癫痫宁片应用于脑卒中继发癫痫的临床治疗体会

摘要

目的：观察在基础抗癫痫药外联合使用癫痫宁片对脑卒中继发癫痫的临床疗效。方法：将2010年11月～2013年12月我院神经内科收治的脑卒中患者873例（脑梗死629例，脑出血244例）中继发癫痫患者76例纳入研究。将76例患者完全随机分为对照组和观察组，每组38例。两组患者均给予相同的基础治疗（卡马西平或丙戊酸钠），观察组在基础治疗的基础上加用癫痫宁片。随访6个月。观察记录脑卒中继发性癫痫的发生时间。以癫痫发作频率及次数进行疗效判定，比较两组的疗效，观察不良反应。结果：脑卒中后继发性癫痫发生率为8．71％，脑出血继发癫痫发生率显著高于脑梗死继发癫痫发生率（P＜0．05）。早发性癫痫发生率为67．1％，显著高于迟发性癫痫的发生率32．9％（P＜0．05）。观察组疗效等级显著高于对照组（Z＝2．977，P＜0．01）。观察组总有效率为97．4％，显著高于对照组的84.2％（P＜0．05）。两组不良反应发生率无差异（P＞0．05）。结论：在基础抗癫痫药外早期联合使用癫痫宁片可更好的提高临床疗效，从而可能对脑卒中的预后起到积极作用，值得临床推广。%Objective:To observe the clinical efficacy of Dianxianning tablets on the basis of antiepileptic drugs.Meth-ods:From November 2010 to December 2013, 76 cases of stroke-epilepsy patients chosen from 873 cases of stroke pa-tients who were in the neurology department of our hospital were studied(629 cases of cerebral infarction, 244 cases of cerebral hemorrhage) .The 76 patients were randomly divided into a control group and an observation group,with 38 ca-ses in each group.Both groups were given the same basic treatment ( carbamazepine or valproate) , and the observation group was treated by Dianxianning tablets on the basis of basic therapy.The patients were followed up for 6 months.Ob-serve and record the occurring time of stroke secondary epilepsy.Seizure frequency and times determined the efficacy, and the efficacy and adverse reactions in the two groups were observed.Results:The incidence of secondary epilepsy af-ter stroke was 8.71%, and the incidence of cerebral hemorrhage epilepsy was significantly higher than the incidence of cerebral infarction ( P<0.05) .Early-onset epilepsy incidence was 67.1%, which was significantly higher than the incidence of late-onset epilepsy 32.9%(P<0.05).The efficacy grade in the observation group was significantly bet-ter than that in the control group (Z=2.977,P<0.01).In the observation group, the total effective rate was 97.4%, which was significantly higher than the 84.2%in control group (P<0.05).The incidence of adverse reactions in two groups had no difference (P>0.05).Conclusion:Dianxianning tablets used for treating stroke-epilepsy patients on the basis of antiepileptic drugs can better improve the clinical efficacy, which may play a positive role in the prognosis of stroke and is worthy of promotion.