目的 探讨拉莫三嗪联合丙戊酸钠治疗脑卒中继发性癫痫的效果。方法 脑卒中继发性癫痫患者98例按照随机数字表法分为治疗组与对照组各49例,两组都给予脑卒中常规治疗,对照组予口服丙戊酸钠,治疗组在此基础上予拉莫三嗪。记录发作情况、发作次数及每次持续时间,监测药物不良反应。治疗期间每月随访1次,复查血、尿常规,血电解质,血脂,肝肾功能等。结果 治疗后治疗组的总有效率为95.8%,对照组为76.6%,治疗组的总有效率明显高于对照组(P<0.05)。治疗后两组的癫痫发作次数以及持续时间有明显下降,与治疗前对比差异明显(P<0.05);同时治疗后治疗组的癫痫发作次数以及持续时间也明显少于对照组(P<0.05)。治疗后1年,两组脑电图有痫样放电及累及导联数减少,组内及组间差异均有统计学意义(P<0.05)。治疗期间治疗组的皮疹、感觉异常、胃肠道反应等不良反应的总发生率与对照组比较,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脑卒中继发性癫痫能提高治疗效果,促进癫痫症状的消失,不良反应少,值得推广应用。

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.