目的 探討拉莫三嗪聯(lián)合丙戊酸鈉治療腦卒中繼發(fā)性癲癇的效果。方法 腦卒中繼發(fā)性癲癇患者98例按照隨機數(shù)字表法分為治療組與對照組各49例,兩組都給予腦卒中常規(guī)治療,對照組予口服丙戊酸鈉,治療組在此基礎(chǔ)上予拉莫三嗪。記錄發(fā)作情況、發(fā)作次數(shù)及每次持續(xù)時間,監(jiān)測藥物不良反應(yīng)。治療期間每月隨訪1次,復(fù)查血、尿常規(guī),血電解質(zhì),血脂,肝腎功能等。結(jié)果 治療后治療組的總有效率為95.8%,對照組為76.6%,治療組的總有效率明顯高于對照組(P<0.05)。治療后兩組的癲癇發(fā)作次數(shù)以及持續(xù)時間有明顯下降,與治療前對比差異明顯(P<0.05);同時治療后治療組的癲癇發(fā)作次數(shù)以及持續(xù)時間也明顯少于對照組(P<0.05)。治療后1年,兩組腦電圖有癇樣放電及累及導(dǎo)聯(lián)數(shù)減少,組內(nèi)及組間差異均有統(tǒng)計學(xué)意義(P<0.05)。治療期間治療組的皮疹、感覺異常、胃腸道反應(yīng)等不良反應(yīng)的總發(fā)生率與對照組比較,差異無統(tǒng)計學(xué)意義(P>0.05)。結(jié)論 拉莫三嗪聯(lián)合丙戊酸鈉治療腦卒中繼發(fā)性癲癇能提高治療效果,促進癲癇癥狀的消失,不良反應(yīng)少,值得推廣應(yīng)用。

Objective To investigate the efficacy of sodium valproate combined with Lamotrigine in treatment of stoke secondary epilepsy. Methods Patients (98 cases) with stoke secondary epilepsy were randomly divided into treatment (49 cases) and control (49 cases) groups, who were given conventional stoke treatment. The patients in control group were given sodium valproate on oral, and the patients in treatment group were given lamotrigine based on the control group. The onset, seizure frequency, and each duration were recorded, and the drug adverse reactions were monitored. During the following-up treatment once a month, the blood and urine, blood electrolytes, lipids, liver and kidney function were reviewed. Results The total efficacy of treatment group was 95.8%, while the control group was 76.6%, the total efficacy in the treatment was higher than that in the control group (P < 0.05). Compared with pre-treatment, the frequency and duration of seizures of two groups were significant lower (P < 0.05), and the frequency and duration of seizures of treatment group after treatment were obvious lower than that in control group (P < 0.05). After treatment for 1 year, the EEG epileptiform discharges and involving lead numbers were decreased, which had statistical difference within and between groups (P < 0.05). Compared with the control group, the overall incidence of rash, paresthesia, and gastrointestinal reactions in treatment group had no significant difference (P < 0.05). Conclusion Sodium valproate combined with Lamotrigine in treatment of stoke secondary epilepsy could improve the treatment efficacy and promote the epilepsy symptoms disappearing, and the adverse reaction was reduced, which could be worth of promoting.