卡马西平和苯巴比妥单药治疗癫痫。

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史密斯Tudur C,马森AG)威廉姆森公关

卡马西平和苯巴比妥单药治疗癫痫。

科克伦数据库系统启2003;(1):CD001904。

PubMed ID

12535420 (在PubMed

]

文摘

背景:在发展中国家,但其常用苯巴比妥在欧洲和美国使用降低了由于担心副作用。卡马西平建议部分性癫痫发作的首选药,还有担心它可能恶化一些广义发作癫痫类型。我们报告一个审查使用个别病人数据相比,卡马西平和苯巴比妥。目的:评估的影响比苯巴比妥卡马西平单药治疗部分性癫痫患者或广义tonic-clonic癫痫发作。必威国际app搜索策略:Cochrane对照试验注册(Cochrane图书馆问题2,2002);MEDLINE;EMBASE;hand必威国际appsearching;联系专家和原始审判人员;卡马西平的联系制造商。 SELECTION CRITERIA: Randomized or quasi-randomized, blinded or unblinded controlled trials in children or adults with partial onset seizures or generalized onset tonic-clonic seizures. DATA COLLECTION AND ANALYSIS: Outcome measures were (i) time to withdrawal of allocated treatment, (ii) time to 12 month remission, and (iii) time to first seizure. Data were analysed using a stratified logrank analysis with results expressed as hazard ratios (HR) and 95% confidence intervals (CIs), where a HR>1 indicates an event is more likely on phenobarbitone. A test for interaction between treatment and seizure type (partial versus generalized onset) was also undertaken. MAIN RESULTS: Data are available for 684 participants from four trials, representing 59% of the participants recruited into the nine trials that met our inclusion criteria. The main overall results (HR 95% CI) adjusted for seizure type were, (i) time to withdrawal 1.63(1.23 to 2.15), (ii) time to 12 month remission 0.87(0.65 to 1.17), (iii) time to first seizure 0.85(0.68 to 1.05). The review suggests that time to withdrawal is significantly improved with carbamazepine compared to phenobarbitone. No overall difference between drugs is identified for the outcomes 'time to 12 month remission' and 'time to first seizure'. Statistical heterogeneity was not encountered. An interaction between treatment and seizure type, confirmed statistically, was identified for time to first seizure, where phenobarbitone was favoured for partial onset seizures and carbamazepine for generalized onset tonic-clonic seizures. REVIEWER'S CONCLUSIONS: We found no overall difference between carbamazepine and phenobarbitone for time to 12 month remission or time to first seizure, however, subgroup analyses for time to first seizure suggest an advantage with phenobarbitone for partial onset seizures and a clinical advantage with carbamazepine for generalized onset tonic-clonic seizures. Phenobarbitone is significantly more likely to be withdrawn, indicating that it is less well tolerated than carbamazepine.

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药物

苯巴比妥