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目的探讨奥卡西平(OXC)联合用药治疗儿童癫的疗效、剂量及药物安全性。方法收集在本院神经内科门诊就诊的41例癫患儿。男23例,女18例;就诊年龄6个月～15岁,平均7.70岁;病程15 d～5 a,平均9个月;随访时间6个月～6 a,平均2 a 6个月。简单局限性发作(SPS)3例,复杂局限性发作(CPS)8例,局限性发作继发全面性发作(sGTCS)14例,SPS和sGTCS 2种类型均有12例,CPS和sGTCS均有4例。根据应用OXC的先后顺序分为A组与B组:A组为开始应用一种非OXC抗癫药治疗,因疗效不好,在原用药剂量不变的情况下加用OXC;B组为首选OXC治疗后因仍有发作加用其他抗癫药物。回顾性分析41例OXC联合用药治疗癫患儿的临床资料,评估其疗效、药物不良反应及患儿的耐受性。结果 A组29例,经OXC添加治疗完全控制发作者占48.3%,发作频率减少≥50%(即总有效率)82.7%;OXC所用剂量为(26.70±6.75)mg.kg-1.d-1。其中12例成功转换为OXC单药治疗,10例单药治疗无发作。B组OXC加小剂量硝西泮药物组合治疗,发作频率减少均≥50%,疗效最高。对发作类型比较,OXC对各种局限性发作类型发作频率减少均≥50%。本研究中8例(19.5%)出现OXC相关药物不良反应,依次为困倦3例,皮疹2例,视物不清、无症状血钠减低和膝关节痛各1例,分别经缓慢加量、略减量或未进行任何处理,上述症状自行消失。结论 OXC联合用药治疗癫疗效高而稳定,耐药性小,安全性高,是适合于长期应用的新型高效抗癫药物之一。
Objective To investigate the efficacy, dosage and drug safety of oxcarbazepine (OXC) in combination with drugs for the treatment of children with epilepsy. Methods A total of 41 cases of epilepsy were collected in our department of neurology clinic. There were 23 males and 18 females. The treatment ages ranged from 6 months to 15 years (average 7.70 years). The course of disease ranged from 15 days to 5 years (range, 9 months). The follow-up time ranged from 6 months to 6 years (average 2 months and 6 months). There were 3 cases of simple and limited episodes (SPS), 8 cases of complicated and limited episodes (CPS), 14 cases of localized total secondary attacks (sGTCS), 12 cases of SPS and sGTCS, 12 cases of both CPS and sGTCS 4 cases. According to the order of application of OXC is divided into A group and B group: A group to begin the application of a non-OXC anti-epileptic drug treatment, due to ineffective, with the same dosage unchanged OXC; B group is preferred OXC treatment because there are still seizures plus other anti-epileptic drugs. A retrospective analysis of 41 cases of OXC combined treatment of epilepsy in children with clinical data to assess its efficacy, adverse drug reactions and children with tolerance. Results In group A, 29 cases were treated with OXC and 48.3% of them were completely controlled. The frequency of seizures was reduced by ≥50% (ie, the total effective rate was 82.7%). The dosage of OXC was (26.70 ± 6.75) mg.kg-1.d- 1. Of these, 12 were successfully converted to OXC monotherapy and 10 to monotherapy. B group OXC plus a small dose of nitrazepam drug combination therapy, seizure frequency reduction ≥ 50%, the highest efficacy. OXC compared to seizure types of various types of localized seizure frequency reduction were ≥ 50%. In this study, 8 patients (19.5%) had adverse reactions of OXC-related drugs, including 3 cases of drowsiness, 2 cases of rash, 1 case of blurred vision, asymptomatic hyponatremia and 1 case of knee joint pain. Slightly reduced or without any treatment, the symptoms disappear on their own. Conclusion OXC combination therapy for the treatment of epilepsy with high efficacy and stability, low drug resistance, high safety, is suitable for long-term use of new and highly effective antiepileptic drugs.