妥泰治疗癫痫的长期临床观察

目的 观察长期应用妥泰（TPM）治疗各种类型癫痫的临床疗效、安全性及用药方法。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合并用药（81例）和单药（65例）治疗，TPM从小剂量开始，起始量儿童〈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，逐渐调整用药剂量。观察时间为1年～3年10个月，平均16．2个月，治疗20周后及1年后与基础期（入组前3个月）月发作频率进行比较。结果 合并用药组治疗有效率为80．2％，单药治疗组有效率为87．7％，服药1年以上总有效率为90．4％。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。

Clinical Observation on the Curative Effects of Topiramate for Epilepsy

Objective To evaluate the clinical efficiency and the reaction of topiramate (TPM) used long-term for various types of epilepsy and the way to administer the drug. Methods 146 cases with epilepsy were randomly assigned to 2 groups: Group A (n=81) treated with routine antiepileptic combining with topiramate, while Group B treated only with topiramate. The dose of topiramate began with small amount, 6.25mg/d for child under 20 Kg in body weight, 12.5mg/d for child over 20Kg, and 25mg/d for adults. The dose was readapted according the status and untoward reaction respectively. The observation went on 1 year to 3 years and 10 months, average time was 16.2 months. The frequency of epileptic attack 20 weeks and 1 year after treatment was compared with the frequency of basic stage 3 months before treatment. Results The effective rate was 87.8% and 80.2% in group B and group A respectively. The total average effective rate was 83.6% 1 year after treatment. Side effects often were found in the augmented dose period, and the rate in group B was less than that in group A. The difference between the two groups was significant. Conclusions TPM is a kind of new antiepileptic with the features of broad-spectrum, high performance and secure. The various conditions of different patients should be given more attention.