托吡酯与丙戊酸钠缓释片治疗难治性癫痫疗效比较

目的 :比较托吡酯与丙戊酸钠缓释片治疗难治性癫痫的疗效。方法 :托吡酯组 39例 ,丙戊酸钠组 4 1例 ,托吡酯成人及儿童剂量在约 2mo中逐渐增至 2 0 0mg·d- 1及 4mg·kg·d- 1左右 ,po ,bid。丙戊酸钠缓释片成人剂量 0 .5～ 1.0 g·d- 1,儿童剂量逐增至总量 15～ 30mg·kg·d- 1,为每日清晨或早晨、中午 2次服用。治疗 4mo及 6mo后评定疗效。结果 :托吡酯组治疗 6mo的继发性全身发作 ,简单及复杂性部分发作有效例数优于丙戊酸钠组 ,4例在加药期快时出现疲劳、嗜睡、注意力不集中等。丙戊酸钠组 1例发生骨髓造血功能严重低下。结论 :托吡酯治疗难治性癫痫简单及复杂部分性发作伴或不伴继发性全身发作疗效优于丙戊酸钠 ,无骨髓抑制 ,也无肝、肾功能损伤

Topiramate vs sodium valproate in treating refractory epilepsy

AIM: To compare the effects between topiramate and slow-release sodium valproate in treating refractory epilepsy. 　METHODS: Topiramate group of 39 patients (M 21, F 18; age 28 a± s 20 a) was compared with sodium valproate group of 41 patients (M 22, F 19; age 27 a±17 a) in antiepileptic effect of refractory epilepsy. Adult's and children's dosages of topiramate were increased gradually about 200 mg*d-1 and 4 mg*kg*d-1 respectively during about 2 mo, po, bid, for 6 mo as a course. Adult's dosage of slow-release sodium valproate was 0.5-1 g*d-1, and children's was increased gradually to total dosage: 15-30 mg*kg*d-1, po, qd or bid (morning or morning and noon), for 6 mo as a course. Effects were analysed between these two drugs after treatment 4 and 6 mo.　RESULTS： Simple and complex partial seizures with or without secondary generalized seizure, in topiramate group were much more improved than these in sodium valproate group 6 mo after treatment. Four patients of topiramate group appeared temporary adverse reactions of central nervous system, such as tiredness, sleepiness and distraction, but one patient of sodium valproate group had severer decreased function of bone marrow.　CONCLUSION: Topiramate is one of effective antiepileptic drugs and superior to slow-release sodium valproate. There are the apparent absence of any effects of topiramate on the bone marrow and on indexes of liver and kidney.