妥泰转换单药治疗部分性癫痫的疗效耐药性研究

目的 观察妥泰在部分性发作伴或不伴发全身性发作癫痫患者转换成单药治疗的可能性大小、疗效、耐药性以及探索转移的最佳方法。方法 将妥泰加用治疗后达控制或有效的（发作减少≥50％）64例癫痫患者,按每两周减去原用抗癫痫药（AEDs）约1／4量或一种一种减去的方法,逐渐将原用AEDs完全撤去,转换成妥泰单药治疗。结果 减撤成功18例（28．13％）,半成功35例（54．69％）,失败11例（17．19％）。合用的AED种类越少,转换成单药的可能性越大。卡马平减用成功的机会似较丙戊略高一点。结论 妥泰转换成单药是可能的,成功率可达28．13％。卡马西平减撤时较丙戊酸相对容易,可能与减去卡马西平时相对提高服泰的血药浓度有关。在合用多种AEDs时,则以先后减撤法为宜,原则上先减去量少的一种,次减肝酶诱导药,再减另一种。即使减撤未获完全成功,至少全用的AEDs种类养活,符合联合用药的原则。

Study on the efficacy tolerability of topiramate in transferring monotherapy for the patients with partial seizures

Objective To observe the possibility and efficacy tolerability of topiramate(TPM) in transferring monotherapy for the patients wi th partial seizures with or without secondary general seizure,as well as to find out the optimum way of the transferring.Methods After T PM add-on therapy 64 patients with seizures reduced ≥50%, it reduced about 1/ 4 of AEDs or one drug each time according to every two weeks until gradually to stop fully and transferring monotherapy.Results 18 patients we re successful with TPM monotherapy (28.13%), 35 patients were half success(54.69 %), 11 cases for failure (17.19%). The less AEDs combined, the higher possibilit y of transferring monotherapy would be. The rate of success for cabamazepine see med higher than valproate.Conclusion It was possible to transfe r monotherapy by TPM. The rate of success was 28.13%. It was easier to reduce ca bamazepine than valproate. In the transferring monotherapy it was better to redu ce one after another, in principle the one of the little dose was reduced first, and then the hepatic enzyme inducing agents was reduced. Even if the transferrin g was half success,the kinds of concomitant AEDs could be reduced at least, it w as in line with the policy of medicine application.