托吡酯治疗癫痫146例长期随访观察

目的探讨托吡酯(TPM)单药及合并用药治疗各种类型癫痫的临床疗效、不良反应及用药方法。方法采用自身对照方法,对146例各种类型的癫痫患者进行TPM单药(65例),合并用药(81例)治疗。TPM从小剂量开始,起始量儿童体重<20kg者为6.25mg/d,≥20kg者为12.5mg/d,成人为25mg/d,根据病情及不良反应,调整用药剂量。结果单药治疗组有效率为87.7%,合并用药组有效率为80.2%,总平均有效率为83.6%。不良反应多发生在加量期,其中单药治疗组低于合并用药组,差异有显著性。结论TPM是一种广谱有效及安全的新型抗癫痫药,可作为一线抗癫痫药,使用过程中应注意个人化原则。

The Effects of Mono Therapy and Add-On Therapy With Topiramate on Patients With Epilepsy: A Report of 146 Cases

Objective To observe the clinical effects, side-effects and usage of mono therapy and add-on therapy with topiramate (TMP) on patients with epilepsy. Methods 146 patients with epilepsy were divided into mono therapy group (65 cases) and add-on therapy group (81 cases) randomly. The topiramate began with low dosage, the dosage of children was 6.25mg/d (body weight was less than 20 kg) and 12.5mg/d (body weight was over 20 kg), the dosage of adult was 25mg/d. The dosage was adjusted by the side effect and patient's condition. Results The effective rates were 87.7% in mono therapy group and 80.2% in add-on therapy group respectively. The total effective rate was 83.6%. The side effects in mono therapy group were less than add-on therapy group significantly, and it often occur at the period of add-on therapy. Conclusions Topiramate is a new, safe and effective broad-spectrum antiepileptic drug and can be used firstly, but the dosage should be individualized.