生酮饮食对儿童难治性癫痫疗效与安全性的Meta分析  

Meta⁃analysis of efficacy and safety of ketogenic diet for children with drug resistant epilepsy

作　　者：孙琴 郝金斗 周启新 董国庆 SUN Qin;HAO Jindou;ZHOU Qixin(Department of Pediatrics,Affiliated Shenzhen Maternity&Child Healthcare Hospital,Southern Medical University,Shenzhen 518028,China)

机构地区：[1]南方医科大学附属深圳妇幼保健院儿科,深圳518028

出　　处：《临床神经病学杂志》2023年第4期300-304,共5页Journal of Clinical Neurology

基　　金：深圳市三名工程项目(SZSM201812056)。

摘　　要：目的系统评价生酮饮食(KD)治疗儿童难治性癫痫的有效率和不良反应。方法检索PubMed、Cochrane Library、中国知网、万方数据库、维普中文科技期刊数据库,检索时限自建库至2021年6月30日,纳入KD治疗儿童癫痫的随机对照研究文献。采用Review Manager 5.4软件对符合纳入标准的临床研究进行Meta分析。结果最终纳入14篇随机对照研究,包含1080例病例。KD组癫痫控制发作有效率显著高于对照组(RR=2.13,95%CI:1.46~3.11,P<0.05)。经典KD组与改良Atkins生酮饮食(MAD)组的癫痫控制有效率(RR=1.21,95%CI:0.95~1.53,P=0.12)及不良反应率(RR=1.11,95%CI:0.81~1.53,P=0.52)差异无统计学意义。结论KD可提高难治性癫痫患儿的治疗有效率,是难治性癫痫的重要手段之一,经典KD和MAD的疗效和不良反应相当。Objective To systematically evaluate the efficacy and adverse reactions of ketogenic diet(KD)in the treatment of drug resistant epilepsy in children.Methods PubMed,Cochrane Library,CNKI,Wanfang Database and VIP Chinese Science and Technology Journal Database were searched from inception to June 30,2021 to collect randomized controlled trials(RCTs)of KD in the treatment of epilepsy in children.Review Manager 5.4 software was used to perform a meta analysis of the included studies.Results Finally,14 RCTs were included,including 1080 cases.The effective rate of seizure control in KD group was significantly higher than that in control group(RR=2.13,95%CI:1.46-3.11,P<0.05).There was no significant difference in the effective rate of epilepsy control(RR=1.21,95%CI:0.95-1.53,P=0.12)and adverse reaction rate(RR=1.11,95%CI:0.81-1.53,P=0.52)between classic KD group and modified Atkins ketogenic diet(MAD)group.Conclusions KD can improve the efficacy in children with drug resistant epilepsy.It’s one of the most important treatments for drug resistant epilepsy.MAD has the same efficacy and side effects as classical KD in the treatment of epilepsy.

关 键 词：生酮饮食 癫痫 疗效 儿童 META分析 

分 类 号：R742.1[医药卫生—神经病学与精神病学]