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目的探讨拉莫三嗪(LTG)单药及联合用药治疗不同类型癫癎发作的疗效。方法选择疗程在6个月以上共130例不同发作类型的癫癎患儿,口服LTG单药或联合用药治疗,年龄5个月~17岁,进行开放性自身对照临床试验。1.单药组LTG初始量:≥12岁者25 mg.d-1,每周递增25 mg.d-1;<12岁者0.5~2.0 mg.kg-1.d-1,每周递增0.5~2.0 mg.kg-1.d-1。2.联合组:原用丙戊酸钠、托吡酯、左乙拉西坦者,起始量:≥12岁者12.5 mg.d-1,每周递增12.5 mg.d-1;<12岁者0.15~0.30 mg.kg-1.d-1,每周递增0.3 mg.kg-1.d-1。原用苯巴比妥、卡马西平、奥卡西平者,起始量:≥12岁者50 mg.d-1,每周递增50 mg.d-1;<12岁者0.15~0.30 mg.kg-1.d-1,每周递增0.3 mg.kg-1.d-1。以上均4~8周达维持量。结果 130例中107例有效控制发作,总有效率达82.31%,其中62例完全控制发作;单药组和联合组疗效比较差异无统计学意义(P>0.05)。出现不良反应14例,其中皮疹9例,嗜睡、头痛、头晕、食欲减少、烦躁各1例。结论 LTG是一种广谱、高效、安全的抗癫癎药物,无论单药或者联合用药治疗均有较好疗效。
Objective To investigate the efficacy of lamotrigine (LTG) monotherapy and combination therapy in treating different types of epileptic seizures. Methods A total of 130 epilepsy children with different seizure types over 6 months were enrolled in this study. Patients undergoing oral LTG alone or combined with drugs were treated with open-label self-controlled clinical trials of 5 months to 17 years old. 1. Monotherapy group initial amount of LTG: ≥12 years old 25 mg.d-1, weekly increase of 25 mg.d-1; <12 years old 0.5 ~ 2.0 mg.kg-1.d-1, increasing weekly 0.5 ~ 2.0 mg.kg-1.d-1.2. Combined group: the original sodium valproate, topiramate, levetiracetam, the initial amount: ≥12 years old 12.5 mg.d-1, each Weekly increase of 12.5 mg.d-1; 0.15 ~ 0.30 mg.kg-1.d-1 of <12 years old, increasing 0.3 mg.kg-1.d-1 weekly. The original use of phenobarbital, carbamazepine, oxcarbazepine, the initial amount: ≥ 12 years old 50 mg.d-1, weekly increase of 50 mg.d-1; <12 years old 0.15 ~ 0.30 mg. kg-1.d-1, increasing 0.3 mg.kg-1.d-1 every week. Above 4 to 8 weeks up to maintain the amount. Results Of the 130 cases, 107 cases were effectively controlled. The total effective rate was 82.31%, of which 62 cases were completely controlled. There was no significant difference between the single drug group and the combined group (P> 0.05). Adverse reactions occurred in 14 cases, of which 9 cases of rash, drowsiness, headache, dizziness, loss of appetite, irritability in 1 case. Conclusion LTG is a broad-spectrum, efficient and safe anti-epileptic drug, which has a good curative effect both in single-drug treatment and in combination therapy.