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目的评价托吡酯治疗脑梗死性癫患者的疗效与安全性。方法将52例脑梗死性癫患者随机分为治疗组32例和对照组20例,治疗组给予托吡酯片口服,每次25 mg.d-1,b id,持续7 d,以后按每周25~50 mg.d-1的量逐渐增加,依临床疗效调整剂量,最大剂量为375~500 mg.d-1;对照组给予卡马西平片口服,每次0.1 g,tid,逐渐加量,依临床疗效调整剂量,最大剂量为1.0~1.2 g.d-1。两组观察期均为20周。结果治疗组总有效率(84.4%)明显高于对照组(60.0%)(P<0.05)。治疗组中小面积梗死的总有效率(95.5%)明显高于大面积梗死患者(60.0%)(P<0.05)。治疗组不良反应发生率21.9%,对照组不良反应发生率40.0%,不良反应均随着治疗时间的延长而消失。结论托吡酯单药治疗脑梗死性癫患者疗效较好,安全,尤其对小面积脑梗死型癫疗效较好。
Objective To evaluate the efficacy and safety of topiramate in patients with cerebral infarction epilepsy. Methods Fifty-two patients with cerebral infarction epilepsy were randomly divided into treatment group (n = 32) and control group (n = 20). The treatment group was given topiramate tablets 25 mg.d-1, b id for 7 days, ~ 50 mg.d-1 gradually increased, the dose adjusted according to clinical efficacy, the maximum dose of 375 ~ 500 mg.d-1; the control group was given carbamazepine orally, each 0.1 g, tid, gradually increase the amount, According to the clinical efficacy of dose adjustment, the maximum dose of 1.0 ~ 1.2 gd-1. The two groups were observed for 20 weeks. Results The total effective rate (84.4%) in the treatment group was significantly higher than that in the control group (60.0%) (P <0.05). The total effective rate of small area infarction in the treatment group (95.5%) was significantly higher than that in the large area infarction patients (60.0%) (P <0.05). The incidence of adverse reactions in the treatment group was 21.9%, the incidence of adverse reactions in the control group was 40.0%, and the adverse reactions disappeared with the prolongation of treatment time. Conclusion Topiramate monotherapy in the treatment of patients with cerebral infarction epilepsy better effect, safe, especially for small area cerebral infarction type epilepsy better effect.