| 摘要: |
| 目的:系统评价拉莫三嗪联合丙戊酸钠治疗小儿癫痫的安全性和疗效。方法:检索中国生物医学数据库(CBM)、维普、
中国知网、万方、PubMed、EMBase、the Cochrane Library、Web of Science 等数据库,检索时限为建库至2023 年2 月。筛选有关丙
戊酸钠和拉莫三嗪治疗小儿癫痫的随机对照试验(RCT),对照组给予丙戊酸钠常规治疗,试验组在对照组的基础上联用拉莫三
嗪治疗。结果:共纳入22 项研究进行Meta 分析,结果显示,试验组患儿治愈率(OR=2. 47,95%CI 1. 62~3. 77,P<0. 01)、显效率
(OR=2. 06,95%CI 1. 57~2. 70,P<0. 01)、总有效率(OR=3. 96,95%CI 2. 80~5. 61,P<0. 01)高于对照组,差异均有统计学意义。
不良反应发生率(OR=0. 53,95%CI 0. 40~0. 71,P<0. 01)、治疗后癫痫发作频率(MD=-2. 91,95%CI -4. 01~ -1. 80,P<0. 01)、
超敏C 反应蛋白(hs-CRP)水平(MD=-4. 02,95%CI -4. 30~-3. 74,P<0. 01)、肿瘤坏死因子-α(TNF-α)水平(MD=-26. 47,95%
CI -27. 21~-25. 74,P<0. 01)、同型半胱氨酸(Hcy)水平(MD=-5. 09,95%CI -5. 37~ -4. 80,P<0. 01) 低于对照组,差异均有统
计学意义。结论:丙戊酸钠联合拉莫三嗪治疗小儿癫痫在治愈率、显效率、总有效率方面均显著优于单独使用丙戊酸钠,可明显
降低不良反应发生率、治疗后癫痫发作频率以及hs-CRP、TNF-α、Hcy 水平。 |
| 关键词: 拉莫三嗪 丙戊酸钠 小儿癫痫 疗效 安全性 Meta 分析 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2024.04.012 |
|
| 基金项目: |
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| Meta-Analysis on Efficacy and Safety of Lamotrigine Combined with Sodium Valproate in the Treatment ofEpilepsy in Children |
| Meng Xuefang, Liang Qian, Wei Yingxiu |
| ((Wuming Hospital of Guangxi Medical University, Nanning 530199, China)) |
| Abstract: |
| Objective: To systematically review the safety and efficacy of lamotrigine combined with sodium valproate in the treatment of
epilepsy in children. Methods: China Biology Medicine (CBM), VIP, CNKI, Wanfang, PubMed, EMBase, the Cochrane Library and
Web of Science databases were retrieved, the retrieval time was from the establishment of the database to Feb. 2023. Randomized
controlled trials (RCT) of sodium valproate and lamotrigine in the treatment of epilepsy in children were screened. The control group
received conventional treatment with sodium valproate, while the experimental group was given lamotrigine on the basis of control group.
Results: A total of 22 RCT were included for Meta-analysis. Results showed that cure rate (OR= 2. 47, 95%CI from 1. 62 to 3. 77,
P<0. 01), significant effective rate (OR=2. 06, 95%CI from 1. 57 to 2. 70, P<0. 01), total effective rate (OR= 3. 96, 95%CI from
2. 80 to 5. 61, P<0. 01) in the experimental group were significantly higher than those in the control group, with statistically significant
differences. The incidence of averse drug reactions (OR=0. 53, 95%CI from 0. 40 to 0. 71, P<0. 01), epileptic seizure frequency after
treatment (MD=-2. 91, 95%CI from -4. 01 to -1. 80), P<0. 01), levels of hypersensitive C-reactive protein (hs-CRP, MD=-4. 02,
95%CI from -4. 30 to -3. 74, P<0. 01), levels of tumor necrosis factor-α (TNF-α, MD=-26. 47, 95%CI from -27. 21 to -25. 74,
P<0. 01), levels of homocysteine (Hcy, MD = -5. 09, 95%CI from -5. 37 to -4. 80, P <0. 01) in the experimental group were
significantly lower than those in the control group, with statistically significant differences. Conclusion: Lamotrigine combined with
sodium valproate in the treatment of epilepsy in children is significantly better than sodium valproate alone in terms of cure rate,
significant effective rate and total effective rate, and could significantly reduce the incidence of adverse drug reactions, epileptic seizure
frequency after treatment and levels of hs-CRP, TNF-α and Hcy. |
| Key words: Lamotrigine sodium valproate children with epilepsy efficacy safety Meta-analysis |
