标题：生酮饮食添加治疗儿童难治性癫痫疗效观察

      作者：杨洋 1，王春晖 1，兰莉 1，王琳 2    1.空军军医大学第二附属医院儿科，陕西 西安 710038；2.长安医院新生儿科，陕西 西安 710016

      卷次： 2020年31卷15期

      【摘要】 目的 探讨生酮饮食(KD)在儿童难治性癫痫治疗中的应用效果。方法 选取空军军医大学第二附属医院儿科2017年12月至2019年5月收治的45例难治性癫痫患儿作为观察组，另选取30例难治性癫痫患儿作为对照组，对照组仅给予常规治疗，观察组在对照组基础上添加KD治疗，比较两组患儿治疗6个月后的临床发作控制有效率，大运动、精细动作、适应性、语言、个人-社交五大功能区发育商以及脑电图改变情况。结果 观察组患儿癫痫发作控制有效率为95.6%，明显高于对照组的73.3%，差异有统计学意义(P<0.05)；两组患儿治疗前各功能区发育商比较差异均无统计学意义(P>0.05)；治疗6个月后，观察组患儿的各功能区发育商明显提高，差异均有统计学意义(P<0.05)，而对照组患儿仅在大运动、语言、个人-社交方面的发育商较治疗前明显提高，差异均有统计学意义(P<0.05)，但在适应性、精细动作方面未见明显改变，差异无统计学意义(P>0.05)；观察组患儿治疗后的各功能区发育商明显高于对照组，差异均有统计学意义(P<0.05)；观察组患儿脑电图癫痫波、痉挛发作脑电图控制有效率分别为91.1%、88.9%，明显高于对照组的73.3%、66.7%，差异均有统计学意义(P<0.05)。结论 KD用于儿童难治性癫痫的临床治疗可明显提高临床控制有效率，同时改善患儿各功能区的发育商，并有效改善其脑电图表现，值得临床推广。
      【关键词】 生酮饮食；儿童；难治性癫痫；临床效果；临床控制
      【中图分类号】 R729 【文献标识码】 A 【文章编号】 1003—6350（2020）15—1975—04

Clinical effect of ketogenic diet on children with intractable epilepsy.
YANG Yang 1, WANG Chun-hui 1, LAN Li 1,WANG Lin 2. 1. Department of Pediatrics, Second Affiliated Hospital of PLA Military Medical University, Xi'an 710038,Shaanxi, CHINA; 2. Neonatal Department, Chang'an Hospital, Xi'an 710016, Shaanxi, CHINA
【Abstract】 Objective To discuss the clinical effects of ketogenic diet (KD) on children with intractable epilep-sy. Methods Forty-five children with intractable epilepsy from Second Affiliated Hospital of PLA Military MedicalUniversity during December 2017 to May 2019 were divided into the observation group, and 30 children with intractableepilepsy were divided into the control group. The control group was given conventional therapy, and the observationgroup was given KD based on the control group. Then the effective rate of clinical attack control, the developmental quo-tient of big movement, fine movement, adaptability, language and individual social interaction, and the change of EEGwere compared between the two groups after 6 months. Results The effective rate of epilepsy control in the observa-tion group was 95.6%, significantly higher than 73.3% in the control group (P<0.05). There was no statistically signifi-cant difference between the two groups before treatment in the development quotient of each functional area (P>0.05).After the treatment for 6 months, the development quotient of each functional area in the observation group was signifi-cantly improved (P<0.05). In the control group, the developmental quotient of sports, language and personal social as-pects was significantly higher than that of the former (P<0.05). There was no significant change in adaptability andfine movement (P>0.05). At the same time, the development quotient of each functional area in the observation groupwas significantly higher than that in the control group 6 months after the treatment (P<0.05). The effective rate of EEGepileptic wave and spasm control of EEG in the observation group was 91.1% and 88.9%, respectively, which were sig-nificantly higher than those in the control group (73.3% and 66.7%), with statistically significant difference (P<0.05).Conclusion KD can significantly improve the clinical control efficiency, development quotient of all functional areas,the quality of life, the EEG performance in the clinical treatment of children with intractable epilepsy, which is worthpromoting.
      【Key words】 Ketogenic diet; Children; Intractable epilepsy; Clinical effect; Clinical control