中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2009年
7期
1174-1179
,共6页
癫痫%药物疗法%丙戊酸%迟效制剂
癲癇%藥物療法%丙戊痠%遲效製劑
전간%약물요법%병무산%지효제제
Epilepsy%Drug therapy%Valproic acid%Delayed-action preparations
目的 观察丙戊酸镁缓释片治疗各种类型癫痫的疗效和安全性.方法 分别用单药和添加治疗各类癫痫患者88例,添加组39例,在原有抗癫痫药基础上,按成人每日0.5～1.5 g,儿童15～30 mg·kg-1·d-1,于早、晚两次口服丙戊酸镁缓释片;单药组49例,成人起始剂量为每日口服丙戊酸镁缓释片0.5 g,每周增加剂量不超过0.5 g,最大剂量不超过每日2.0 g;儿童按15～30 mg·kg-1·d-1,最大不超过40 mg·kg-1·d-1.服药24周根据发作频率减少情况进行疗效评定.结果 对各种类型的癫痫发作治疗总控制率为43.2%,总显效率为23.9%,总有效率为81.8%,无一例出现发作次数增多.单药治疗组控制率为51.0%,显效率为22.4%,总有效率为83.7%;添加治疗组控制率为33.3%,显效率为25.6%,总有效率为79.5%.两组相比,单药组治疗效果略高于添加治疗组,但差异无统计学意义.单药治疗疗效较为明显者为失神发作、强直发作、肌阵挛发作、失张力发作等,而局灶性发作仅占50.0%;添加治疗组其疗效较为明显者是继发强直阵挛性发作(90.0%).不良反应主要为头昏、体重增加、嗜睡、脱发、血小板减少、一过性氨基转移酶升高等,多数患者反应较轻,只要从小剂量开始,加药速度慢,注意肝功能等检查,就能够坚持服药.虽然此药比较安全,但在发育期女性及孕妇中应用仍然要慎重.随访一年以上患者依从性较好.结论 丙戊酸镁缓释片具有较好的临床疗效和药物依从性,是较理想的抗癫痫药物.
目的 觀察丙戊痠鎂緩釋片治療各種類型癲癇的療效和安全性.方法 分彆用單藥和添加治療各類癲癇患者88例,添加組39例,在原有抗癲癇藥基礎上,按成人每日0.5～1.5 g,兒童15～30 mg·kg-1·d-1,于早、晚兩次口服丙戊痠鎂緩釋片;單藥組49例,成人起始劑量為每日口服丙戊痠鎂緩釋片0.5 g,每週增加劑量不超過0.5 g,最大劑量不超過每日2.0 g;兒童按15～30 mg·kg-1·d-1,最大不超過40 mg·kg-1·d-1.服藥24週根據髮作頻率減少情況進行療效評定.結果 對各種類型的癲癇髮作治療總控製率為43.2%,總顯效率為23.9%,總有效率為81.8%,無一例齣現髮作次數增多.單藥治療組控製率為51.0%,顯效率為22.4%,總有效率為83.7%;添加治療組控製率為33.3%,顯效率為25.6%,總有效率為79.5%.兩組相比,單藥組治療效果略高于添加治療組,但差異無統計學意義.單藥治療療效較為明顯者為失神髮作、彊直髮作、肌陣攣髮作、失張力髮作等,而跼竈性髮作僅佔50.0%;添加治療組其療效較為明顯者是繼髮彊直陣攣性髮作(90.0%).不良反應主要為頭昏、體重增加、嗜睡、脫髮、血小闆減少、一過性氨基轉移酶升高等,多數患者反應較輕,隻要從小劑量開始,加藥速度慢,註意肝功能等檢查,就能夠堅持服藥.雖然此藥比較安全,但在髮育期女性及孕婦中應用仍然要慎重.隨訪一年以上患者依從性較好.結論 丙戊痠鎂緩釋片具有較好的臨床療效和藥物依從性,是較理想的抗癲癇藥物.
목적 관찰병무산미완석편치료각충류형전간적료효화안전성.방법 분별용단약화첨가치료각류전간환자88례,첨가조39례,재원유항전간약기출상,안성인매일0.5～1.5 g,인동15～30 mg·kg-1·d-1,우조、만량차구복병무산미완석편;단약조49례,성인기시제량위매일구복병무산미완석편0.5 g,매주증가제량불초과0.5 g,최대제량불초과매일2.0 g;인동안15～30 mg·kg-1·d-1,최대불초과40 mg·kg-1·d-1.복약24주근거발작빈솔감소정황진행료효평정.결과 대각충류형적전간발작치료총공제솔위43.2%,총현효솔위23.9%,총유효솔위81.8%,무일례출현발작차수증다.단약치료조공제솔위51.0%,현효솔위22.4%,총유효솔위83.7%;첨가치료조공제솔위33.3%,현효솔위25.6%,총유효솔위79.5%.량조상비,단약조치료효과략고우첨가치료조,단차이무통계학의의.단약치료료효교위명현자위실신발작、강직발작、기진련발작、실장력발작등,이국조성발작부점50.0%;첨가치료조기료효교위명현자시계발강직진련성발작(90.0%).불량반응주요위두혼、체중증가、기수、탈발、혈소판감소、일과성안기전이매승고등,다수환자반응교경,지요종소제량개시,가약속도만,주의간공능등검사,취능구견지복약.수연차약비교안전,단재발육기녀성급잉부중응용잉연요신중.수방일년이상환자의종성교호.결론 병무산미완석편구유교호적림상료효화약물의종성,시교이상적항전간약물.
Objective To observe the efficacy and safety of sustained release tablets of magnesium valproate in 88 various type epileptic seizure.Methods 88 patients with epilepsy were divided into two groups.39 patients who have had many AEDs in turn served as add-on therapy group,and 49 newly diagnosed patients who had never accepted standard therapy entered monotherapy group.In adults,the initial dose was 500 mg(given twice per day),the maintenance dose was 500～1 000 mg,maximum did not surpass 2 000 mg.In children,the initial dose was 15～30 mg·kg-1·d-1,and maximum did not surpass 40 mg·kg-1·d-1.During the first 24 weeks of treatment therapeutic effect evaluation was carried out both in monotherapy group and add-on therapy group according to seizure frequency reduction.Results The total control rate was 43.2%,total excellence rate was 23.9%,total effective rate was 81.8%,for different epileptic seizure.Neither occurrence seizure frequency was increased.Among monotherapy group,control rate was 51.0%,excellence rate was 22.4%,total effective rate was 83.7%;in add-on therapy group control rate was 33.3%,excellence rate was 25.6%,total effective rate was 79.5%.In monotherapy group good therapeutic effect was seen in patients with absence seizure,tonic seizure,myoclonic seizure and atonic seizure.It's side effects were dizziness,fat,somnolence,alopecia,thrombopeny,transaminase increasing temporality,etc.Most reaction were light and can insist on dose,but pregnant women still need discretion.Good treatment compliance in patients was observed during more than 1 year's follow-up.Conclusions Sustained release tablets of magnesium valproate has well therapeutic effect,well dependence,it is an ideal antiepileptic drug.
