小剂量托吡酯治疗Tourette综合征疗效观察

目的：探讨托吡酯治疗Tourette综合征的临床效果及合适剂量。方法：本组79例Tourette综合征患儿均应用托吡酯单药治疗，起始剂量0．5mg·kg^-1·d^-1，滴定法加量，每周加量0．5mg·kg^-1·d^-1，最大剂量为3mg·kg^-1·d^-1，2次／d，用药3个月后依据抽动控制情况评定疗效，并观察药物不良反应。结果：79例中除2例出现明显药物不良反应而退出观察外，余77例于治疗后2^-14周症状均获显著改善，抽动完全控制47例（61．03％），显效24例（31．16％），无效6例（7．79％），总有效率为92．19％。治疗早期3例出现疲乏，3例体重下降，2例出汗减少，继续用药后症状有所缓解，患儿均能耐受并逐渐缓解。结论：托吡酯治疗Tourette综合征疗效好，所需剂量小，不良反应轻，可作为治疗该病的首选药物之一。

Effect of low-dose topiramate on Tourette syndrome

Objective:To determine the effect of low-dose topiramate on Tourette syndrome and its appropriate dosage. Methods:Seventy-nine children patients with Tourette syndrome were treated using topiramate solely,the initial dose was 0.5 mg·kg-1·d-1,and the following dose of therapy was on the base of initial dose giving added dose of 0.5 mg·kg-1·d-1 weekly through titration,the maximal dose was 3 mg·kg-1·d-1,2 times daily,the efficacy was evaluated after 3 months medication according to the improvement of tic,side effects of the drug were observed. Results:Two patients pulled out treatment due to markedly side effects of drug,symptoms of 77 patients improved significantly after 2~4 weeks therapy,tics disappeared in 47 cases (61.03%),effectual rate was 31.16 % (24 cases),6 cases (7.79%) had no effect,total effective rate was 92.19%. Three cases happened fatigue in early time of therapy,3 cases had weight loss,and 2 cases presented decreased sweating ,these adverse reactions remitted in the following medication and they tolerated gradually. Conclusion:Topiramate has good efficacy on the treatment of Tourette syndrome and may be the primary choice of medication,with merits of small dosage and mild side effects.