网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
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及安全性
作者:陈洁  葛梦娜 
单位:解放军第一零一医院, 江苏 无锡 214000
关键词:丙戊酸钠 抑郁 特发性癫痫 草酸艾司西酞普兰 安全性 
分类号:R742.1;R749.4
出版年·卷·期(页码):2018·37·第九期(997-1002)
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.

参考文献:

[1] 李继,王建军,李烨,等.草酸艾司西酞普兰对脑卒中后抑郁、认知及神经功能的影响[J].河北医科大学学报,2017,38(5):589-592.
[2] LI M,HENG X,TAO R,et al.A genetic epidemiological survey of idiopathic epilepsy in the Chinese Han population[J].Epilepsy Research,2012,98(2/3):199-205.
[3] BONINI F,EGEO G,FATTOUCH J,et al.Natural evolution from idiopathic photosensitive occipital lobe epilepsy to idiopathic generalized epilepsy in an untreated young patient[J].Brain & Development,2014,36(4):346-350.
[4] 韦迪岱,陈晋,郑文明,等.拉莫三嗪与丙戊酸钠对改善颅脑损伤后晚期癫痫疗效的比较[J].重庆医学,2015,33(22):3125-3126.
[5] 夏杰,郑铮,张其梅,等.奥卡西平和丙戊酸钠对癫痫患者血浆同型半胱氨酸和不对称二甲基精氨酸水平的影响[J].重庆医学,2015,21(6):783-784.
[6] 林晓静,杨建波,邹全,等.丙戊酸钠片对老年癫痫患者腺苷酶水平的影响[J].中国老年学杂志,2014,33(19):5349-5350.
[7] 白树新,王德斌,李广玉,等.草酸艾司西酞普兰与盐酸帕罗西汀治疗脑卒中后抑郁的临床对照研究[J].河北医药,2013,35(2):230-231.
[8] 郑学宝,王洪飞,吴新君,等.草酸艾司西酞普兰联合奥氮平治疗老年抑郁症的临床疗效及安全性研究[J].中国临床药理学杂志,2015,23(7):495-497.
[9] 林若庭,洪志林,蔡若蔚,等.丙戊酸钠缓释片治疗老年癫痫患者的临床疗效[J].中国老年学杂志,2015,18(3):612-613.
[10] HEATH R P,ANNE T B,GRAEME D J,et al.Sodium valproate use is associated with reduced parietal lobe thickness and brain volume[J].Neurology,2013,80(20):1895-1900.
[11] 张其梅,夏杰,郑铮,等.丙戊酸钠和卡马西平对癫痫患者血同型半胱氨酸、叶酸、维生素B12水平的影响[J].临床神经病学杂志,2012,25(4):291-292.
[12] WEAAELS A M,JIN Y,POLLOCK B G,et al.Adherence to escitalopram treatment in depression:a study of electronically compiled dosing histories in the ‘Depression:the search for phenotypes’ study[J].International Clinical Psychopharmacology,2012,27(6):291-297.
[13] 潘继英,全传升.草酸艾司西酞普兰治疗脑卒中后抑郁的疗效分析[J].神经疾病与精神卫生,2013,13(4):387-388.
[14] HANASH J A,HANSEN B H,HANSEN J F.et al.Cardiovascular safety of one-year escitalopram therapy in clinically nondepressed patients with acute coronary syndrome:results from the DEpression in Patients with Coronary ARtery Disease (DECARD) trial[J].Journal of Cardiovascular Pharmacology,2012,60(4):397-405.
[15] 严峻,高作惠,龚传鹏,等.喹硫平联合丙戊酸钠对首发性精神分裂症伴有冲动与攻击行为患者兴奋躁动的影响[J].东南大学学报(医学版),2015,34(4):567-571.
[16] 周光,李倩.草酸艾司西酞普兰联合丙戊酸钠治疗特发性癫痫合并抑郁的疗效观察[J].医学综述,2016,22(9):1793-1796.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 729516 位访问者


 ©《现代医学》编辑部
联系电话:025-83272481;83272479
电子邮件: xdyx@pub.seu.edu.cn

苏ICP备09058541