the control group[81.97%(50/61 cases)vs.55.74%(34/61 cases)],and the difference was statistically significant(χ2=13.623,P<0.05).After 12 months of treatment,the children in the observation group had significantly higher fitness,gross motor,fine motor,language,and personal social,and total development quotient scores than the control group[(56.64±13.29)scores vs.(46.04±12.86)scores,(54.84±12.18)scores vs.(47.62±11.91)scores,(54.44±10.70)scores vs.(44.31±11.56)scores,(51.48±12.99)scores vs.(42.04±11.18)scores,(57.88±11.04)scores vs.(47.42±13.16)scores,(275.28±54.71)scores vs.(227.42±55.79)scores],the differences were statistically significant(t=5.997,5.887,6.003,5.889,6.007,6.010,all P<0.05).Conclusion The ketogenic diet can significantly reduce seizures,improve EEG and neurobehavioral development in children with epilepsy.

关 键 词：癫痫 生酮饮食 脑电图 神经行为发育 

分 类 号：R742.1[医药卫生—神经病学与精神病学]