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目的探讨添加-更换拉莫三嗪联合丙戊酸治疗丙戊酸治疗无效的癫痫患者的临床疗效。方法选取遂宁市中心医院神经内科2014年1月—2015年1月收治的丙戊酸治疗无效的癫痫病患者103例,根据治疗方法不同分为对照组50例和观察组53例。对照组患者直接改为单独服用拉莫三嗪;观察组患者给予拉莫三嗪进行添加-替换治疗;两组患者均持续治疗6个月。观察比较两组患者的临床疗效、拉莫三嗪血药浓度及不良反应发生情况。结果观察组患者治疗总有效率高于对照组,拉莫三嗪血药浓度高于对照组,且不良反应发生率低于对照组(P<0.05)。结论采用添加-更换拉莫三嗪联合丙戊酸治疗丙戊酸治疗无效的癫痫的临床疗效确切,可有效减少患者疾病发作次数和发作时间,且血药浓度高,不良反应少。
Objective To investigate the clinical efficacy of adding-replacing lamotrigine and valproic acid in the treatment of valproic acid-refractory epilepsy patients. Methods 103 cases of epilepsy patients with valproic acid ineffective treatment were selected from Department of Neurology, Suining Central Hospital from January 2014 to January 2015, and divided into control group (n = 50) and observation group (n = 53) according to different treatment methods. Patients in the control group were switched to taking lamotrigine alone; patients in the observation group were given lamotrigine for addition-replacement therapy; and both groups were treated for 6 months. The clinical efficacy, lamotrigine concentration and adverse reactions in the two groups were observed and compared. Results The total effective rate of observation group was higher than that of control group. The blood concentration of lamotrigine was higher than that of control group, and the incidence of adverse reactions was lower than that of control group (P <0.05). Conclusions The clinical efficacy of adding-replacing lamotrigine and valproic acid in the treatment of valproic acid is effective in treating epilepsy. It can effectively reduce the number of patients’ seizures and the onset time, and has high plasma concentration and few adverse reactions.