丙戊酸钠联合拉莫三嗪治疗癫痫疗效及安全性的Meta分析

发布时间：2018-03-03 23:37

本文选题：癫痫　切入点：丙戊酸　出处：《中国全科医学》2017年29期 　论文类型：期刊论文

【摘要】：目的系统评价丙戊酸钠(VPA)联合拉莫三嗪(LTG)治疗癫痫的总有效率及不良反应,为临床癫痫的联合用药提供循证医学证据。方法 2015年12月,计算机检索PubMed、Cochrane Library、EMBase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)中收录的VPA联合LTG治疗癫痫疗效和安全性的随机对照试验,提取第一作者、发表时间、样本量、患者年龄、用药、疗程、癫痫类型、观察指标等资料,并采用改良的Jadad量表评价纳入文献的方法学质量。结果共纳入16篇文献,15篇中文文献,1篇英文文献,1 687例患者。分配方案的隐藏、盲法、选择性报道存在未知风险,纳入文献方法学质量较低。Meta分析显示,VPA联合LTG治疗癫痫的总有效率高于单用VPA[比值比(OR)=5.76,95%CI(3.78,8.78),P0.001]或LTG[OR=2.80,95%CI(1.83,4.28),P0.001],神经系统[危险差(RD)=-0.04,95%CI(-0.06,-0.02),P=0.002]、消化系统[RD=-0.05,95%CI(-0.08,-0.02)]、血液系统[RD=-0.03,95%CI(-0.05,-0.01),P=0.040]、皮肤附件[RD=-0.04,95%CI(-0.06,-0.01),P=0.008]不良反应发生率低于单用VPA或LTG。结论 VPA联合LTG治疗癫痫的临床疗效优于单用VPA或LTG,且耐受性好。受纳入文献方法学质量限制,该结论有待大样本、高质量的随机对照试验进一步证实。
[Abstract]:Objective to systematically evaluate the total effective rate and adverse reactions of valproate sodium valproate combined with lamotriazine LTG in the treatment of epilepsy, and to provide evidence-based medical evidence for the combined use of valproate and lamotriazine in the treatment of epilepsy. Methods December 2015. To search for the efficacy and safety of VPA combined with LTG in the efficacy and safety of VPA in epileptic patients, the authors were searched by computer in PubMedan Cochrane Library EMBase and Wanfang data knowledge Service platform, Wipl.com, CNKI, China Biomedical Literature Database (CBM). Time of publication, sample size, patient age, medication, course of treatment, type of epilepsy, observation index, etc. The modified Jadad scale was used to evaluate the methodological quality of the literature included. Results there were 16 articles, 15 Chinese articles and 1 English document in 1 687 patients. The hidden, blind and selective report of the allocation scheme had unknown risks. The total effective rate of VPA combined with LTG in the treatment of epilepsy was lower. Meta analysis showed that the total effective rate was higher than that of VPA alone [the ratio was higher than OR5.76CI3.78CI8.78P0.001] or LTG [OR2.8095CI1.83CI1.83.28P0.001], the nervous system [dangerous difference RDD-95CI-0.04CI-0.02CI-0.02CI-0.02P0.002], the digestive system [RD-0.0595CI-0.08CI-0.02], the blood system [RD-0.0395CI-0.05CI-0.05CI-0.05CI-0.08CI-0.040], the skin attachment [RD-0.04CI-0.06CI-0.08CI-0.02]. Conclusion the clinical efficacy of VPA combined with LTG in the treatment of epilepsy is better than that of VPA or LTG alone. This conclusion needs to be further confirmed by a large sample and a high-quality randomized controlled trial.
【作者单位】：石河子大学药学院;石河子大学医学院第一附属医院;
【分类号】：R742.1

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