拉莫三嗪治疗儿童及青少年失神性癫痫的系统评价

目的 系统评价拉莫三嗪治疗儿童及青少年失神性癫痫的疗效和安全性。方法 通过PubMed、The Cochrane Library、EMbase、维普、万方、CBM和CNKI数据库进行检索,检索时限均为从建库至2014年8月,收集拉莫三嗪治疗儿童及青少年失神性癫痫的临床试验资料。由两位研究者按照纳入与排除标准,独立进行文献筛选、资料提取,评价纳入研究的方法学质量,采用RevMan 5.2软件进行荟萃分析。结果 共纳入7项研究,721例患儿。纳入研究文献质量评价结果是,A级2篇,B级3篇,C级2篇。荟萃分析结果显示:拉莫三嗪单药治疗儿童及青少年失神癫痫疗效优于安慰剂,但弱于丙戊酸和乙琥胺。拉莫三嗪常见不良反应发生率与丙戊酸、乙琥胺无显著性差异。结论 拉莫三嗪单药治疗儿童及青少年失神性癫痫的疗效确切,耐受良好。对于使用丙戊酸或乙琥胺不耐受的患者来说,拉莫三嗪是一种较好的选择。

Lamotrigine for absence seizures in children and adolescents: a systematic review

Objective To assess the efficacy and safety of lamotrigine for absence seizures in children and adolescents. Methods Databases of PubMed, the Cochrane Library, EMbase, CENTRAL, VIP, WanFang, CBM and CNKI were electronically searched till August, 2014 for clinical trials on lamotrigine for absence seizures in children and adolescents. All literature were screened by two reviewers independently according to the inclusion and exclusion criteria.The data was extracted, and the methodological quality was assessed. Then, meta-analysis was performed using RevMan 5.2. Results Seven trials were included involving a total of 721 patients. The Results of methodological qualities were two studies rated as A-class, three studies rated as B-class and two studies rated as C-class. Meta-analysis Results showed that the efficacy of lamotrigine monotherapy for absence seizure in children and adolescents was better than placebo, but efficacy of lamotrigine was lower than valproic acid and ethosuximide. The adverse reaction rates of lamotrigine were with no significant difference compared with valproic acid and ethosuximide. Conclusion Lamotrigine monotherapy was effective for absence seizures in children and adolescents and was well tolerated. Lamotrigine was a good choice for patients that are intolerable to valproic acid or ethosuximide.