CAJ | 학술논문

目的　观察妥泰在部分性发作伴或不伴继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、耐药性以及探索转换的最佳方法　.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.卡马西平减用成功的机会似较丙戊酸略高一点.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妥泰的血药浓度有关. 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.既使减撤未获完全成功,至少合用的 AEDs种类可减少,符合联合用药的原则.
목적　관찰타태재부분성발작반혹불반계발전신성발작전간환자전환성단약치료적가능성대소、료효、내약성이급탐색전환적최가방법　.방법　장타태가용치료후체공제혹유효적(발작감소≥50%)64례전간환자,안매량주감거원용항전간약(AEDs)약1/4량혹일충일충감거적방법　,축점장원용AEDs완전철거,전환성타태단약치료.결과　감철성공18례(28.13%),반성공35례(54.69%),실패11례 (17.19%).합용적AED충류월소,전환성단약적가능성월대.잡마서평감용성공적궤회사교병무산략고일점.결론　타태전환성단약시가능적,성공솔가체28.13 %. 잡마서평감철시교병무산상대용역,가능여감거잡마서평시상대제고타태적혈약농도유관. 재합용다충AEDs시,칙이선후감철법위의,원칙상선감거량소적일충,차감간매유도약,재감령일충.기사감철미획완전성공,지소합용적 AEDs충류가감소,부합연합용약적원칙.
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.