ObjectiveTo explore clinical curative effects of lamotrigine combined with or replacing alproic acid in treatment of epileptic patients, for whom the single treatment of alproic acid is ineffective.Methods 51 epileptic patients with ineffective single treatment of valproic acid who were admitted to our hospital from July 2011 to July 2011 were selected as research objects and they were allocated to two groups according to clinical data. 19 patients were in the lamotrigine single medication group and 32 patients were in the lamotrigine combined with alproic acid medication group. Condition control and adverse drug reactions of epileptic patients were observed in the treatment process.ResultsBy observation, it was found that disease condition of 51 epileptic patients who received combine treatment of lamotrigine and alproic acid was better. Among whom, disease conditions of 20 patients were totally controlled accounting for 47%, 8 patients got effective treatment accounting for 25%, 14 patients got ineffective treatment accounting for 12%. And the total effective rate was 28 cases accounting for 87%. 19 patients were received single lamotrigine treatment. Among whom, disease conditions of 9 patients were totally controlled accounting for 60%, 3 patients got effective treatment accounting for 15%, 7 patients got ineffective treatment accounting for 36%. And the total effective rate was 12 cases accounting for 63%. By comparison, disease control rate, the total effective rate, effective rate and ineffective rate of patients receiving single lamotrigine treatment and combine treatment of lamotrigine and alproic acid had certain differences. And the differences of drug treatment of two groups were statistically significant(P<0.05). Conclusion Epileptic patients, for whom the single treatment of alproic acid is ineffective receive single lamotrigine treatment or combine treatment of lamotrigine and alproic acid which can both effectively reduce adverse reactions. It is worthy of clinical application and promotion.%目的：探讨拉莫三嗪添加-替换治疗丙戊酸治疗无效的癫痫患者的临床疗效。方法选取我院2011年7月~2014年7月收治的丙戊酸治疗无效的51例癫痫患者作为研究对象，并根据其临床资料将所有患者分为两组，分别为拉莫三嗪单独用药组19例，拉莫三嗪与丙戊酸联合用药组32例。观察治疗过程癫痫患者病情控制情况及药物不良反应。结果通过观察得知，本次临床研究的51例癫痫患者在结束拉莫三嗪与丙戊酸联合用药治疗后，病发情况有一定好转，其中有20例（60％）病发得到完全控制，8例（25％）有效，4例（12％）无效，总有效28例（87％）；19例患者采用拉莫三嗪进行单药治疗，其中9例（47％）得到完全控制，3例（15％）有效，7例（36％）无效，总有效12例（63％）。通过对比得知，患者采用拉莫三嗪单药治疗与拉莫三嗪和丙戊酸联合治疗无论是控制率、总有效率，还是有效与无效率都存在一定差异，同时两组药物治疗差异有统计学意义（P＜0.05）。结论对丙戊酸治疗无效的癫痫患者采用拉莫三嗪单药或联合丙戊酸的治疗方式能有效减少患者不良反应，同时该治疗方式在临床上也具有一定应用价值与推广作用。
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