目的 对比观察拉莫三嗪（LTG）早期联合硝基安定（NZP）与丙戊酸钠（VPA）单药治疗儿童 失神癫痫的疗效及不良反应。方法 选取通过典型临床表现和视频脑电图确诊儿童失神癫痫患儿 52 例， 将其分为 VPA 组 26 例及 LTG+NZP 组 26 例，分别给予丙戊酸钠单药或拉莫三嗪早期联合硝基安定（服用 第 4 个月开始 1 个月内逐渐减停）治疗，随访 1 年，观察患者的发作控制情况以及不良反应。结果 VPA 组 和 LTG + NZP 组患儿服药 1 个月时完全控制的分别为 12 例（48.0%）、10 例（41.7%）；3 个月时分别为 14 例 （56.0%）和 12 例（50.0%）；6 个月时分别 15 例（60.0%）和 14 例（58.3%）；12 个月时分别为 17 例（68.0%）和 16 例（66.7%），差异均无统计学意义（P > 0.05）。VPA 组和 LTG + NZP 组患儿治疗后 1 个月的总有效率分 别为 68.0%和 66.7%；治疗后 3 个月总有效率分别为 72.0%和 66.7%；治疗后 6 个月总有效率分别为 76.0%和 75.0%；治疗后 12 个月分别为 84.0%和 79.2%，差异无统计学意义（P > 0.05）。两组患儿不良反应发生率差 异无统计学意义（P > 0.05）。结论 拉莫三嗪早期联合硝基安定治疗儿童失神癫痫疗效与丙戊酸钠相 当；拉莫三嗪早期短时联合添加硝基安定治疗儿童失神癫痫，能兼顾疗效和起效速度。

Objective To compare the efficacy and side effects between early add ⁃ on Nitrodiazepam （NZP）to Lamotrigine（LTG）and sodium valproate（VPA）only on absence epilepsy in children. Methods The children with epilepsy diagnosed by typical clinical manifestations and video electroencephalogram were divided into VPA group（n = 26）and LTG+NZP group（n = 26）. The children were treated with VPA or early add⁃on NZP to LTG respectively（NZP tailed off at 4th month within one month）. The patients were followed up for 1 year to observe seizure control and adverse reactions of the patients. Results In VPA group and LTG+NZP group，12 cases （48.0%）and 10 cases（41.7%）were completely controlled at the first month；14 cases（56.0%）and 12 cases （50.0%）at the 3rd month；15 cases（60.0%）and 14 cases（58.3%），at the 6th month；and 17 cases（68.0%）and 16 cases（66.7%），at 12 months，indicating no statistical significance（P > 0.05）. The total effective rate of VPA group and LTG + NZP group was 68.0% and 66.7% 1 month after treatment，72.0% and 66.7% 3 months after treatment，76.0% and 75.0% 6 months after treatment，and 84.0% and 79.2% 12 months after treatment，respec⁃ tively，showing no significant difference（P > 0.05）. There was no significant difference in the incidence of adverse reactions between 2 groups（P > 0.05）. Conclusion Early add⁃on NZP to LTG onchildren with absence epilepsy has nearly the same efficacy as sodium valproate. Early add ⁃ on NZP to LTG on children with absence epilepsy might take both curative effect and onset time into consideration.