目的 探討羚羊角顆粒聯(lián)合左乙拉西坦治療小兒癲癇的臨床效果。方法 選取2014年10月-2018年7月蘇州大學(xué)附屬兒童醫(yī)院和蘇州科技城醫(yī)院收治的癲癇患兒124例，隨機分成對照組（62例）和治療組（62例）。對照組口服左乙拉西坦片，起始劑量10 mg/（kg·d），2次/d，連用1周后以每周增加10 mg/（kg·d）的幅度調(diào)整劑量至30 mg/（kg·d），2次/d，維持治療。治療組在對照組基礎(chǔ)上口服羚羊角顆粒，4~5歲2.5 g/次，5~10歲3.75 g/次，10~13歲5 g/次，2次/d。兩組患者連續(xù)治療6個月。觀察兩組患者臨床療效，同時比較治療前后兩組患者癲癇發(fā)作情況、動態(tài)腦電圖（AEEG）監(jiān)測結(jié)果、血清金屬基質(zhì)蛋白-9（MMP-9）、神經(jīng)元特異性烯醇化酶（NSE）和S-100β水平以及兒童生活質(zhì)量量表4.0（Peds QLTM4.0）量表評分。結(jié)果 治療后，對照組臨床有效率為79.0%，顯著低于治療組的91.9%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者癲癇發(fā)作頻率均顯著降低（P<0.05），持續(xù)時間均顯著縮短（P<0.05），且治療組癲癇發(fā)作情況的改善效果顯著好于對照組（P<0.05）。治療后，兩組患者AEEG顯示癇性放電人數(shù)和總異常人數(shù)均顯著低于治療前（P<0.05），且治療組明顯少于對照組（P<0.05）。治療后，兩組患者血清MMP-9、NSE、S-100β水平均顯著下降（P<0.05），且治療組患者血清MMP-9、NSE、S-100β水平明顯低于對照組（P<0.05）。治療后，兩組患者Peds QLTM4.0普適型家長代評量表中生理領(lǐng)域和心理社會領(lǐng)域評分及其總分均顯著升高（P<0.05），且治療組患者Peds QLTM4.0量表評分明顯高于對照組（P<0.05）。結(jié)論 羚羊角顆粒聯(lián)合左乙拉西坦治療小兒癲癇能有效穩(wěn)定患兒病情，改善腦部異常放電，減輕腦組織損傷，提升患兒生活質(zhì)量。

Objective To investigate the clinical effect of Lingyangjiao Granules combined with levetiracetam in treatment of children with epilepsy. Methods Children (124 cases) with epilepsy in Children's Hospital of Suzhou University and the Affiliated Hospital Science & Technology Town Hospital of Nanjing Medical University from October 2014 to July 2018 were randomly divided into control (62 cases) and treatment (62 cases) groups. Children in the control group were po administered with Levetiracetam Tablets, the initial dose was 10 mg/(kg·d), twice daily, and adjusted to 30 mg/(kg·d) by increasing 10 mg/(kg·d) per week after one week of continuous use, twice daily. Children in the treatment group were po administered with Lingyangjiao Granules on the basis of the control group, 2.5 g/time for 4-5 years old children, 3.75 g/time for 5-10 years old children, 5 g/time for 10-13 years old children, twice daily. Children in two groups were treated for 6 months. After treatment, the clinical efficacy was evaluated, and the epileptic seizures, AEEG monitoring results, the serum levels of MMP-9, NSE, S-100β, and Peds QLTM 4.0 scale scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 79.0%, which was significantly lower than 91.9% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the seizure frequency in two groups was significantly decreased (P<0.05), but duration of epilepsy was significantly shortened (P<0.05), and the epileptic seizures situation in the treatment group was significantly better than those in the control group (P<0.05). After treatment, the epileptic discharge and total abnormal persons of AEEG monitoring results in two groups were significantly reduced (P<0.05), and the number in the treatment group was significantly less than that in the control group (P<0.05). After treatment, the serum levels of MMP-9, NSE, S-100β in two groups were significantly decreased (P<0.05), and these indicators level in the treatment group was significantly better than those in the control group (P<0.05). After treatment, the total scores and scores of physiological and psychosocial field of Peds QLTM4.0 in two groups were significantly increased (P<0.05), and the Peds QLTM 4.0 scale scores in the treatment group were significantly higher than those in the control group (P<0.05). Conclusion Lingyangjiao Granules combined with levetiracetam in treatment of children with epilepsy can effectively stabilize the patient's condition, improve abnormal brain discharge, reduce brain tissue damage, and improve the quality of life.

R985;R971