卡马西平、托吡酯联合左乙拉西坦治疗创伤性难治性癫痫

目的探讨卡马西平、托吡酯联合左乙拉西坦治疗创伤性难治性癫痫的临床效果。方法选取我院2009年1月-2013年2月期间收治创伤性难治性癫痫患者180例为研究对象进行分析，按数字随机表法分为对照组、观察组1、观察组2，常规外科治疗基础上分别采用卡马西平＋托吡酯、卡马西平＋托吡酯＋左乙拉西坦、左乙拉西坦药物治疗方案，对比治疗前后其癫痫发作次数、持续时间及不良反应。结果观察组1总有效率93．33％显著高于观察组2的81．67％、对照组的78．33％，差异有统计学意义（x2=5．23，5．67，P〈0．05），观察组2与对照组无显著性差异（P〉0．05）；治疗后3组患者癫痫发作率均显著降低，观察组1效果最为显著（P〈0．05），观察组2与对照组无显著性差异（P〉0．05）；3组患者不良反应对比无显著性差异（P〉0．05），未加重神经功能抑制等副作用。结论卡马西平、托吡酯联合左乙拉西坦治疗创伤性难治性癫痫能显著提高疗效，降低癫痫发作次数，安全性好，是创伤性难治性癫痫的有益选择。

The combined use of carbamazepine,topiramate and levetiracetam in treating traumatic intractable epilepsy

Objective To study the combined use of carbamazepine, topiramate and levetiracetam in trea- ting traumatic intractable epilepsy. Methods A total of 180 patients with traumatic intractable epilepsy from Jun. 2009 to Feb. 2013 were randomly divided into control group and observation group 1, group 2 （60 cases in each group ）. Patients in the control group were given carbamazepine and topiramate;patients in the observation group 1 were treated with carbamazepine, topiramate and levetiracetam; and patients in the observation group 2 were given levetiracetam alone. The epileptic seizure frequency, duration, and adverse reactions of the three groups before and after the treatment were compared and the curative effect was evaluated. Results The total effective rate of the ob- servation group 1 was 93.33% （ 56/60 ） , significantly higher than the 81.67% of the observation group 2 （ 49/60 ） and 78.33% （47/60） of the control group ,with a statistically significant difference （X2 = 5.23,5.67, P 〈 0.05 ） ; while there was no significant difference between the observation group 2 and the control group （ P 〉 0.05 ）. The ep- ilepsy seizure frequency of the three groups after treatment was significantly lower than before treatment （ P 〈 0.05 ） , which was significantly lower in the observation group 1 than the control group and the observation group 2 （ P 〈 0. 05 ） , and had no significant difference between the observation group 2 and the control group （ P 〉 0.05 ）. The ad- verse reaction of the observation group 1, the observation group 2 and the control group was 21.67% （13/60） , 15% （ 9/60 ） , and 16.67% （ 10/60 ） , respectively, indicating no statistically significant difference among the three groups （ P 〉 0.05 ）. Conclusion The combined use of carbamazepine, topiramate and levetiracetam in treating traumatic intractable epilepsy can significantly improve the curative effect, reduce the number of epileptic seizures and have good security. This treatment method can be a useful therapeutic option for the traumatic intractable epilepsy.