奥卡西平与卡马西平单药治疗儿童部分性癫(癎)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(癎)的疗效.方法 71例新诊断的儿童部分性癫(癎)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(癎)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.     

奥卡西平单药治疗小儿部分性癫发作27例疗效观察

目的:探讨奥卡西平对部分性癫发作的疗效安全性。方法:选择部分性癫患儿27例应用奥卡西平单药治疗,进行自身对照,观察6个月。结果:所有病例完全控制无发作及显效18例占66.7%(其中完全控制无发作16例占59.2%),好转8例占29.6%,有效率(完全控制+显效+有效)占96.3%:无效1例占3.7%:加重0例。结论:奥卡西平单药治疗对部分性癫的疗效与金标准卡马西平一致,疗效好。奥卡西平与卡马西平比,不良反应少、安全,依从性好。     

奥卡西平治疗儿童部分发作性癫80例临床分析

目的观察国产奥卡西平(OXC)治疗儿童部分发作性癫的疗效、安全性和耐受性。方法用国产奥卡西平单药治疗80例部分发作性癫患儿,分析治疗后1、2、3、6、9、12个月的疗效和不良反应。奥卡西平起始剂量5~10 mg/(kg·d),最大剂量30~40 mg/(kg.d),维持剂量中位值20 mg/(kg·d),bid。结果本组总有效率为87.50%,服药12个月时累积控制率为73.75%,有5例因严重不良反应而调用其他药物,余75例均能耐受。结论国产奥卡西平为治疗儿童部分性发作性癫相对理想的药物选择。     

奥卡西平治疗癫部分性发作50例疗效观察

目的观察奥卡西平治疗癫部分发作的疗效及安全性。方法 50例部分发作的癫患者采用奥卡西平治疗。成年患者的起始剂量为300mg/d。根据病情逐渐加量,3d后增至基本维持量600mg/d,仍有发作者继续加量,2周后达最佳效果或可耐受的最高剂量1 800mg/d;儿童患者起始剂量8～10mg/(kg.d),根据病情每周增加1次剂量,每次加量在10mg/(kg.d)以下,直至维持量30～40mg/(kg.d)。观察治疗后癫发作情况及药物不良反应。结果奥卡西平治疗5个月后,本组总有效率67.3%,完全控制率24.5%。用药1月内,本组10例患者出现不良反应,1例因剥脱性皮炎而停用此药。结论奥卡西平治疗癫部分性发作疗效较好,但有时可能产生严重的不良反应,临床应用时应谨慎。     

奥卡西平治疗儿童部分性发作的临床疗效及安全性观察

目的观察及评价奥卡西平（OXC）对儿童部分性发作的临床疗效和安全性。方法2006年3月-2007年5月经门诊诊断的PS／CPS或sGTCS儿童患者81例，其中27例采用奥卡西平添加治疗，54例单药治疗，经4～6周加量期和12周稳定期观察后进行评价。结果OXC添加治疗组及单药治疗组总有效率分别为81．5％和83．3％，完全控制率分别为37．0％和40．7％，且不良反应较轻，耐受性良好。结论奥卡西平治疗儿童部分性发作有效且安全，可用于儿童部分性发作的单药治疗和添加治疗。     

奥卡西平活性代谢产物测定在儿童局灶性癫治疗中的应用

目的探讨奥卡西平活性代谢产物10-单羟基卡马西平(MHD)血药浓度测定在儿童局灶性癫治疗中的应用价值。方法共110例儿童局灶性癫患者于奥卡西平单药或药物联合治疗3个月后,采用高效液相色谱法测定MHD血药谷浓度。结果 110例患儿奥卡西平平均治疗剂量(25.52±7.28)mg/(kg·d),MHD中位血药谷浓度7.00(4.95,10.50)mg/L,89例(80.91%)12 mg/L。Spearman秩相关分析,MHD血药谷浓度与奥卡西平治疗剂量呈正相关(rs=0.337,P=0.000)。奥卡西平治疗剂量仅年长(7岁)局灶性癫患儿低于年幼(≤7岁)患儿且差异有统计学意义[(23.13±5.56)mg/(kg·d)对(28.09±8.06)mg/(kg·d);t=3.778,P=0.000],而男性与女性(t=1.067,P=0.288)、药物难治性与非药物难治性(t=1.417,P=0.159)、单药治疗与药物联合治疗(t=1.671,P=0.098)组间差异无统计学意义;MHD血药谷浓度仅药物难治性局灶性癫患儿低于非药物难治性患儿且差异有统计学意义[6.32(3.05,8.58)mg/L对8.30(5.75,10.85)mg/L;Z=2.380,P=0.017],而男性与女性(Z=0.604,P=0.546)、年长与年幼(Z=0.179,P=0.858)、单药治疗与药物联合治疗(Z=1.583,P=0.113)组间差异无统计学意义。结论 MHD血药谷浓度与奥卡西平治疗剂量呈正相关关系;为达到相同的MHD血药浓度,年幼局灶性癫患儿应服用更大剂量的奥卡西平;奥卡西平治疗儿童药物难治性局灶性癫时,应根据MHD血药浓度及时调整药物剂量。     

奥卡西平治疗癫(癎)部分性发作的疗效观察

目的:观察奥卡西平治疗癫癎部分性发作的疗效.方法:51例部分性发作的癫癎患者采用奥卡西平治疗.成年患者起始剂量300mg/d,根据病情逐渐加量,3d后增至基本维持量(600mg/d),仍有发作者继续加量,2周后达最佳效果或可耐受的最高剂量(1800mg/d);儿童患者起始剂量8-10mg/(kg·d),根据病情每周加1次剂量,每次加量不超过10 mg/(kg·d),直至维持剂量30-40mg/(kg·d).观察治疗后癫癎发作情况及药物不良反应.结果:奥卡西平治疗5个月后,本组患者总有效率为74%,完全控制率为30%.用药1个月内,本组7例患者出现不良反应,1例因全身皮疹停用奥卡西平.结论:奥卡西平治疗癫癎部分性发作的疗效较好,但有时可产生较严重不良反应,临床应用须谨慎.     

奥卡西平治疗儿童部分发作性癫痫80例临床分析

目的观察国产奥卡西平（OXC）治疗儿童部分发作性癫痫的疗效、安全性和耐受性。方法用国产奥卡西平单药治疗80例部分发作性癫痫患儿,分析治疗后1、2、3、6、9、12个月的疗效和不良反应。奥卡西平起始剂量5~10 mg/（kg·d）,最大剂量30~40 mg/（kg.d）,维持剂量中位值20 mg/（kg·d）,bid。结果本组总有效率为87.50%,服药12个月时累积控制率为73.75%,有5例因严重不良反应而调用其他药物,余75例均能耐受。结论国产奥卡西平为治疗儿童部分性发作性癫痫相对理想的药物选择。     

单用不同剂量托吡酯与奥卡西平治疗儿科癫的疗效比较

目的观察单用不同剂量托吡酯及奥卡西平治疗儿科癫患儿的临床疗效和不良反应。探讨单用托吡酯更安全、更有效的给药方法。方法儿科癫患儿120例,分为奥卡西平组31例,服用奥卡西平从8~10mg/(kg.d)开始,再逐渐增量到10~30mg/(kg.d),2次/d服用;单用托吡酯组,89例患儿按服药剂量不同又分为低剂量组47例托1组从0.625mg/(kg.d)开始增加至4mg/(kg.d)为止;高剂量组42例托2组从1.5mg/(kg.d)开始,逐增至8mg/(kg.d)为止。结果托1组总有效率81%,托2组总有效率74%;奥卡西平组总有效率77%,3组比较无显著差异(P>0.05)。托2组不良反应发生率(57%)高于托1组(34%)(P<0.05)。托吡酯组主要不良反应为胃纳差、头痛、感觉异常、嗜睡和体质量减轻。结论单用较小剂量托吡酯治疗儿科癫发作,疗效好,不良反应少。     

奥卡西平与卡马西平治疗脑卒中后继发性癫痫对比研究

目的探讨奥卡西平与卡马西平单药治疗脑卒中后继发性癫痫(post stoke pilepsy,PSE)的临床疗效和安全性。方法选取2012-05—2014-05脑梗死后继发性癫痫患者112例为研究对象,随机分为对照组和观察组,每组各56例,对照组给予卡马西平治疗,观察组给予奥卡西平治疗,疗程为6个月,观察2组患者的脑电图、临床疗效和不良反应等情况。结果治疗前2组患者脑电图情况比较,差异无统计学意义(P0.05),治疗后2组脑电图均较治疗前改善,但观察组较对照组改善更明显,差异具有统计学意义(P0.05);6个月后,2组有效率分别为87.50%、64.29%,无效率分别为12.50%、35.71%,观察组临床治疗总有效高于对照组,差异有统计学意义(P0.05);2组患者治疗后不良反应情况有头晕、轻微皮疹、乏力、嗜睡、恶心呕吐等胃肠道反应,2组发生率分别为8.93%和14.29%,观察组不良反应率低于对照组,差异有统计学意义(P0.05)。结论奥卡西平对脑卒中后继发性癫痫的临床治疗效果满意,且安全性较高,推广应用。     

Oxcarbazepine therapy in very young children: a single-center clinical experience

Oxcarbazepine is indicated for use as monotherapy or adjunctive therapy in the treatment of partial seizures in adults and children >or=4 years of age. The purpose of this retrospective chart review was to assess efficacy and tolerability of oxcarbazepine in children 相似文献   

左乙拉西坦单药或添加治疗癫痫的临床观察

目的观察左乙拉西坦单药和添加治疗癫痫的临床疗效和不良反应。方法对91例门诊癫痫患者进行左乙拉西坦开放性治疗;其中少儿组54例,成人组37例;简单部分性发作(SPS)19例,复杂部分性发作(CPS)20例,全面性强直阵挛性发作(GTCS)32例,继发性全面性强直阵挛性发作(sGTCS)20例;采用单药治疗66例,添加治疗25例。左乙拉西坦起始剂量即为治疗剂量,儿童为10 mg/(kg.d),成人为0.5～3.0 g/d;治疗6个月时根据发作频率自身对照评价疗效,观察不良反应。结果治疗6个月时本组癫痫控制率为52.7%(48例),总有效率为75.8%;少儿组控制率和总有效率分别为64.8%及90.7%,明显高于成人组(35.1%,54.1%;均P<0.01);单药治疗组分别为62.1%及81.8%,明显高于添加治疗组(28.0%,60.0%;均P<0.01);SPS、CPS和GTCS的控制率分别为68.4%和55.0%及53.1%,明显高于sGTCS(35.0%,均P<0.01);SPS控制率明显高于GTCS(P<0.05)。本组不良反应发生率为16.5%,多较轻微,2例因明显脱发而换药。结论左乙拉西坦对多种类型的癫痫发作具有较好的疗效,对儿童及单药治疗的患者疗效更好;儿童及成人患者均有较好的耐受性。     

比较奥卡西平或拉莫三嗪联合丙戊酸钠治疗脑外伤术后癫疒间复发疗效

目的探讨丙戊酸钠治疗脑外伤术后癫疒间复发后,添加奥卡西平或拉莫三嗪联合治疗外伤性癫疒间效果。方法以治疗前3个月癫疒间发作频度为对照,对治疗12个月后的疗效、不良反应及安全性进行自身对比观察。结果应用奥卡西平或拉莫三嗪联合丙戊酸钠治疗12个月后,患者发作频率均较用药前明显减少;发作频率减少≥50%的患者分别为89.2%和89.7%,用药前后差异无统计学意义(P<0.05);奥卡西平或拉莫三嗪联合丙戊酸钠两组间差无明显统计学意义(P>0.05)。奥卡西平联合丙戊酸钠不良反应的发生率为19.3%,拉莫三嗪联合丙戊酸钠不良反应的发生率为9.1%,差异显著(P<0.05)。结论奥卡西平或拉莫三嗪联合丙戊酸钠治疗外伤性癫疒间复发疗效确切,副作用拉莫三嗪组明显低于奥卡西平组。     

托吡酯治疗带状疱疹后神经痛的疗效观察

目的观察托吡酯(TPM)治疗带状疱疹后神经痛(PHN)的疗效及安全性。方法将66例PHN患者随机分为TPM组(34例)和卡马西平组(CBZ,32例);采用视觉模拟量表(VAS)评估患者用药前和用药后1周、2周、3周及4周时疼痛情况,观察药物不良反应。结果两组VAS评分随治疗时间延长显著下降(均P<0.01),两组间差异无统计学意义(P>0.05);总有效率TPM组为(76.5%),CBZ组为(71.9%),两组间差异无统计学意义(P>0.05)。不良反应发生率TPM组为(14.7%),CBZ组为(28.1%),两组间差异无统计学意义(P>0.05),TPM组不良反应轻。结论TPM治疗PHN安全有效,耐受性好。     

托吡酯联合丙戊酸钠治疗儿童癫痫的有效性及安全性

目的探讨托吡酯联合丙戊酸钠治疗儿童癫痫的有效性及安全性。方法选取80例癫痫患儿,随机分为对照组和联合组各40例,对照组给予托吡酯单药治疗,联合组在对照组用药基础上加用丙戊酸钠治疗。观察2组疗效及不良反应发生情况。结果治疗3个月时联合组治疗总有效率95.00%高于对照组80.00%(P0.05),治疗6个月时2组治疗总有效率分别为97.50%、87.50%,差异无统计学意义(P0.05);治疗3、6个月时2组癫痫发作月均频率明显低于治疗前(P0.01),治疗6个月癫痫发作月均频率明显低于治疗3个月(P0.01),治疗3、6个月时联合组癫痫发作月均频率明显低于对照组(P0.01);对照组不良反应发生率10.00%,联合组为15.00%,差异无统计学意义(P0.05)。结论托吡酯联合丙戊酸钠治疗儿童癫痫可在短期内减少癫痫发作频率,未明显增加不良反应发生率,耐受性较好。     

The cognitive effects of oxcarbazepine versus carbamazepine or valproate in newly diagnosed children with partial seizures

OBJECTIVE: To investigate the effect of oxcarbazepine against standard antiepileptic drug therapy (carbamazepine and valproate) on cognitive function in children and adolescents (aged 6 to <17 years) with newly diagnosed partial seizures. METHODS: A multicentre, open-label, randomised, active-control, three-arm, parallel-group, 6-month study. The primary cognitive variable, the Computerized Visual Searching Task (CVST), assessed mental information processing speed and attention. Secondary variables included additional tests assessing psychomotor speed, alertness, memory and learning, and non-verbal intelligence. RESULTS: Of 112 patients randomised, 99 completed the study. The dropout rate was 11.6%; 13 patients discontinued due to adverse events (n=5) or unsatisfactory therapeutic effect (n=8). Mean CVST time decreased in all groups, indicating an improvement of mental processing speed and no cognitive impairment in any treatment group. No statistically significant difference was observed between oxcarbazepine and combined carbamazepine/valproate. Analysis of secondary variables did not show statistically significant differences between oxcarbazepine, carbamazepine and valproate. Analysis of intelligence test results showed that the number of correct answers increased at end point in all groups. The percentage of patients remaining seizure free throughout treatment was comparable across all groups (oxcarbazepine 58%; carbamazepine 46%; valproate 54%; carbamazepine/valproate 50%). The most common adverse events were fatigue and headache for oxcarbazepine, fatigue and rash for carbamazepine, and headache, increased appetite and alopecia for valproate. CONCLUSION: Oxcarbazepine treatment over 6 months does not display any differential effects on cognitive function and intelligence in children and adolescents with newly diagnosed partial seizures relative to standard antiepileptic drug therapy. No impairment in cognitive function was observed in any treatment group over a 6-month period.     

Comparison of the effects of carbamazepine and oxcarbazepine on peripheral nerve conduction

Twenty-five epileptic outpatients were studied to assess possible effects of the first 6 months of treatment with carbamazepine or oxcarbazepine using serial peripheral nerve conduction measurements. Carbamazepine caused a small slowing effect on the motor conduction of the median nerve after 4 weeks of treatment, and the effect was correlated with the fasting serum concentration of the drug. Slowed motor conduction value of the median nerve was also observed after 6 months of treatment with carbamazepine. Oxcarbazepine did not cause any statistically significant slowing of nerve conduction.     

Efficacy, safety, and tolerability of oxcarbazepine monotherapy

OBJECTIVE: This prospective, open-label, multicenter study evaluated the efficacy and tolerability of oxcarbazepine as monotherapy in patients with partial seizures who switched from their current antiepileptic drug (AED) monotherapy because of lack of efficacy or poor tolerability. METHOD: Patients (>or=12 years old) experiencing 2-40 seizures per month while receiving an AED were included. During a 16-week treatment phase, oxcarbazepine was initiated (8-10mg/kg for children; 600 mg/day for adults) and titrated up over 4 weeks while the existing AED was tapered off. Improvement in seizure frequency (defined as >or=50% reduction compared with baseline) was evaluated for all patients, as well as the subgroups of patients switched due to poor tolerability or lack of efficacy. RESULTS: Overall, 52% of patients experienced a 50% reduction in seizure frequency, 35% had a >or=75% reduction, and 18% were seizure-free. The most frequent (>10%) adverse events were dizziness, nausea, headache, somnolence, and fatigue. Overall, 17% of patients prematurely withdrew because of an adverse event; 62% of these withdrawals occurred during the conversion period. CONCLUSION: Oxcarbazepine as monotherapy may be a favorable treatment option for patients with partial seizures or poor tolerability of their existing monotherapy regimen.     

奥卡西平联合银杏达莫注射液对癫痫患儿的作用机制研究

目的探讨奥卡西平联合银杏达莫注射液对癫痫患儿T淋巴细胞亚群及血清碱性磷酸酶(ALP)、细胞间黏附分子1(ICAM-1)水平变化的影响。方法选取洛阳市妇女儿童医疗保健中心77例癫痫患儿,按照随机数字表法分组,对照组38例予以单一奥卡西平治疗,观察组39例给予奥卡西平+银杏达莫注射液治疗,观察2组临床治疗效果、T淋巴细胞亚群(CD3+、CD4+、CD8+)及血清ALP、ICAM-1水平变化情况,并统计2组不良反应发生情况及生活质量评分。结果观察组总有效率94.87%(37/39),高于对照组的71.05%(27/38),差异有统计学意义(P0.05)。治疗3个月后观察组CD3+及CD4+均高于对照组,CD8+低于对照组,差异有统计学意义(P0.05)。治疗3个月后2组血清ALP水平比较,差异无统计学意义(P0.05),观察组血清ICAM-1水平低于对照组,差异有统计学意义(P0.05)。观察组不良反应发生率15.38%(6/39),对照组为10.53%(4/38),差异无统计学意义(P0.05)。治疗3个月后观察组社会能力、认知功能、总体健康、生活质量、药物影响、精神健康及生活满意度评分均高于对照组,差异有统计学意义(P0.05)。结论银杏达莫注射液辅助奥卡西平治疗癫痫效果显著,安全性高,可改善患儿血清ICAM-1水平及T淋巴细胞亚群,提高其生活质量。