妥泰加用治疗成人难治性部分性癫痫的疗效观察

目的：观察妥泰（TPM）加用治疗成人难治性部分性伴或不伴随继发身性发作（GTCS）的疗效，安全性及耐受性。方法：56例在不动原用抗癫痫药（AEDs)的基础上加用TPM治疗20周、前8周为加量期，后12周为维持治疗的稳定期，治疗前（基础期）记录好作频率，用药情况。体重等作为自身对照。TPM自25mg/d开始，逐渐加量，目标剂量为200mg/d，治疗及治疗结束各查基础AEDs血药浓度进行比较，治疗结束行全面疗效分析。结果：TPM加用治疗20周后，与基础期发作频率比较，64．29％患者发作频率降低≥50％；25．00％，患者发生频率降低≥75％＜100％；16．07％完全不发。不良反应轻至中度，但与合AEDs的多少有关。50％患者体重可有不同程度的下降。TPM对止痛民西平及丙戊酸钠血药浓度影响不大。结论：TMP是治疗难治性部分性伴或不伴继发GTCS的表效的药物。

Therapeutic effect of topiramate as adjunctive therapy in adults with refractory partial epilepsy

Objective　To observe the effectiveness,safety and tolerability of Topiramate(TPM) as adjunctive therapy in adults with refractory partial epilepsy with or without secondary generalized tonic-clinic seizure (GTCS).Methods　TPM as adjunctive therapy in 56 cases (original therapy with antiepileptic drugs) for 20 weeks,the first 8 weeks for titration phase, the last 12 weeks for stabilization phase of maintain therapy. In baseline phase the seizure frequency, dosage situation,weight were noted,and as the contrast of self.With 25 mg/d TPM as a starting dosage and titration,the target dosage was 200 mg/d.The blood concentration of the AEDs blood compared before and after the treatment,and the therapy was analysed widely by the end of the treatment.Results　After TPM adjunctive therapy for 20 weeks,as compared with the seizure frequency in baseline phase,the seizure frequencies of 64.29% patients were reduced ≥50%;the seizure frequencies of 25% patients ≥75%<100%;16.07% were free.The adverse responses were from mild to moderate,but it related to the dosage of AEDs.The weight of 50% patients reduced in different degree.The effects of the blood concentration weren't great on TPM to carbamazepine and valproate.Conclusion TPM is a safe effective drug for treating adult patients with refractory partial epilepsy with or without secondary GTCS.