摘要
目的探讨托吡酯(TPM)联合苯妥英钠(DPH)对难治性癫痫(RE)患者的疗效。方法依照治疗方法将驻马店市第二人民医院收治的74例RE患者分为观察组、对照组,各37例。对照组接受DPH治疗,观察组于对照组基础上加用TPM。两组持续用药3个月。比较两组治疗效果、脑电图参数、炎症因子水平、神经因子水平、蒙特利尔认知评估量表(MoCA)评分及癫痫生活质量量表-31(QOLIE-31)评分。结果观察组总有效率较对照组高(P<0.05)。治疗后两组β频段、δ频段、α频段、θ频段数量减少,且观察组少于对照组(P<0.05)。治疗后两组高迁移率族蛋白1、核转录因子、C反应蛋白、肿瘤坏死因子、胶质纤维酸性蛋白、髓鞘碱性蛋白水平降低,且观察组低于对照组,5-羟色胺、多巴胺水平上升,且观察组高于对照组(P<0.05);治疗后两组MoCA、QOLIE-31评分升高,且观察组高于对照组(P<0.05)。结论TPM与DPH联合能提高RE治疗效果,有效减轻患者炎症反应,抑制脑电活动,有助于改善患者认知功能及生活质量。
Objective To investigate the effects of topiramate(TPM)combined with diphenylhydantoin(DPH)in patients with refractory epilepsy(RE).Methods Seventy-four patients with RE admitted to Zhumadian Second People’s Hospital were divided into an observation group and a control group according to treatment methods,with 37 cases in each group.The control group was treated with DPH,and the observation group was treated with TPM on the basis of the control group.The treatment effect,electroencephalogram parameters,inflammatory mediator levels,neurological factors levels,Montreal cognitive assessment(MoCA)score and quality of life in epilepsy scale-31(QOLIE-31)score were compared between the two groups.Results The total effective rate in observation group was higher than that in control group(P<0.05).After treatment,the number ofβ-band,δ-band,α-band andθ-band decreased in both groups,and above index in observation group were less than those in control group(P<0.05).After treatment,the levels of high mobility group box 1,nuclear transcription factor,C-reactive protein,tumor necrosis factor-α,glial fibrillary acidic protein and myelin basic protein decreased in both groups,and above index in observation group were less than those in control group,and the levels of 5-hydroxytryptamine and dopamine increased in both groups,and above index in observation group were higher than those in control group(P<0.05).The MoCA and QOLIE-31 scores increased in both groups after treatment,and the scores in observation group were higher than those in control group(P<0.05).Conclusion The combination of TPM and DPH can improve the effect of RE,effectively reduce patients’inflammatory response and suppress EEG activity,and help improve patients’cognitive function and quality of life.
作者
周继锋
高松寅
梁新生
ZHOU Jifeng;GAO Songyin;LIANG Xinsheng(Emergency Department,Zhumadian Second People’s Hospital,Zhumadian 463000,China;Department of Psychiatry,Zhumadian Second People’s Hospital,Zhumadian 463000,China;Department of Neurology,Zhumadian Second People’s Hospital,Zhumadian 463000,China)
出处
《河南医学研究》
CAS
2022年第17期3177-3180,共4页
Henan Medical Research
关键词
难治性癫痫
苯妥英钠
托吡酯
炎症反应
脑电图参数
refractory epilepsy
diphenylhydantoin
topiramate
inflammatory response
electroencephalographic parameters
