摘要目的:分析托吡酯大剂量冲击疗法治疗小儿癫痫的临床效果及安全性。方法:选取2015年5月至2019年5月佛山市高明区人民医院儿科收治的86例癫痫患儿，男47例，女39例，年龄(8.06±0.62)岁，年龄范围为4～12岁。按照随机数表法将患儿随机分为大剂量治疗组和小剂量治疗组，每组43例。大剂量治疗组患儿采用大剂量托吡酯冲击治疗，小剂量治疗组患儿采用小剂量托吡酯治疗，两组患儿均治疗12周，比较两组患儿临床治疗效果、言语智商(VIQ)、总智商(FIQ)评分及不良反应(感觉异常、注意力分散、恶心头晕)发生情况。结果:大剂量治疗组临床有效率[95.3%(41/43)]明显高于小剂量治疗组[69.8%(30/43)]，差异有统计学意义( P<0.05)。治疗前两组患儿VIQ、FIQ评分比较，差异无统计学意义( P>0.05)；治疗后大剂量治疗组VIQ[(108.26±6.85)分]、FIQ评分[(109.26±3.64)分]均高于小剂量治疗组[(96.85±1.62)分、(100.05±2.84)分]，差异有统计学意义( P<0.05)。大剂量治疗组不良反应发生率与小剂量治疗组比较，差异无统计学意义( P>0.05)。 结论:大剂量托吡酯冲击治疗小儿癫痫可有效减少癫痫发作次数，改善患儿认知功能，且不良反应较少，值得在临床上推广应用。

abstractsObjective:To analyze the clinical efficacy and safety of topiramate high-dose shock therapy in the treatment of children with epilepsy.Methods:A total of 86 children with pediatric epilepsy who were admitted to the Pediatrics of Gaoming District People′s Hospital from May 2015 to May 2019 were selected, aged 4 to 12 years old, and the age range was(8.06±0.62)years old.The children were randomly divided into the high-dose treatment group and the low-dose treatment group, with 43 cases in each group.Patients in the high-dose treatment group were treated with high-dose topiramate shock, and patients in the low-dose treatment group were treated with low-dose topiramate shock.Both groups were treated for 12 weeks.Clinical treatment effect, verbal intelligence quotient(VIQ), full intelligence quotient(FIQ)score and adverse reactions(paresthesia, distraction, nausea and dizziness)were compared between the two groups.Results:The clinical effectiveness of the high-dose treatment group[95.3%(41/43)]was significantly higher than that of the low-dose treatment group[69.8%(30/43)], and the difference was statistically significant( P<0.05). There was no significant difference in VIQ and FIQ scores between the two groups of children before treatment( P>0.05); both VIQ[(108.26±6.85)points]and FIQ scores[(109.26±3.64)points]of the high-dose treatment group after treatment was significantly higher than the low-dose treatment group[(96.85±1.62)points, (100.05±2.84)points], and the difference was statistically significant( P<0.05). There was no significant difference in the incidence of adverse reactions between the high-dose treatment group and the low-dose treatment group( P>0.05). Conclusion:High-dose topiramate shock treatment for pediatric epilepsy can effectively reduce the number of seizures, improve children′s cognitive function, and less adverse reactions, it is worthy of clinical application.