摘要
目的:探讨丙戊酸钠与草酸艾司西酞普兰联合治疗特发性癫痫合并抑郁的临床疗效和安全性。方法:将本院收治的68例特发性癫痫合并抑郁患者随机分为两组,每组各34例,对照组给予丙戊酸钠联合西酞普兰治疗,观察组给予丙戊酸钠联合草酸艾司西酞普兰治疗,对比两组临床疗效,记录两组患者治疗前及治疗1、3、6个月的汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分,并监测患者用药前后血脂指标和甲状腺功能指标。结果:观察组完全控制率和治疗总有效率分别为58. 82%、97. 06%,均显著高于对照组的41. 18%、82. 35%(P <0. 05);两组治疗1、3、6个月的HAMD评分和HAMA评分均较治疗前显著降低,且观察组低于对照组(P <0. 05);两组治疗后的总胆固醇、甘油三脂和低密度脂蛋白胆固醇水平均较治疗前显著上升(P <0. 05),组间比较无显著差异(P> 0. 05);两组治疗后促甲状腺激素水平较治疗前显著上升(P <0. 05),游离甲状腺素4水平显著下降(P <0. 05),组间比较无显著差异(P>0. 05)。结论:丙戊酸钠与草酸艾司西酞普兰联合治疗特发性癫痫合并抑郁疗效确切,可显著改善患者焦虑、抑郁情绪,但长期使用丙戊酸钠会干扰血脂代谢,影响甲状腺激素水平,因此,在治疗时还应该加强对患者血脂的监测。
Objective： To investigate the clinical efficacy and safety of sodium valproate combined with escitalopram oxalate in the treatment of idiopathic epilepsy combined with depression. Methods： 68 cases of idiopathic epilepsy combined with depression in our hospital were randomly divided into two groups（ 34 cases in each group）,the control group was treated with sodium valproate combined with citalopram,the observation group was given sodium valproate combined with escitalopram oxalate. The two groups of clinical curative effect,scores of Hamilton depression scale（ HAMD） and Hamilton anxiety scale（ HAMA） pre-treatment,treatment for one month,treatment for two months and six months were compared,and the lipid indicators and thyroid function indicators of patients before and after treatment were monitored. Results： The complete control rate and the total effective rate of the observation group were 58. 82% and 97. 06%,respectively,which were significantly higher than those of the control group（ 41. 18% and 82. 35%）（ P〈0. 05）; The HAMD scores and HAMA scores of the two groups after treatment were significantly lower than those before treatment,and which in the observation group were lower than those in the control group（ P〈0. 05）; The levels of TG,TC and LDL-C in both groups after treatment were significantly higher than those before treatment（ P〈0. 05）,and there was no significant difference between the two groups（ P〉0. 05）; The TSH levels of the two groups after treatment were significantly higher than those before treatment（ P〈0. 05）,FT4 level was significantly lower than before treatment（ P〈0. 05）,but there was no significant difference between the two groups（ P〈0. 05）. Conclusion： Sodium valproate combined with escitalopram oxalate in the treatment of idiopathic epilepsy combined with depression is effective and which can significantly improve anxiety and depression in patients,but long-term use of sodium valproate will interfere with lipid metabolism,affect thyroid hormone levels,therefore,the blood lipid monitoring of patients in the treatment should be strengthened.
作者
陈洁
葛梦娜
CHEN Jie;GE Mengna(The No.101 Hospital of People＇s Liberation Army,Wuxi 214000,China)
出处
《现代医学》
2018年第9期997-1002,共6页
Modern Medical Journal
