目的 探讨小儿癫痫应用小儿抗痫胶囊联合奥卡西平片治疗的临床效果。方法 选取2016年1月—2018年8朝阳市第二医院收治的150例小儿癫痫患者，运用随机数字表法将其随机分成观察组（n=75）和对照组（n=75）。对照组患者口服奥卡西平片，以10 mg/（kg·d）为起始剂量，而后每隔1周，增加剂量10 mg/（kg·d），直至维持剂量30 mg/（kg·d），均分早晚2次给药。观察组在对照组基础上口服小儿抗痫胶囊，8粒/次，3次/d。连续治疗6个月。对比两组临床疗效，治疗前后癫痫计分、发作频率、持续时间、痫性放电比率、儿童生活质量量表（Peds QLTM4.0）普适型家长代评量表评分及韦氏儿童智力量表第四版（WISC-Ⅳ）评分变化。结果 治疗后，观察组总有效率为93.3%，较对照组81.3%显著增加（P<0.05）。与治疗前相比，两组治疗后癫痫发作情况（包括意识状态及意识障碍、强直、阵挛的持续时间和脑电图）计分及其总分均显著下降（P<0.05）；但观察组减少更显著（P<0.05）。两组治疗后发作频率、痫性放电比率均较治疗前显著降低，而持续时间均显著缩短（P<0.05）；且观察组改善更显著（P<0.05）。两组治疗后Peds QLTM4.0普适型家长代评量表中各维度（生理功能、社交功能、学校表现、情感功能）评分及其总分均较治疗前显著升高（P<0.05），而观察组上升更显著（P<0.05）。两组治疗后WISC-Ⅳ中各指数（语言理解、知觉推理、工作记忆、加工速度）评分及总智商评分均显著高于治疗前（P<0.05），且观察组增高更显著（P<0.05）。结论 小儿癫痫应用小儿抗痫胶囊联合奥卡西平片治疗的整体效果显著，可明显稳定患儿病情，控制癫痫发作，减少痫性放电，提高患儿生活质量及智力水平，且安全性较高。

Objective To investigate the clinical effect of Xiaoer Kangxian Capsules combined with Oxcarbazepine Tablets in treatment of pediatric epilepsy. Methods Children (150 cases) with pediatric epilepsy admitted to Chaoyang Second Hospital from January 2016 to August 2018 were selected and randomly divided into observation group (n=75) and control group (n=75) by random number table method. The control group were po administered with Oxcarbazepine Tablets, the starting dose was 10 mg/(kg·d), and then every other week, the dose was increased by 10 mg/(kg·d) until the maintenance dose was 30 mg/(kg·d), twice in the morning and evening. And the observation group were po administered with Xiaoer Kangxian Capsules on the basis of control group, 8 grains/time, three times daily. All the children were treated for 6 months. The clinical effects in two groups were compared. The epileptic score, seizure frequency, duration, epileptic discharge ratio, Peds QLTM4.0 score, and WISC-IV score changes and side effects before and after treatment were compared. Results After treatment, the total effective rate in the observation group was 93.3%, which was significantly higher than 81.3% in the control group (P<0.05). Compared with before treatment, the scores and total scores of epileptic seizures (including the state of consciousness, disturbance of consciousness, duration of tonic and clonic seizures, and electroencephalogram) after treatment in two groups were significantly decreased (P<0.05). However, the decrease was more significant in the observation group (P<0.05). After treatment, the seizure frequency and epileptiform discharge ratio in both groups were significantly lower than those before treatment, while the duration was significantly shortened (P<0.05). And the improvement in observation group was more significant (P<0.05). After treatment, the scores and total scores of all dimensions (physiological function, social function, school performance, emotional function) in Peds QLTM4.0 universal parental surrogate scale of two groups were significantly higher than those before treatment (P<0.05), while the increase in the observation group was more significant (P<0.05). After treatment, the scores of each index (language understanding, perceptual reasoning, working memory, and processing speed) and the total IQ score in WISC-Ⅳ in two groups were significantly higher than those before treatment (P<0.05), and the increase in the observation group was more significant (P<0.05). Conclusion The overall effect of Xiaoer Kangxian Capsules combined with Oxcarbazepine Tablets is significant in treatment of pediatric epilepsy. It can obviously stabilize the condition of the child, control epileptic seizure, reduce epileptic discharge, improve the quality of life and intelligence level of the child, and has high safety.

R971

辽宁省自然科学基金项目（2015020276）