标题：拉莫三嗪、奥卡西平分别联合丙戊酸镁缓释片治疗小儿癫痫的疗效比较

      作者：陈润莹，洪岩，陈先平    安康市中医医院儿科，陕西 安康 725000

      卷次： 2019年30卷19期

      【摘要】 目的 比较拉莫三嗪、奥卡西平分别联合丙戊酸镁缓释片治疗小儿癫痫的疗效。方法 选取2017年11月至 2018年 11月安康市中医医院儿科收治的 94例癫痫患儿作为研究对象，按简单随机数字法分为两组各 47例，其中LTG组患儿给予拉莫三嗪联合丙戊酸镁缓释片治疗，OXC组患儿给予奥卡西平联合丙戊酸镁缓释片治疗，疗程均为32周；比较两组患儿的治疗效果及治疗期间的不良反应，采用韦氏儿童智力量表第四版(WISC-Ⅳ)评分量表评估患者治疗前后的认知能力并进行比较。结果 LTG组患儿的治疗总有效率为 95.74%，与OXC组的93.62%比较差异无统计学意义(P>0.05)；LTG组患儿治疗期间的不良反应总发生率为 6.38%，明显低于OXC组的21.28%，差异有统计学意义(P<0.05)；LTG组患儿治疗前后的WISC-Ⅳ评分中的各项评分比较差异均无统计学意义(P>0.05)，而治疗后OXC组患儿WISC-Ⅳ评分中的言语理解、直觉推理、工作记忆、加工速度、总智商评分明显低于其治疗前的评分，且治疗后，OXC组患儿的言语理解、直觉推理、工作记忆、加工速度、总智商评分均明显低于LTG组，差异均有统计学意义(P<0.05)。结论 拉莫三嗪或奥卡西平联合丙戊酸镁缓释片治疗小儿癫痫均具有较好疗效，但在安全性和对患儿的认知能力上，拉莫三嗪联合丙戊酸镁缓释片优于奥卡西平联合丙戊酸镁缓释。
      【关键词】 癫痫；小儿癫痫；拉莫三嗪；奥卡西平；丙戊酸镁缓释片；疗效；认知能力
      【中图分类号】 R729 【文献标识码】 A 【文章编号】 1003—6350（2019）19—2528—04

Comparison of the efficacy of lamotrigine and oxcarbazepine combined with magnesium valproatesustained-release tablets in the treatment of pediatric epilepsy.
CHEN Run-ying, HONG Yan, CHEN Xian-ping.Department of Pediatrics, Ankang Hospital of Traditional Chinese Medicine, Ankang 725000, Shaanxi, CHINA
【Abstract】 Objective To compare the efficacy of lamotrigine and oxcarbazepine combined with magnesiumvalproate sustained-release tablets in the treatment of pediatric epilepsy. Methods A total of 94 children with epilepsyadmitted to the Department of Pediatrics at Ankang Hospital of Traditional Chinese Medicine from November 2017 toNovember 2018 were selected as subjects. They were divided into two groups according to the simple random numbermethod, with 47 cases in each group. Among them, children in the LTG group were treated with lamotrigine combinedwith magnesium valproate sustained-release tablets, and those in the OXC group were treated with oxcarbazepine com-bined with magnesium valproate sustained-release tablets; both groups were treated for 32 weeks. The efficacy and ad-verse reactions during treatment were compared between the two groups. The Wechsler Intelligence Scale for Chil-dren-fourth edition (WISC-IV) was used to assess and compare the cognitive ability of patients before and after treat-ment. Results The total effective rate of children in the LTG group was 95.74%, which was not statistically significantcompared with 93.62% in the OXC group (P>0.05). The total incidence of adverse reactions during treatment in the LTGgroup was 6.38%, which was significantly lower than 21.28% in the OXC group (P<0.05). There was no significant dif-ference in the WISC-IV scores of children before and after treatment in the LTG group (P>0.05). The scores of speechcomprehension, intuitive reasoning, working memory, processing speed and total intelligence quotient in the OXC groupwere significantly lower after treatment than before treatment; and those scores were significantly lower in the OXCgroup than in the LTG group (all P<0.05). Conclusion Lamotrigine or oxcarbazepine combined with magnesium val-proate sustained-release tablets are effective in the treatment of pediatric epilepsy, but lamotrigine combined with magne-sium valproate sustained-release tablets is superior to oxcarbazepine combined with magnesium valproate sustained-re-lease tablets in the safety and cognitive ability of children.
      【Key words】 Epilepsy; Pediatric epilepsy; Lamotrigine; Oxcarbazepine; Magnesium valproate sustained-releasetablets; Efficacy; Cognitive ability