夜间给予不同剂量抗癫痫药治疗清晨或夜间癫痫发作患儿的疗效观察

Efficacy of Night Administration of Different Dosage of Antiepileptic Drug for Early Morning or Night Seizures in Children

目的：探讨针对清晨或夜间癫痫发作患儿,夜间给予其不同剂量抗癫痫药治疗的临床效果。方法：将60例清晨或夜间癫痫发作患儿,按入院时间随机分为观察组与对照组各30例。2组患儿给予抗癫痫药丙戊酸钠治疗,初始剂量为10 mg/（kg·d）,按照每周5~10 mg/（kg·d）的剂量逐渐增加,直至有效维持剂量[20~30 mg/（kg·d）],均1日给药2次,按照日常作息时间服药（分别为夜间睡觉前1 h和清晨）,2次服药的时间需间隔12 h。对照组患儿夜间给药剂量与清晨给药剂量相同,观察组患儿夜间给药剂量则为对照组的2倍。对比观察2组患儿的疗效与不良反应。结果：治疗3个月后,观察组患儿的总有效率为90.00%（27/30）,略高于对照组的86.67%（26/30）,差异无统计学意义（P〉0.05）;治疗6个月后,观察组患儿的总有效率为86.67%（26/30）,明显优于对照组的60.00%（18/30）,差异有统计学意义（P〈0.05）。观察组患儿的不良反应发生率略低于对照组,差异无统计学意义（P〉0.05）。结论：针对清晨或夜间癫痫发作的患儿,在夜间给予较大剂量的抗癫痫药（丙戊酸钠）治疗,可明显控制患儿的癫痫发作情况,降低不良反应发生率,临床效果较好,值得推广。

OBJECTIVE： To evaluate the clinical efficacy of night administration of different dosage of antiepileptic drug for early morning or night seizures in children. METHODS： 60 children with early morning or night seizures were randomly divided into observation group and control group of 30 cases each. All were treated with antiepileptic drug（ sodium valproate） at an initial dose of 10 mg /（ kg·d）,with dosage increased weekly by 5-10 mg /（ kg·d） until reaching effecive maintanance dosage [20 ~ 30 mg /（ kg·d） ]. The drug was administered twice a day（ early morning and 1 hour before sleeping） with time span of 12 hours. The dosage at morning and night remained the same for the control group while the night dosage was twice the morning dosage for the observation group. The two groups were compared with regard the efficacy and safety. RESULTS： At 3 months,the total effective rate in the observation group was slightly higher than in the control group [90. 0%（ 27 /30） vs. 86. 7%（ 26 /30）; P〉0. 05） ]; however,at 6months,the total effective rate of observation group was signficantly higher than in the control group[86. 7%（ 26 /30）vs. 60. 00%（ 18 /30）; P〈0. 05]. Adverse reaction was slightly less frequent in the observation group than in the control group（ P〉0. 05）. CONCLUSIONS： Night administration of large dosage of antiepileptic drug is safe and effective for early morning or night seizures in children,which thus is worthy of recommendation.