孟庆林 苗爱亮 李俊 张慧敏

【摘要】 目的：探讨拉莫三嗪联合丙戊酸钠治疗初诊癫痫的临床效果。方法：选取本院2016年

3月-2020年12月初诊癫痫患者60例，采用随机数字表法分为对照组（n=30）和观察组（n=30）。对照组给予丙戊酸钠治疗，观察组给予拉莫三嗪联合丙戊酸钠治疗。两组均持续治疗6个月，观察两组临床治疗效果、治疗前后细胞因子肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、白细胞介素-Iβ（interleukin-Iβ，IL-Iβ）、白细胞介素-6（interleukin-6，IL-6）水平及不良反應的发生情况。结果：观察组治疗总有效率为96.67%，高于对照组的73.33%，差异有统计学意义（P<0.05）。治疗前，两组间血清TNF-α、IL-Iβ及IL-6水平比较，差异均无统计学意义（P>0.05）;治疗后，两组血清TNF-α、IL-Iβ、IL-6水平均低于治疗前，且观察组各细胞因子水平均低于对照组，差异均有统计学意义（P<0.05）。两组治疗期间的不良反应发生率比较，差异无统计学意义（P>0.05）。结论：拉莫三嗪联合丙戊酸钠治疗初诊癫痫临床效果确切，安全性较好，在临床治疗中值得借鉴。

【关键词】 癫痫 拉莫三嗪 丙戊酸钠 细胞因子

Clinical Efficacy of Lamotrigine Combined with Sodium Valproate in the Treatment of Newly Diagnosed Epilepsy/MENG Qinglin， MIAO Ailiang， LI Jun， ZHANG Huimin. //Medical Innovation of China， 2021， 18（34）： 089-093

[Abstract] Objective： To evaluate the clinical efficacy of Lamotrigine combined with Sodium Valproate in the treatment of newly diagnosed epilepsy. Method： A total of 60 newly diagnosed epilepsy patients in our hospital from March 2016 to December 2020 were selected and randomly divided into control group （n=30） and observation group （n=30）. The control group was treated with Sodium Valproate， and the observation group was treated with Lamotrigine combined with Sodium Valproate. Both groups were treated continuously for 6 months. Clinical efficacy， cytokine levels [tumor necrosis factor-α （TNF-α）， interleukin-Iβ （IL-Iβ）， interleukin-6 （IL-6）] and adverse reactions of the two groups were observed. Result： The total effective rate of the observation group was 96.67%， which was higher than 73.33% of the control group， the difference between two groups was statistically significant （P<0.05）. Before treatment， there were no significant differences in the levels of TNF-α， IL-Iβ and IL-6 between the two groups （P>0.05）. After treatment， the levels of serum TNF-α， IL-Iβ and IL-6 in two groups were lower than those before treatment， and the levels of cytokines in the observation group were significantly lower than those in the control group （P<0.05）. There was no significant difference in the incidence of adverse reactions during treatment between two groups （P>0.05）. Conclusion： Lamotrigine combined with Sodium Valproate is effective and safe in the treatment of newly diagnosed epilepsy. It is worthy of reference in clinical treatment.

[Key words] Epilepsy Lamotrigine Sodium Valproate Cytokine

First-author’s address： Suqian First People’s Hospital， Suqian 223800， China

doi：10.3969/j.issn.1674-4985.2021.34.021

癫痫是神经系统常见疾病之一，流行病学显示，我国癫痫患病率约为5‰，年发病率为（50～70）/

10万，目前我国有900万以上的癫痫患者，每年新发患者（65～70）万[1-3]。癫痫发病机制复杂，临床发作有突发性、反复性等特点，能够迁延数年甚至终生，对患者的生活和健康产生严重影响。有研究认为，对初次诊断的癫痫患者首选单药治疗[4-5];也有学者认为，新诊断的癫痫患者可以联合治疗，提出合理且适量的不同作用机制的联合用药可能产生更为显著的临床疗效，在不增加不良反应的同时提高疗效[6-7]。……