目的 探討小兒癲癇應(yīng)用小兒抗癇膠囊聯(lián)合奧卡西平片治療的臨床效果。方法 選取2016年1月—2018年8朝陽市第二醫(yī)院收治的150例小兒癲癇患者，運用隨機(jī)數(shù)字表法將其隨機(jī)分成觀察組（n=75）和對照組（n=75）。對照組患者口服奧卡西平片，以10 mg/（kg·d）為起始劑量，而后每隔1周，增加劑量10 mg/（kg·d），直至維持劑量30 mg/（kg·d），均分早晚2次給藥。觀察組在對照組基礎(chǔ)上口服小兒抗癇膠囊，8粒/次，3次/d。連續(xù)治療6個月。對比兩組臨床療效，治療前后癲癇計分、發(fā)作頻率、持續(xù)時間、癇性放電比率、兒童生活質(zhì)量量表（Peds QLTM4.0）普適型家長代評量表評分及韋氏兒童智力量表第四版（WISC-Ⅳ）評分變化。結(jié)果 治療后，觀察組總有效率為93.3%，較對照組81.3%顯著增加（P<0.05）。與治療前相比，兩組治療后癲癇發(fā)作情況（包括意識狀態(tài)及意識障礙、強(qiáng)直、陣攣的持續(xù)時間和腦電圖）計分及其總分均顯著下降（P<0.05）；但觀察組減少更顯著（P<0.05）。兩組治療后發(fā)作頻率、癇性放電比率均較治療前顯著降低，而持續(xù)時間均顯著縮短（P<0.05）；且觀察組改善更顯著（P<0.05）。兩組治療后Peds QLTM4.0普適型家長代評量表中各維度（生理功能、社交功能、學(xué)校表現(xiàn)、情感功能）評分及其總分均較治療前顯著升高（P<0.05），而觀察組上升更顯著（P<0.05）。兩組治療后WISC-Ⅳ中各指數(shù)（語言理解、知覺推理、工作記憶、加工速度）評分及總智商評分均顯著高于治療前（P<0.05），且觀察組增高更顯著（P<0.05）。結(jié)論 小兒癲癇應(yīng)用小兒抗癇膠囊聯(lián)合奧卡西平片治療的整體效果顯著，可明顯穩(wěn)定患兒病情，控制癲癇發(fā)作，減少癇性放電，提高患兒生活質(zhì)量及智力水平，且安全性較高。

Objective To investigate the clinical effect of Xiaoer Kangxian Capsules combined with Oxcarbazepine Tablets in treatment of pediatric epilepsy. Methods Children (150 cases) with pediatric epilepsy admitted to Chaoyang Second Hospital from January 2016 to August 2018 were selected and randomly divided into observation group (n=75) and control group (n=75) by random number table method. The control group were po administered with Oxcarbazepine Tablets, the starting dose was 10 mg/(kg·d), and then every other week, the dose was increased by 10 mg/(kg·d) until the maintenance dose was 30 mg/(kg·d), twice in the morning and evening. And the observation group were po administered with Xiaoer Kangxian Capsules on the basis of control group, 8 grains/time, three times daily. All the children were treated for 6 months. The clinical effects in two groups were compared. The epileptic score, seizure frequency, duration, epileptic discharge ratio, Peds QLTM4.0 score, and WISC-IV score changes and side effects before and after treatment were compared. Results After treatment, the total effective rate in the observation group was 93.3%, which was significantly higher than 81.3% in the control group (P<0.05). Compared with before treatment, the scores and total scores of epileptic seizures (including the state of consciousness, disturbance of consciousness, duration of tonic and clonic seizures, and electroencephalogram) after treatment in two groups were significantly decreased (P<0.05). However, the decrease was more significant in the observation group (P<0.05). After treatment, the seizure frequency and epileptiform discharge ratio in both groups were significantly lower than those before treatment, while the duration was significantly shortened (P<0.05). And the improvement in observation group was more significant (P<0.05). After treatment, the scores and total scores of all dimensions (physiological function, social function, school performance, emotional function) in Peds QLTM4.0 universal parental surrogate scale of two groups were significantly higher than those before treatment (P<0.05), while the increase in the observation group was more significant (P<0.05). After treatment, the scores of each index (language understanding, perceptual reasoning, working memory, and processing speed) and the total IQ score in WISC-Ⅳ in two groups were significantly higher than those before treatment (P<0.05), and the increase in the observation group was more significant (P<0.05). Conclusion The overall effect of Xiaoer Kangxian Capsules combined with Oxcarbazepine Tablets is significant in treatment of pediatric epilepsy. It can obviously stabilize the condition of the child, control epileptic seizure, reduce epileptic discharge, improve the quality of life and intelligence level of the child, and has high safety.

R971

遼寧省自然科學(xué)基金項目（2015020276）