拉莫三嗪治疗儿童及青少年失神性癫痫的系统评价

田怀平; 高蕙敏; 张金莲; 唐跃年

doi:10.3969/j.issn.1006-0111.2015.03.020

拉莫三嗪治疗儿童及青少年失神性癫痫的系统评价

doi: 10.3969/j.issn.1006-0111.2015.03.020

1.
上海交通大学医学院附属新华医院药学部, 上海 200092
2.
上海中医药大学中药学院2015届学生, 上海 201302

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

1.
Pharmacy of Department, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
2.
Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

摘要: 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。
- 失神癫痫 /
- 失神性癫痫 /
- 拉莫三嗪 /
- 丙戊酸 /
- 乙琥胺 /
- 儿童 /
- 青少年 /
- 系统评价 /
- 荟萃分析
Abstract: 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.
- absence seizures /
- absence epilepsy /
- juvenileabsence epilepsy /
- lamotrigine /
- valproic acid /
- ethosuximide /
- children /
- adolescent /
- systematic review

[1]	Commission on classification and terminology of the international league against epilepsy.Proposal for revised classification of epilepsies and epileptic syndromes[J].Epilepsia,1989,30( 4) :389-399.
[2]	周东, 吴欣桐,刘凌, 等. "国际抗癫痫联盟关于单药治疗癫痫发作及癫痫综合症治疗指南"简介[J].中华神经科杂志, 2007, 40(3):207-209.
[3]	Holmes GL, Frank LM, Sheth RD,et al.Lamotrigine monotherapy for newly diagnosed typical absence seizures in children[J].Epilepsy Res, 2008, 82(2-3):124-132.
[4]	Posner EB, Mohamed KK, Marson AG. Ethosuximide, sodium valproate or lamotrigine for absence seizures in children and adolescents (Review)[J]. Cochrane Library, 2005, 4:CD003032.
[5]	Glauser T,Ben-Menachem E,Bourgeois B, et al.Updated ILAE evidence review of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes[J].Epilepsia, 2013, 54( 3) : 551-563.
[6]	Vanessa Delgado Nunes, Laura Sawyer, Julie Neilson,et al.Guidelines: diagnosis andmanagement of the epilepsies in adults and children: summary of updated NICE guidance[J].BMJ, 2012, 344(7842): e281.
[7]	Higgins JPT, Grenn S. Cochrane handbook for systematic reviews of interventions version 5.1.0[M].London:The Cochrane Collaboration,2011.
[8]	Frank LM, EnlowT, Gregory L, et al.Lamictal (lamotrigine) monotherapy for typical absence seizures in children[J].Epilepsia, 1999, 40(7):973-979.
[9]	Coppola G, Auricchio G, Federico R,et al.Lamotrigine versus valproic acid as first-line monotherapy in newly diagnosed typical absence seizures an open-label, randomized, parallel-group study[J].Epilepsia, 2004, 45(9):1049-1053.
[10]	黄铁栓, 朱金兰, 李冰, 等. 丙戊酸和拉莫三嗪治疗儿童失神癫痫的临床研究[J].中国当代儿科杂志, 2009, 11(8):653-655.
[11]	张言春. 拉莫三嗪治疗儿童失神癫痫的疗效研究[J].中国社区医师, 2012, 27(14):101.
[12]	Glauser TA, Cnaan A, ShinnarS,et al.Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy initial monotherapy outcomes at 12 months[J].Epilepsia, 2013,54(1):141-155.
[13]	范磊, 陈海燕. 乙琥胺与拉莫三嗪治疗儿童失神性癫痫的疗效比较[J].中国现代药物应用, 2013, 7(13):161-162.
[14]	Buoni S, Grosso S,Fois A.Lamotrigine in typical absence epilepsy[J].Brain Devel, 1999, 21 (5):303-306.
[15]	Pressler RM, Binnie CD, Coleshill SG, et al.Effect of lamotrigine on cognition in children with epilepsy[J].Neurology, 2006, 66(10):1495-1499.
[16]	杨米凤, 肖农. 拉莫三嗪单药治疗2~12岁儿童癫痫及其对认知功能影响的研究进展[J].儿科药学杂志, 2014, 20(7):57-60.

[1]	冯志惠, 邓仪卿, 叶冰, 安培, 张宏, 张海军. 雀梅藤石油醚提取物诱导三阴性乳腺癌细胞凋亡的实验研究 . 药学实践与服务, 2024, 42(6): 253-259. doi: 10.12206/j.issn.2097-2024.202311055
[2]	丁华敏, 郭羽晨, 秦春霞, 宋志兵, 孙莉莉. 消风止痒颗粒通过降低白三烯水平对小鼠特应性皮炎急性瘙痒的治疗作用研究 . 药学实践与服务, 2024, 42(5): 211-216. doi: 10.12206/j.issn.2097-2024.202306031
[3]	戴菲菲, 傅翔, 陈琼年, 俞苏纯. 上海某二级医院革兰阴性菌流行特征的回顾性分析 . 药学实践与服务, 2024, 42(): 1-5. doi: 10.12206/j.issn.2097-2024.202305005
[4]	刘依秦, 王超群, 邱娇娜. 胆宁片预处理在糖尿病患者结肠镜检查前的应用效果分析 . 药学实践与服务, 2024, 42(9): 407-410. doi: 10.12206/j.issn.2097-2024.202407037
[5]	瞿文君, 白若楠, 崔力, 周琰. 基于联合库存的公立医院多院区药品采购模式分析 . 药学实践与服务, 2024, 42(7): 315-318. doi: 10.12206/j.issn.2097-2024.202401002
[6]	宋红卫, 王燕, 方铭, 马云鹏, 钟超, 徐一新, 徐峰, 周婷. 2021−2023年我院药品不良反应的特点分析 . 药学实践与服务, 2024, 42(): 1-6. doi: 10.12206/j.issn.2097-2024.202404041
[7]	张晶晶, 索丽娜, 郑兆红. 89例细菌性肝脓肿的临床特征及抗感染治疗分析 . 药学实践与服务, 2024, 42(6): 267-272. doi: 10.12206/j.issn.2097-2024.202302039
[8]	崔晓林, 付晓菲, 杜艳红, 刘娟, 朱茜, 刘子祺. 临床药师参与吉瑞替尼致QTc间期延长的病例分析 . 药学实践与服务, 2024, 42(6): 263-266. doi: 10.12206/j.issn.2097-2024.202309050
[9]	尹小娟, 台力丽, 肖俊峰, 季波. 铜绿假单胞菌合并按蚊伊丽莎白菌肺部感染的病例分析 . 药学实践与服务, 2024, 42(5): 223-226. doi: 10.12206/j.issn.2097-2024.202310042
[10]	姚小静, 计佩影, 陆峰, 施国荣, 傅翔. 表面增强拉曼光谱法快速测定尿液中曲马多的研究 . 药学实践与服务, 2024, 42(): 1-5. doi: 10.12206/j.issn.2097-2024.202401072
[11]	杨嘉宁, 赵一颖, 肖伟. 七味脂肝方对非酒精性脂肪性肝炎动物模型的药效学评价 . 药学实践与服务, 2024, 42(9): 389-398. doi: 10.12206/j.issn.2097-2024.202404096
[12]	宋雨桐, 夏德润, 顾珩, 唐少文, 易洪刚, 沃红梅. 帕博利珠单抗与铂类化疗方案在晚期非小细胞肺癌一线治疗中的药物经济学评价 . 药学实践与服务, 2024, 42(8): 334-340. doi: 10.12206/j.issn.2097-2024.202303023
[13]	张岩, 李炎君, 刘家荟, 邓娇, 原苑, 张敬一. 药物性肝损伤不良反应分析 . 药学实践与服务, 2024, 42(): 1-5. doi: 10.12206/j.issn.2097-2024.202404034
[14]	丁千雪, 尚圣兰, 余梦辰, 余爱荣. 机器学习在肾病综合征患者他克莫司个体化用药中的应用 . 药学实践与服务, 2024, 42(6): 227-230, 243. doi: 10.12206/j.issn.2097-2024.202310007
[15]	王鹏, 陈顺, 赵逸, 高守红, 王志鹏. 卡培他滨致小鼠手足综合征模型的建立及评价 . 药学实践与服务, 2024, 42(9): 385-388, 398. doi: 10.12206/j.issn.2097-2024.202308045
[16]	景凯, 杨慈荣, 张圳, 臧艺蓓, 刘霞. 黄芪甲苷衍生物治疗慢性心力衰竭小鼠的药效评价及作用机制研究 . 药学实践与服务, 2024, 42(5): 190-197. doi: 10.12206/j.issn.2097-2024.202310004
[17]	陈怡君, 王卓, 何苗, 张宇, 田泾. 泌尿系统碎石术抗菌药物预防使用合理管控实践 . 药学实践与服务, 2024, 42(): 1-5. doi: 10.12206/j.issn.2097-2024.202402034
[18]	陈春娟, 郑志新, 李骊. 平喘方联合孟鲁司特钠治疗儿童支气管哮喘患者的临床疗效观察 . 药学实践与服务, 2024, 42(): 1-5. doi: 10.12206/j.issn.2097-2024.202405035
[19]	练鲁英, 刘盈, 殷佳, 诸国樑, 徐飞. 上海某三级公立医院药品管理内部控制评价实践研究 . 药学实践与服务, 2024, 42(): 1-7. doi: 10.12206/j.issn.2097-2024.202402003
[20]	桂明珠, 李静, 李志玲. 儿童伏立康唑的血药浓度与CYP2C19、CYP2C9和CYP3A5基因多态性的相关性研究 . 药学实践与服务, 2024, 42(): 1-5. doi: 10.12206/j.issn.2097-2024.202402020

点击查看大图

计量

文章访问数: 3871
HTML全文浏览量: 301
PDF下载量: 695
被引次数: 0

姓名
邮箱
手机号码
标题
留言内容
验证码

留言板

拉莫三嗪治疗儿童及青少年失神性癫痫的系统评价

doi: 10.3969/j.issn.1006-0111.2015.03.020

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

计量

拉莫三嗪治疗儿童及青少年失神性癫痫的系统评价

doi: 10.3969/j.issn.1006-0111.2015.03.020

1. 上海交通大学医学院附属新华医院药学部, 上海 200092

2. 上海中医药大学中药学院2015届学生, 上海 201302

English Abstract

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

1. Pharmacy of Department, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China

2. Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

全文HTML

目录

留言板

拉莫三嗪治疗儿童及青少年失神性癫痫的系统评价

doi: 10.3969/j.issn.1006-0111.2015.03.020

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

计量

出版历程

拉莫三嗪治疗儿童及青少年失神性癫痫的系统评价

doi: 10.3969/j.issn.1006-0111.2015.03.020

1. 上海交通大学医学院附属新华医院药学部, 上海 200092 2. 上海中医药大学中药学院2015届学生, 上海 201302

English Abstract

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

1. Pharmacy of Department, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China 2. Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

全文HTML

目录

1. 上海交通大学医学院附属新华医院药学部, 上海 200092

2. 上海中医药大学中药学院2015届学生, 上海 201302

1. Pharmacy of Department, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China

2. Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China