新型和传统抗癫痫药治疗新诊断癫痫患者的评价

目的评价新型和传统抗癫痫药(AEDs)单药治疗新诊断癫痫患者的疗效及安全性。方法前瞻性收集143例新诊断癫痫患者,分为卡马西平(CBZ)、丙戊酸钠(VPA)、托吡酯(TPM)和拉莫三嗪(LTG)治疗组,其中CBZ用于癫痫部分性发作,VPA用于癫痫全面性发作,而TPM和LTG用于各种类型癫痫发作,至少观察1年。采用生存分析Kaplan-Meier法比较治疗后癫痫初次发作时间、治疗失败时间,同时比较各组患者达"6月、1年无发作"比例和药物不良反应。结果 4组AEDs单药治疗后至癫痫初次发作时间、治疗失败时间的差异均无统计学意义(P0.05);CBZ、VPA、TPM和LTG组"6月无发作"率分别为80%、78%、87.9%、63.3%(均P0.05);"1年无发作"率分别为70%、66%、66.7%、50%(均P0.05)。TPM组不良反应率为63.3%,高于CBZ组(20%)、VPA组(24%)(均P0.01),而LTG组不良反应率为16.7%,与CBZ、VPA组相当(均P0.05)。结论从疗效和安全性综合考虑,新型AEDs治疗癫痫并不优于传统AEDs,其中TPM轻、中度不良反应还明显高于传统AEDs。     

血府逐瘀汤联合度洛西汀治疗抑郁症伴疼痛的疗效观察

目的观察血府逐瘀汤联合度洛西汀治疗抑郁症伴疼痛的效果,为临床提供理论依据。方法选取我院2014-02—2016-02抑郁症伴疼痛患者86例,随机分为观察组和对照组各43例。观察组给予血府逐瘀汤联合度洛西汀治疗,对照组给予度洛西汀治疗,对比2组治疗效果、VAS和HAMD评分、不良反应发生情况。结果治疗前2组VAS和HAMD评分比较无显著差异(P0.05);治疗2、4、8周后,2组VAS和HAMD评分均较治疗前有所改善,且观察组VAS和HAMD评分明显优于对照组,差异有统计学意义(P0.05);观察组总有效率90.69%(39/43),对照组为69.76%(30/43),观察组总有效率高于对照组,差异有统计学意义(P0.05);观察组发生不良反应4例(9.30%),对照组13例(30.23%),2组比较差异有统计学意义(P0.05)。结论血府逐瘀汤联合度洛西汀治疗抑郁症伴疼痛临床效果较佳,值得推广应用。     

加巴喷丁与卡马西平治疗原发性三叉神经痛的临床疗效及不良反应

目的比较加巴喷丁与卡马西平治疗原发性三叉神经痛的临床疗效及不良反应。方法选取原发性三叉神经痛患者101例,随机分为加巴喷丁组(51例)与卡马西平组(50例),采用视觉模拟评分(VAS)评估患者用药前和用药后1周、2周、4周疼痛程度,同时观察患者的不良反应。结果加巴喷丁组治疗前与治疗后1周、2周、4周比较差异有统计学意义(P0.01)。卡马西平组治疗前与治疗后1周、2周、4周比较差异有统计学意义(P0.01)。2组同一用药时期比较差异无统计学意义(P0.05)。2组治疗后1周、2周、4周有效率比较差异无统计学意义(P0.05)。2组不良反应差异有统计学意义(P0.05)。结论加巴喷丁与卡马西平治疗原发性三叉神经痛的疗效无差异,但加巴喷丁比卡马西平不良反应小,更加安全,值得应用。     

普瑞巴林联合神经阻滞治疗带状疱疹后神经痛的疗效

目的观察普瑞巴林联合神经阻滞对带状疱疹后遗神经痛(PHN)的治疗效果及安全性。方法 60例患者随机分为2组各30例,对照组采用神经阻滞治疗,治疗组在对照组基础上加服普瑞巴林,对2组治疗前后进行视觉模拟评分(VAS)、睡眠质量评分(QS),并进行疗效评定;详细记录2组不良反应。结果 2组入组时VAS及QS比较无显著差异(P0.05),随访1、2、4、6、8、10周时,治疗组各时点VAS及QS评分均明显低于对照组(P0.05)。治疗组总有效率80.00%,对照组为50.00%,2组比较差异有统计学意义(P0.05)。对照组2例出现胃肠道不适;治疗组2例嗜睡,1例眩晕,均未作处理自行缓解,2组不良反应发生率比较差异无统计学意义(χ~2=1.227,P0.05)。结论普瑞巴林联合神经阻滞治疗PHN,可显著减轻或消除患者疼痛症状,改善睡眠质量,疗效确切。     

神经妥乐平治疗老年带状疱疹后神经痛的疗效观察

目的观察神经妥乐平治疗老年带状疱疹后神经痛(PHN)的疗效。方法将58例老年PHN患者随机分为神经妥乐平组和卡马西平组,应用视觉模糊评分法(VAS)评价两组治疗后疼痛的改善情况并观察药物不良反应。结果治疗第2周、4周、6周后神经妥乐平组VAS较治疗前明显下降(均P<0.01),总有效率为80%,明显优于卡马西平组(46.4%)(P<0.05),两组患者均未出现明显不良反应。结论神经妥乐平治疗老年PHN的疗效优于卡马西平。     

多奈哌齐联合尼莫地平片对脑小血管病患者认知功能的影响

目的探讨盐酸多奈哌齐联合尼莫地平片对脑小血管病致认知功能障碍患者认知功能及生活质量的影响。方法选取郑州大学附属郑州中心医院91例脑小血管病致认知功能障碍患者,按照随机数字表法分组,对照组45例予以盐酸多奈哌齐治疗,观察组46例予以盐酸多奈哌齐+尼莫地平片治疗,观察2组认知功能(MoCA)评分及临床治疗效果,并统计2组不良反应发生情况及生活质量(QOL)评分。结果观察组用药3个月后MoCA评分较对照组高,差异有统计学意义(P0.05);观察组治疗总有效率为89.13%(41/46),高于对照组68.89%(31/45),差异有统计学意义(P0.05);观察组不良反应发生率为15.22%(7/46),对照组为6.67%(3/45),组间比较差异无统计学意义(P0.05);用药3个月后观察组QOL评分高于对照组,差异有统计学意义(P0.05)。结论对脑小血管病致认知功能障碍患者给予盐酸多奈哌齐联合尼莫地平片治疗,效果显著,用药安全性高,可改善患者生活质量及认知功能。     

EPO与TPM对癫痫大鼠神经元的保护作用

目的探讨并比较托吡酯(topiramate,TPM)和促红细胞生成素(erythropoietin,EPO)对癫痫大鼠神经元的保护作用及机制。方法建立致痫前即用TPM及EPO干预的新型癫痫大鼠模型。将86只成年雄性SD大鼠随机分为健康对照组、单纯致痫组(SE组)、TPM[按体重50 mg/(kg.d)]干预后致痫组(TPM50组)、TPM[按体重100 mg/(kg.d)]干预后致痫组(TPM100组)、重组人促红细胞生成素(r HuEPO)[按体重5000 U/kg]干预后致痫组(EPO组)。采用Morris水迷宫和悬吊实验方法检测致痫前后大鼠学习记忆功能及悬吊耐受性变化,采用免疫组化法检测神经元caspase-3活性变化,应用流式细胞仪和电镜检测神经元凋亡情况。结果(1)TPM50组及TPM100组致痫前寻找平台潜伏期与对照组比较差异均有统计学意义(P<0.05),致痫后TPM50组与对照组差异具统计学意义(P<0.05);致痫前后EPO组寻找平台潜伏期与对照组比较差异无统计学意义(P>0.05)。致痫前TPM50组和TPM100组悬吊耐受时间均短于对照组(P<0.05),而致痫后两组均有逆转,与对照组比较差异无统计学意义(P>0.05);致痫前后EPO组悬吊耐受时间与对照组比较差异无统计学意义(P>0.05)。(2)SE组及TPM50组电镜下可见凋亡神经元,而其他组则无此所见。(3)对照组、SE组、TPM50组、TPM100组和EPO组神经元凋亡率分别为0.4%、9.9%、7.8%、0.7%和0.5%。TPM100组及EPO组与对照组比较差异无统计学意义(P>0.05),与SE组比较差异有统计学意义(P<0.05);TPM50组与SE组差别无统计学意义(P>0.05)。(4)SE组和TPM50组其额皮质活化型caspase-3的表达较健康对照组多(P<0.05);活化型caspase-3的表达与神经元凋亡率呈正相关(r=0.955,rs=1.000)。结论(1)大剂量TPM及EPO均可保护癫痫持续状态后大鼠海马及额叶皮质神经元免受损伤。(2)大剂量TPM及EPO的神经元保护作用可能通过抑制caspase-3活化实现。(3)TPM可影响癫痫大鼠的功能行为,而EPO则无此作用。     

文拉法辛缓释片治疗广泛性焦虑症的临床疗效及安全性分析

目的探讨广泛性焦虑症患者采用文拉法辛缓释片治疗的临床效果及安全性。方法对2011-09-2016-09我院收治的80例广泛性焦虑症患者的一般资料进行回顾性分析,按随机数字表法分为观察组(盐酸文拉法辛缓释片)与对照组(盐酸舍曲林)各40例。对比2组治疗效果、治疗前后HAMA评分变化情况及不良反应发生情况。结果观察组、对照组总有效率分别为95.0%、92.5%,差异无统计学意义(P0.05);治疗前,2组HAMA评分差异无统计学意义(P0.05);治疗后1周,2组HAMA评分均有所下降,但观察组低于对照组,差异有统计学意义(P0.05);治疗后2周、4周,2组HAMA评分差异无统计学意义(P0.05);观察组、对照组不良反应发生率分别为20.0%(8/40)、22.5%(9/40),差异无统计学意义(P0.05)。结论广泛性焦虑症患者采用文拉法辛缓释片治疗的效果显著,其起效时间较盐酸舍曲林快,且不良反应少,安全可靠,值得深入研究和推广。     

卡马西平联合文拉法辛对原发性三叉神经痛的疗效

目的探讨卡马西平联合文拉法辛对原发性三叉神经痛患者疼痛程度改善及日常生活能力的影响。方法选取98例原发性三叉神经痛患者,根据治疗方案分为2组各49例。对照组予以卡马西平治疗,观察组予以卡马西平+文拉法辛治疗。统计2组疗效及不良反应发生率,对比2组治疗前后疼痛评分(VAS)及日常生活能力评分(ADL)。结果观察组总有效率81.63%(40/49)高于对照组的63.27%(31/49),差异有统计学意义(P0.05)。治疗前,观察组VAS、ADL评分与对照组比较,差异无统计学意义(P0.05);治疗后,观察组VAS评分低于对照组,ADL评分高于对照组,差异有统计学意义(P0.05)。观察组不良反应发生率12.24%(6/49),与对照组的16.33%(8/49)比较,差异无统计学意义(P0.05)。结论卡马西平联合文拉法辛治疗原发性三叉神经痛能有效减轻患者疼痛感,提高日常生活能力,临床效果显著,安全性较高。     

托吡酯长期治疗对成年癫疒间患者血清甲状腺激素水平的影响

目的 探讨托吡酯(TPM)长期治疗对成年癫疒间患者血清甲状腺激素水平的影响.方法 用化学发光分析法测定成年癫疒间组患者(32例)TPM治疗前、后的血清甲状腺激素水平,并与健康对照组(40人)进行比较. 结果治疗前成年癫疒间组患者甲状腺激素水平与健康对照组比较无统计学意义(均P>0.05);TPM治疗后3个月、6个月、12个月及24个月的甲状腺激素水平与治疗前及健康对照组比较差异亦无统计学意义(均P>0.05).结论 TPM短期与长期治疗对成年癫疒间患者的甲状腺激素水平没有影响.     

活血化瘀中药治疗眼睑带状疱疹后遗神经痛临床观察

目的观察中药桃红四物汤联合西药治疗眼睑带状疱疹后遗神经痛(PHN)的临床疗效。方法回顾性研究我院眼科近年来收治的60例眼睑PHN患者,根据治疗方法分为对照组和治疗组各30例。对照组给予阿昔洛韦注射液静滴,1次/d,连用1周,布洛芬片和甲钴胺片口服,3次/d,连用2周;治疗组在对照组基础上加用中药桃红四物汤水煎服,1剂/d,连用2周。治疗2周后,比较2组治疗前后疼痛程度视觉模拟评分(VAS)和睡眠质量评分(QS),以及临床疗效。结果治疗1周和2周后,2组VAS评分均逐渐降低,且治疗组低于对照组(P0.05);2组QS评分均逐渐降低,且治疗组高于对照组(P0.05)。治疗组临床总有效率83.4%,高于对照组的63.4%(P0.05)。治疗组在有效率、减轻疼痛症状及改善睡眠质量等方面均优于对照组。结论中药桃红四物汤联合西药治疗眼睑PHN疗效肯定,安全性好。     

Effect of topiramate or carbamazepine on the pharmacokinetics of an oral contraceptive containing norethindrone and ethinyl estradiol in healthy obese and nonobese female subjects

PURPOSE: To study the pharmacokinetics of a combination oral contraceptive (OC) containing norethindrone and ethinyl estradiol during OC monotherapy, concomitant OC and topiramate (TPM) therapy, and concomitant OC and carbamazepine (CBZ) therapy in order to comparatively evaluate the pharmacokinetic interaction, which may cause contraceptive failure. METHODS: This randomized, open-label, five-group study included two 28-day cycles. Five groups of female subjects received oral doses of ORTHO-NOVUM 1/35 alone (cycle 1) and then concomitant with TPM or CBZ (cycle 2). The treatment groups were group 1, TPM, 50 mg/day; group 2, TPM, 100 mg/day; group 3, TPM, 200 mg/day; group 4, TPM, 200 mg/day (obese women); and group 5, CBZ, 600 mg/day. Group 4 comprised obese women whose body mass index (BMI) was between 30 and 35 kg/m(2). The BMI of the remaining four groups was < or =27 kg/m2. RESULTS: Coadministration of TPM at daily doses of 50, 100, and 200 mg (nonobese) and 200 mg (obese) nonsignificantly (p > 0.05) changed the mean area under the curve (AUC) of ethinyl estradiol by -12%, +5%, -11%, and -9%, respectively, compared with OC monotherapy. A similar nonsignificant difference was observed with the plasma levels and AUC values of norethindrone (p > 0.05). CBZ (600 mg/day) significantly (p < 0.05) decreased the AUC values of norethindrone and ethinyl estradiol by 58% and 42%, respectively, and increased their respective oral clearance by 69% and 127% (p < 0.05). Because CBZ induces CYP 3A-mediated and glucuronide conjugation metabolic pathways, the significant increase in the oral clearance of ethinyl estradiol and norethindrone was anticipated. CONCLUSIONS: TPM, at daily doses of 50-200 mg, does not interact with an OC containing norethindrone and ethinyl estradiol. The lack of the TPM-OC interaction is notable when it is compared with the CBZ-OC interaction.     

阿立哌唑与氯米帕明治疗强迫症的疗效对照分析

目的比较阿立哌唑与氯米帕明治疗强迫症的疗效及不良反应。方法将符合CCMD-3诊断标准的强迫症患者62例，随机分成研究组（阿立哌唑组）29例，对照组（氯米帕明组）33例。分别应用临床疗效评定标准、Yale-Brown强迫症量表（Y—BOCS）和Hamilton抑郁量表（HAMD）、自编不良反应出现频率表，分别评定疗效及不良反应。结果研究结束时，两组自身在治疗前后的临床疗效、Y-BOCS量表及Hamilton量表的减分率均显示有显著性差异（P〈0．01）。阿立哌唑组和氯米帕明组的有效率分别为53％和56％，但是两组之间的疗效则无显著性差异（P〉0．05）。两组不良反应格局略有不同。结论结果显示阿立哌唑在治疗强迫症时，其临床疗效与氯米帕明相当，而不良反应虽有所差异，但不影响治疗。     

抗癫痫药物对大鼠记忆和学习功能影响的研究

目的探讨抗癫痫药物对大鼠认知功能的影响。方法健康雄性性成熟SD大鼠70只,随机分为正常对照组(NS组)、癫痫对照组(PTZ组)、卡马西平(CBZ)组、苯妥英钠(PHT)组、丙戊酸钠(VPA)组、妥泰(TPM)组及拉莫三嗪(LTG)组,每组10只。除NS组外其他6组用PTZ点燃。抗癫痫治疗2周后用Morris水迷宫测试认知功能。采用方差分析进行统计学处理。结果PTZ组学习成绩提高快(P<0.05,P<0.01)。卡马西平组、丙戊酸钠组、拉莫三嗪组测试成绩捉高很快(P<0.01),优于NS组。苯妥英钠组测试成绩提高较慢(P<0.05),与NS组比较无明显差异。妥泰组测试成绩提高慢,各次、各天之间差异无显著性(P>0.05),较NS组差。在寻找平台象限和在平台象限逗留时间的测试中,妥泰寻找时间最长,逗留时间最短,两项成绩均低于其他组(P<0.05,P<0.01);其他各组之间差异无显著性。结论PHT可能损害大鼠的学习、判断功能,TPM还可损害大鼠的记忆功能。     

A comparative study of the effect of carbamazepine and valproic acid on the pharmacokinetics and metabolic profile of topiramate at steady state in patients with epilepsy

PURPOSE: To compare the influence of enzyme-inducing comedication and valproic acid (VPA) on topiramate (TPM) pharmacokinetics and metabolism at steady state. METHODS: Three groups were assessed: (a) patients receiving TPM mostly alone (control group, n =13); (b) patients receiving TPM with carbamazepine (CBZ; n = 13); and (c) patients receiving TPM with VPA (n = 12). TPM and its metabolites were assayed in plasma and urine by liquid chromatography-mass spectrometry (LC-MS). RESULTS: No significant differences were found in TPM oral (CL/F) and renal (CL(r)) clearance between the VPA group and the control group. Mean TPM CL/F and CL(r) were higher in the CBZ group than in controls (2.1 vs. 1.2 L/h and 1.1 vs. 0.6L/h, respectively; p < 0.05). In all groups, the urinary recovery of unchanged TPM was extensive and accounted for 42-52% of the dose (p > 0.05). Urinary recovery of 2,3-O-des-isopropylidene-TPM (2,3-diol-TPM) accounted for 3.5% of the dose in controls, 2.2% in the VPA group (p > 0.05), and 13% in the CBZ group (p < 0.05). The recovery of 10-hydroxy-TPM (10-OH-TPM) was twofold higher in the CBZ group than in controls, but it accounted for only <2% of the dose. The plasma concentrations of TPM metabolites were severalfold lower than those of the parent drug. CONCLUSIONS: Renal excretion remains a major route of TPM elimination, even in the presence of enzyme induction. The twofold increase in TPM-CL/F in patients taking CBZ can be ascribed, at least in part, to stimulation of the oxidative pathways leading to formation of 2,3-diol-TPM and 10-OH-TPM. VPA was not found to have any clinically significant influence on TPM pharmacokinetic and metabolic profiles.     

The effects on cognitive function and behavioral problems of topiramate compared to carbamazepine as monotherapy for children with benign rolandic epilepsy

PURPOSE: To evaluate the cognitive and behavioral effects of topiramate (TPM) versus carbamazepine (CBZ) using efficacious doses of each drug as monotherapy for children with benign rolandic epilepsy. METHODS: A multicenter, randomized, open-label, observer-blinded, parallel-group clinical trial was conducted. TPM was introduced at a dose of 12.5 mg/day with the minimum target dose of 50 mg/day in patients <30 kg and 75 mg/day in patients >30 kg over 4 weeks. CBZ was started at a dose of 10 mg/kg/day with the minimum target dose of 20 mg/kg/day over 4 weeks. Additional individual escalation was allowed up to a maximum target dose. The primary study end point was change on a neuropsychological test battery after 28 weeks of treatment. RESULTS: Neuropsychological data were available for 88 patients (45 patients for TPM and 43 patients for CBZ). Of the cognitive variables measured, arithmetic showed significant worsening in TPM (p = 0.037). An additional test, for maze, also showed a significantly greater improvement for CBZ (p = 0.026). Of behavioral variables, no significant changes were found but the scores had a negative trend for the TPM. When 30 patients on the minimum target dose for TPM were compared to 40 patients treated with minimum target CBZ, there was no significant worsening of cognitive and behavioral effects in the TPM. CONCLUSION: The pattern of neuropsychometric changes with TPM seemed to be slightly worse overall than CBZ. However, outcome with the minimum target dose did not differ significantly in comparisons between the treatment groups.     

Clinical Science

Dorit Mimrod, Luigi M. Specchio, Malka Britzi, Emilio Perucca, Nicola Specchio, Angela La Neve, Stefan Soback, René H. Levy, Giuliana Gatti, Dennis R. Doose, Bruce E. Maryanoff, and Meir Bialer The study's aim was to compare the influence of comedication by carbamazepine (CBZ) and valproic acid (VPA) on the pharmacokinetics and metabolism of topiramate (TPM). Three groups were assessed: (a) patients receiving TPM mostly alone (control group, n = 13); (b) patients receiving TPM with CBZ (n = 13); and (c) patients receiving TPM with VPA (n = 12). TPM and its metabolites were assayed in plasma and urine. No significant differences were found in TPM total and renal clearance between the VPA group and the control group. Mean TPM total and renal clearance values were higher in the CBZ group than in controls (2.1 vs. 1.2 L/h and 1.1 vs. 0.6 L/h respectively; p < 0.05). In all groups, the urinary recovery of unchanged TPM was extensive and accounted for 42% to 52% of the dose (p > 0.05). Urinary recovery of 2,3‐O‐des‐isopropylidene‐TPM (2,3‐diol‐TPM) accounted for 3.5% of the dose in controls, 2.2% in the VPA group (p > 0.05), and 13% in the CBZ group (p < 0.05). The recovery of 10‐hydroxy‐TPM (10‐OH‐TPM) was twofold higher in the CBZ group than in controls, but it accounted for <2% of the dose. The plasma concentrations of TPM metabolites were severalfold lower than those of the parent drug. Renal excretion remains a major route of TPM elimination, even in the presence of enzyme induction by other concurrently taken seizure medications. The twofold increase in TPM metabolism and excretion in patients taking CBZ can be ascribed, at least in part, to stimulation of the oxidative pathways in the liver, leading to formation of 2,3‐diol‐TPM and 10‐OH‐TPM. VPA was not found to have any clinically significant influence on TPM pharmacokinetic and metabolic profile. Epilepsia 2005;46(7).     

低频重复经颅磁刺激治疗首发青少年抑郁症的临床对照研究

目的 探讨低频重复经颅磁刺激(rTMS)治疗首发青少年抑郁症的疗效及安全性.方法 将30例首发未用药的青少年抑郁症患者随机分为rTMS组和对照组各15例,均不采用药物治疗.rTMS组采用低频rTMS刺激右侧额叶背外侧皮质(DLPFC),对照组采用假性刺激,每周治疗5次,连续治疗2周.采用汉密尔顿抑郁量表24项(HAMD24)评估治疗前后的疗效.结果 (1)rTMS组有效率100%,对照组有效率0%,两组差异有统计学意义(P<0.01).(2)治疗后rTMS组HAMD24总分及因子分均较基线期显著下降(P<0.05),对照组HAMD24总分及因子分较基线期无明显变化(P>0.05).(3)rTMS组和对照组的不良反应发生率差异无统计学意义(P>0.05),两组均未出现严重不良反应.结论 低频rTMS可有效改善首发青少年抑郁症,有较好的安全性.     

109例癫痫停药患者的用药分析

目的总结并探讨三种抗癫痫药(AEDs)的疗效,从而选取最佳的AEDs。方法回顾性分析109例临床已获控制并停药患者的临床资料。结果在治疗时间上,卡马西平(CBZ)组、丙戊酸钠(VPA)组均与妥泰(TPM)组有显著性差异(分别为P<0.01,P<0.05),而CBZ组与VPA组无显著性差异(P>0.05)。结论与CBZ、VPA相比,TPM为理想的AEDs。     

奥卡西平与卡马西平单药治疗儿童部分性癫的对照研究

目的比较奥卡西平与卡马西平单药治疗儿童部分性癫的疗效。方法71例新诊断的儿童部分性癫患者按单双号顺序分为奥卡西平组(35例)和卡马西平组(36例),并给予相应的药物治疗;6个月后进行疗效评价,观察不良反应。结果奥卡西平组和卡马西平组分别有25例及29例完成6个月治疗;脑电图改善率分别为44.0%及44.8%;显效率分别为92.0%及86.2%;不良反应发生率分别为22.2%及41.2%,两组间比较差异无统计学意义(均P>0.05);卡马西平组2例出现严重不良反应。结论奥卡西平与卡马西平单药治疗新诊断的儿童部分性癫均有很好的疗效,不良反应及耐受性相似,但奥卡西平组未见严重的不良反应。