拉莫三嗪添加治疗对丙戊酸钠治疗无效癫痫患者疗效与安全性的Meta分析  

Meta-analysis of the Efficacy and Safety of Lamotrigine in the Treatment of Patients with Epilepsy Treated with Sodium Valproate

作　　者：智勇刚[1] 张霞 张智慧[1] 张永军[1] ZHI Yong-gang;ZHANG Xia;ZHANG Zhi-hui;ZHANG Yong-jun(Department of Pharmacy, the First Affiliated Hospital of Shihezi University Medical College, Shihezi, Xinjiang, 832008 China;College of Pharmacy, Shihezi University, Shihezi, Xinjiang, 832008 China)

机构地区：[1]石河子大学医学院第一附属医院药剂科,新疆石河子832008 [2]石河子大学药学院,新疆石河子832008

出　　处：《中外医疗》2019年第7期114-117,共4页China & Foreign Medical Treatment

摘　　要：目的系统评价拉莫三嗪添加治疗丙戊酸钠治疗无效癫痫患者的疗效与安全性。方法以"丙戊酸""癫痫""拉莫三嗪"为主题词,检索Pub Med、web of science以及万方数据知识服务平台、维普网、中国知网(CNKI)、中国生物医学文献数据库(CBM),检索年限均从建库至2018年1月。获得拉莫三嗪添加治疗对丙戊酸钠治疗无效癫痫患者的临床随机对照研究,对照组为拉莫三嗪替换治疗,对疗效、安全性、血药浓度进行评价,采用改良后的Jadad量表评价文献的质量,使用RevMan5.3软件进行Meta分析。结果共纳入9篇文献,742例患者。结果显示,拉莫三嗪添加治疗的总有效率明显高于拉莫三嗪替换治疗,差异有统计学意义(P<0.05);皮肤附件、神经系统的不良反应发生率,差异无统计学意义(P>0.05);消化系统不良反应的发生率低于对照组。结论拉莫三嗪添加治疗的临床疗效优于拉莫三嗪替换治疗,不良反应发生率相比拉莫三嗪替换治疗较低。但由于纳入文献的方法学质量较低,该结论有待于大样本,高质量的随机双盲实验进行进一步的验证。Objective To evaluate the efficacy and safety of lamotrigine in the treatment of patients with epilepsy treated with sodium valproate. Methods "Valproic acid""epilepsy""Lamotriazine" as the key words, search Pub Med, web of science and Wanfang data knowledge service platform, Weipu, China Knowledge Network(CNKI), China Biomedicine Literature Database(CBM) has a search period from the establishment of the database to January 2018. A randomized controlled trial of lamotrigine in the treatment of patients with epilepsy treated with sodium valproate was given. The control group was treated with lamotrigine replacement, and the efficacy, safety, and blood concentration were evaluated. The modified Jadad amount was used. The quality of the literature was evaluated and Meta analysis was performed using RevMan 5.3 software.Results A total of 9 articles were included in 742 patients. The results showed that the total effective rate of lamotrigine addition treatment was significantly higher than that of lamotrigine replacement therapy, the difference was statistically significant(P<0.05);the incidence of adverse reactions of skin attachment and nervous system, the difference was not statistically significant(P>0.05). The incidence of adverse reactions in the digestive system was lower than in the control group. Conclusion The clinical efficacy of lamotrigine addition therapy is better than that of lamotrigine replacement therapy. The incidence of adverse reactions is lower than that of lamotrigine replacement therapy. However, due to the low methodological quality of the included literature, this conclusion needs to be further verified by large-scale, high-quality random doubleblind experiments.

关 键 词：拉莫三嗪 丙戊酸钠 癫痫 META分析 

分 类 号：R742.1[医药卫生—神经病学与精神病学]