抗癫痫中药制剂中西药成分监测

目的：测定服用抗癫痫中药制剂患者血清中苯巴比妥、丙戊酸和卡马西平的浓度,以监测抗癫痫中药制剂的合理应用。方法：采用荧光偏振免疫法测定患者空腹血清苯巴比妥、丙戊酸和卡马西平的浓度。结果：研究对象为2009年到我院门诊就诊并确诊为癫痫并服用抗癫痫中药制剂的患者57例,其中男性32例,女性25例,年龄10～49岁。57份血样中,除42例患者的血样中未检出西药成分外,其余15例患者血清中均检出1～3种西药成分。57例患者中54例病情未得到控制,且2例出现大发作。结论：抗癫痫中药制剂使用时部分存在添加苯巴比妥、丙戊酸和卡马西平这3种抗癫痫西药,中西药合用未考虑药物相互作用、重复用药、超剂量用药等情况,贻误治疗时机,不能有效地控制病情,给患者带来较大损害。因此,临床上使用抗癫痫中药制剂时应加强血药浓度监测,同时也应加强抗癫痫中药制剂的质量控制。

Monitoring on The Western Medicine Compositions in Traditional Chinese Anti-epileptic Drugs

OBJECTIVE: To determine serum concentrations of phenobarbital,valproic acid and carbamazepine in traditional Chinese anti-epileptic drugs so as to promote the rational use of anti-epileptic drugs.METHODS: Serum concentrations of phenobarbital,valproic acid and carbamazepine were determined by fluorescence polarization immunoassay.RESULTS: In 2009,a total of 57 epileptic patients who were seen in our hospital and treated with oral anti-epileptic drugs were included in our study,of whom,32 were male and 25 female(age range 10-49 years).In serum samples of 57 cases,1-3 western medicine compositions were detected in 15 samples and the western composition was not detected in the other 42 cases.Of the 57 cases,the epilepsy in 54 was out of control and there were 2 grand mal cases.CONCLUSION: In some of the traditional Chinese anti-epileptic dugs,the western medicine compositions such as phenobarbital,valproic acid and carbamazepine were added.During the combination use of Chinese medicine with western medicines fails to consider the drug interactions,repeated medication,overdose etc,which does great harm to patients because of the delay of treatment thus patients’ condition was out of control.Therefore,it is advisable to strengthen monitoring on serum drug concentrations during the use of traditional Chinese anti-epileptic drugs and tighten quality control on the traditional Chinese anti-epileptic drugs.