文章摘要
经颅磁刺激联合抗癫痫药物治疗癫痫发作的效果：Meta分析
Transcranial magnetic stimulation combined with antiepileptic drugs in treatment of epileptic seizures： a meta-analysis
  
DOI：10.12089/jca.2026.03.011
中文关键词: 经颅磁刺激  抗癫痫药物  癫痫  荟萃分析
英文关键词: Transcranial magnetic stimulation  Antiepileptic drugs  Epilepsy  Meta-analysis
基金项目:国家自然科学基金面上项目（82371476）
作者单位E-mail
王法涵 710032,西安市,空军军医大学第一附属医院麻醉与围术期医学科,麻醉学教育部重点实验室  
蒋晓帆 710032,西安市,空军军医大学第一附属医院神经外科  
付静文 710032,西安市,空军军医大学第一附属医院麻醉与围术期医学科,麻醉学教育部重点实验室  
何姗 710032,西安市,空军军医大学第一附属医院麻醉与围术期医学科,麻醉学教育部重点实验室  
庹小双 710032,西安市,空军军医大学第一附属医院麻醉与围术期医学科,麻醉学教育部重点实验室  
路志红 710032,西安市,空军军医大学第一附属医院麻醉与围术期医学科,麻醉学教育部重点实验室 deerlu23@163.com 
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中文摘要:
      
目的： 采用荟萃分析的方法探讨经颅磁刺激联合常规抗癫痫药物治疗癫痫发作的效果。
方法： 检索中国知网、中国生物医学文献数据库、万方、维普数据库、中华医学会数据库、PubMed、Embase、Cochrane Library，收集经颅磁刺激联合常规抗癫痫药物治疗癫痫发作的随机对照试验。根据Cochrane偏倚风险评价标准评价纳入文献的研究质量。采用Review Manager 5.4.1软件进行荟萃分析。
结果： 共纳入10篇文献，患者269例，其中TMS组136例，对照组133例。与对照组比较，TMS组治疗有效率明显升高（RR=1.34，95%CI 1.20～1.49，P<0.001），癫痫发作频率（MD=-0.59，95%CI -0.94 ～-0.24，P=0.001）、发作频率减少至50%所用的时间（MD=-2.92 d，95%CI -3.62～-2.21 d，P<0.001）明显缩短，认知功能明显改善（SMD=6.48，95%CI 2.07～10.89，P=0.004），同时治疗期间不良反应发生率明显降低（RR=0.33，95%CI 0.21～0.53，P<0.001）。
结论： 经颅磁刺激联合抗癫痫药物可进一步提升癫痫治疗效果，减少治疗期间不良反应。
英文摘要:
      
Objective: To investigate the relationship between transcranial magnetic stimulation combined with conventional antiepileptic drugs and seizure using a meta-analytic method.
Methods: Databases including CNKI, China Biomedical Literature Database, Wanfang and VIP database, Chinese Medical Association, PubMed, Embase and Cochrane Library were searched to collect randomized controlled trials of transcranial magnetic stimulation combined with conventional anti-epileptic drugs for the treatment of epileptic seizures. The quality of the included studies were evaluated based on the Cochrane risk of bias criteria. Meta-analysis were performed using Review Manager 5.4.1 software.
Results: A total of 10 studies were included, 269 patients were enrolled, 136 patients in the TMS group and 133 patients in the control group. Compared with the control group, the treatment effective rate in the TMS group was significantly increased (RR = 1.34, 95% CI 1.20 to 1.49, P < 0.001), the frequency of seizures (MD = -0.59, 95% CI -0.94 to -0.24, P = 0.001) and the time taken to reduce the frequency of seizures to 50% (MD = -2.92 d, 95% CI -3.62 to -2.21 d, P < 0.001) were significantly reduced, the cognitive function was significantly improved (SMD = 6.48, 95% CI 2.07 to 10.89, P = 0.004), and the incidence of adverse events during treatment was significantly reduced (RR = 0.33, 95% CI 0.21 to 0.53, P < 0.001).
Conclusion: The addition of transcranial magnetic stimulation to antiepileptic drugs can further improve the efficacy and reduce adverse events during treatment.
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