托吡酯治疗儿童多发性抽动症的临床研究

目的观察与分析托吡酯(妥泰)单药和联合其他药物治疗儿童抽动症的临床疗效及安全性。方法选择符合ICD-10TS诊断标准的多发性抽动症80例,随机分为治疗组、对照组各40例。治疗组采用托吡酯从加药剂量到目标剂量缓慢加药,从每日0·5mg/kg开始,每周加量0·5mg/kg,目标剂量每日(2-3)mg/kg;对照组采用硫必利,根据年龄,(50-150)mg/次不等,每天两次。以抽动发作减少次数作为评定疗效,于治疗第4周、8周及12周对两组病人进行疗效和不良反应评价。对上述两组不能控制的采用托吡酯和硫必利联合用药。结果12周末治疗组有效率82·5%,对照组有效率77·5%,两组疗效统计学上无显著差异(z=1·23,p=0·22>0·05),4周末治疗组和对照组在疗效上有显著差异(z=2·77,p=0·003<0·05)。联合组对顽固性TS疗效明显,且治疗组不良反应轻微。结论托吡酯治疗儿童多发性抽动疗效肯定,且起效快,不良反应轻微。对顽固性TS可采用联合用药治疗

Clinical Study of Topiramate in Treating with Childhood Tourette Syndrome

Objective To observe and analyze the clinical curative effect and safety of using topiramate (topamax) alone or combining with tiapride to treat children tourette syndrome. Methods 80 cases with tourette syndrome consistented with ICD-10TS diagnostic criteria were divided at random into therapy and control group with 40 cases in each. Cases in therapy group were treated with topiramate, the dose of topiramate was increased from initial dose (0.5 mg/kg) to target dose (2-3mg/kg) by adding 0.5mg/kg weekly. Cases in the control group were treated with tiapride based on age, 50-150 mg, twice a day. The reduction in the number of attachment was recorded to measure curative effect. The clinical curative effect and adverse reaction was evaluated at the 4th, 8th and 12th week. Cases unable to be controlled in the two groups were treated by combination of topiramate and tiapride.Results There was no difference in curative effect between therapy group (82.5%) and control group (77.5%) at the end of the 12th week. But there were some significant differences between two groups at the end of the 4th week. Using combination of topiramate and tiapride to treat intractable tourette syndrome show significant effects and mild adverse reactions.Conclusion Topiramate is an efficient and fast effect drug with mild adverse reaction for transient tic disorder. Combination of topiramate and tiapride is available therapy for treating the intractable TS.