A Meta-analysis for the evaluation of efficacy and safety of oxcarbazepine and carbamazepine for post-stroke epilepsy
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摘要: 目的 系统评价奥卡西平与卡马西平治疗脑卒中后继发性癫痫的疗效和安全性。 方法 计算机检索PubMed、Cochrane Library、EMbase、万方、中国知网、维普、中国生物医学文献数据库（CBM）等收录的奥卡西平和卡马西平治疗脑卒中后继发性癫痫的相关文献，检索时限为建库以来到2017年8月，使用RevMan5.3软件进行Meta分析。 结果 共纳入6项研究，包含517例患者。Meta分析结果显示：奥卡西平组控制癫痫的总体有效率高于卡马西平组，差异有统计学意义（RR=1.44，95%CI：1.29~1.60，P<0.000 01）；奥卡西平组总不良反应发生率低于卡马西平组，差异有统计学意义（RR=0.39，95%CI：0.26~0.57，P<0.000 01）；皮疹、头晕、嗜睡、恶心、呕吐发生率的比较差异均无统计学意义。 结论 奥卡西平治疗脑卒中后继发性癫痫的疗效优于卡马西平，安全性较卡马西平好。由于本研究纳入的文献数量和样本量较少，因此还需更多大样本、多中心的高质量临床随机对照试验（randomized controlled trials，RCT）进一步研究验证。Abstract: Objective To evaluate the efficacy and safety of oxcarbazepine and carbamazepine in treating post-stroke epilepsy. Methods PubMed, Cochrane Library, EMbase, VIP, CNKI and CBM were used for searching literatures related to oxcarbazepine and carbamazepine in the treatment of post-stroke epilepsy before August 2017, followed with RevMan5.3 software for data analysis. Results 6 studies were included with 517 patients. Meta-analysis showed that the total effective rate in oxcarbazepine group was higher than carbamazepine group with statistical significance (RR=1.44,95%CI:1.29~1.60,P<0.000 01). The incidence of total adverse reactions in oxcarbazepine group was also statistically significant lower than carbamazepine group (RR=0.39,95%CI:0.26~0.57,P<0.000 01). There was no statistically significant difference (P>0.05) in rash, dizziness, somnolence, nausea and vomiting between two groups. Conclusion Our analysis indicated that oxcarbazepine had better efficacy than carbamazepine in treating post-stroke epilepsy with less adverse reactions. Due to the limited number of literatures and sample size, large samples with multi-center and high quality clinical randomized controlled trials are needed to confirm the credibility of our conclusions.
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Key words:
- oxcarbazepine /
- carbamazepine /
- post-stroke epilepsy /
- efficacy /
- safety /
- Meta-analysis
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