摘要目的 探讨夜间较大剂量丙戊酸钠治疗夜间和清晨癫(癎)发作的疗效及安全性.方法 选择69例新诊断的完全在夜间或清晨发作的癫(癎)患儿,随机分为试验组(35例)和对照组(34例).均予丙戊酸钠片治疗,从小剂量开始,逐渐增加至有效维持量,分2次给药.试验组夜间剂量为清晨剂量的2倍；对照组夜间剂量与清晨剂量相同.随访6个月后评价疗效和不良反应.结果 69例患儿全部完成观察和随访.试验组28例完全控制发作(80.0％),总有效率为85.7％；对照组20例完全控制发作(58.8％),总有效率为64.7％.2组总有效率比较差异有统计学意义(P＜0.05).2组均未见严重不良反应,试验组日间嗜睡发生率(0/35例)低于对照组(2/34例).结论 夜间较大剂量丙戊酸钠能更好地控制儿童夜间和清晨癫(癎)发作,同时稳定夜间睡眠,减少日间嗜睡,不良反应短暂轻微.

abstractsObjective To explore the efficacy and safety of sodium valproate in a higher dose in the evening for treating nocturnal and early-morning seizures.Methods A total of 69 newly diagnosed pediatric patients with nocturnal or early-morning seizures were enrolled.They were randomly distributedinto experimental group (35 cases) and control group (34 cases) and treated with sodium valproate tablets.The initial dose was little.It was gradually increased to the effective maintenance dose.With sodium valproate given twice a day,the post meridiem(PM) dose was twice the ante meridiem(AM) dose in the experimental group,while the PM/AM dose was equal in the control group.All patients were at least been followed up for 6 months.Results In the experimental group,28 cases were seizure free (80.0％),and the total effective rate was 85.7％.In the control group,20 cases were seizure free (58.8％),and the total effective rate was 64.7％.The difference in the total effective rate between the 2 groups was significant (P ＜ 0.05).No severe adverse effect was found among all patients.The incidence of daytime sleepiness (0/35 cases) in the experimental group was lower than that in the control group (2/34 cases).Conclusions A higher dose of sodium valproate in the evening for nocturnal and early-morning seizures led to better seizure control,better nocturnal sleep,less daytime somnolence,and the side effects are slight.