摘要
目的:系统评价拉莫三嗪联合丙戊酸钠治疗癫痫的临床疗效与安全性。方法:通过计算机检索PubMed、the Cochrane Library、Embase、中国知网、万方数据库和维普数据库,检索建库至2021年1月发表的拉莫三嗪联合丙戊酸钠治疗癫痫的随机对照研究文献(研究组患者服用拉莫三嗪联合丙戊酸钠,对照组患者服用丙戊酸钠),采用改良Jadad评分表进行文献质量评价,提取有效率、癫痫发作频率、癫痫发作时间以及超敏C反应蛋白水平为参数,应用RevMan 5.3软件进行荟萃分析(Meta分析)、敏感性分析及发表偏倚检测。结果:共纳入18篇符合标准的随机对照研究文献,总病例数为1430例(研究组713例,对照组717例)。Meta分析结果显示,两组患者的总有效率(OR=3.90,95%CI=2.85~5.33,Z=8.51,P<0.00001)、癫痫发作持续时间(MD=-3.27,95%CI=-3.59~-2.95,Z=20.16,P<0.00001)、癫痫发作频率(MD=-1.82,95%CI=-2.21~-1.43,Z=9.17,P<0.00001)和超敏C反应蛋白水平(MD=-3.79,95%CI=-4.05~-3.53,Z=28.65,P<0.00001)比较,差异均有统计学意义,研究组患者上述指标水平明显优于对照组;研究组患者的不良反应发生情况明显比对照组少,差异有统计学意义(OR=0.45,95%CI=0.33~0.62,Z=4.99,P<0.00001)。结论:拉莫三嗪联合丙戊酸钠治疗癫痫的综合疗效以及不良反应发生情况优于单独使用丙戊酸钠治疗,且在减少癫痫发作频率、缩短癫痫发作持续时间和降低超敏C反应蛋白水平方面的效果明显优于单独使用丙戊酸钠治疗。
OBJECTIVE:To systematically evaluate the clinical efficacy and safety of lamotrigine combined with sodium valproate in the treatment of seizure.METHODS:PubMed,the Cochrane Library,Embase,CNKI,Wanfang database and VIP database were retrieved to collect the randomized controlled trials of lamotrigine combined with sodium valproate in the treatment of seizure(the study group was treated with lamotrigine combined with sodium valproate,while the control group received sodium valproate).The retrieval time was from the establishment of the database to Jan.2021.The modified Jadad scale was used to evaluate the quality of the literature,efficiency,seizure frequency,seizure duration and high-sensitivity C-reactive protein levels were extracted as the parameters.Meta-analysis,sensitivity analysis and publication bias test were performed by using RevMan 5.3 software.RESULTS:A total of 18 randomized controlled trials that met the criteria were included in the literature,with a total of 1430 cases(713 in the study group and 717 in the control group).Meta-analysis results showed that the differences of total effective rate(OR=3.90,95%CI=2.85-5.33,Z=8.51,P<0.00001)and seizure duration(MD=-3.27,95%CI=-3.59--2.95,Z=20.16,P<0.00001),seizure frequency(MD=-1.82,95%CI=-2.21--1.43,Z=9.17,P<0.00001)and high-sensitivity C-reactive protein level(MD=-3.79,95%CI=-4.05--3.53,Z=28.65,P<0.00001)in two groups were statistically significant,and the levels of above indicators in the study group were significantly better than those in the control group.The incidence of adverse drug reactions in the study group was lower than that in the control group,and the difference was statistically significant(OR=0.45,95%CI=0.33-0.62,Z=4.99,P<0.00001).CONCLUSIONS:Lamotrigine combined with sodium valproate in the treatment of seizure is better than valproate alone in the comprehensive efficacy and adverse drug reactions,and significantly better than that of valproate alone in reducing seizure frequency,shortening seizure duration,and lowering hypersensitive C-
作者
王卓媛
黄颖
苟小军
郭思思
WANG Zhuoyuan;HUANG Ying;Gou Xiaojun;Guo Sisi(School of Pharmacy,Shaanxi University of Traditional Chinese Medicine,Shaanxi Xianyang 712046,China;Dept of Neurology,Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201999,China;Experimental Research Center,China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《中国医院用药评价与分析》
2021年第11期1371-1376,共6页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
北京市自然科学基金项目(No.7192142)。
关键词
拉莫三嗪
丙戊酸钠
癫痫
系统评价
Lamotrigine
Sodium valproate
Seizure
Systematic review
