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目的 观察托吡酯作为添加药物治疗难治性癫痫的疗效、用药方法、剂量及副作用。方法 采用开放性试验的方法对 5 0例难治性癫痫患者 (其中成人 30例 ,小儿 2 0例 )进行添加托吡酯治疗 ,观察其疗效。结果 托吡酯作为添加药物治疗难治性癫痫 ,总有效率达 5 8% ,2 2 %的患者发作停止。对复杂部分性发作有效率达 6 9% ,对其他发作类型亦有一定疗效。本组中成人的疗效好于儿童。平均有效剂量成人为 (12 3 9± 47 9)mg/d ,小儿为 (3 6± 1 2 )mg·kg-1·d-1,明显低于国外报道的剂量。部分患者其最佳疗效在减量后获得。副作用主要表现为胃纳差、体重减轻及神经系统表现 ,其发生与剂量以及加量的速度有关。结论 托吡酯作为添加药物对难治性癫痫有良好疗效 ,使用过程中应注意剂量的掌握。
Objective To observe the efficacy, medication, dosage and side effects of topiramate as add-on drug in treatment of refractory epilepsy. Methods A total of 50 patients with refractory epilepsy (30 adults and 20 children) were treated with topiramate (TPD) by open-label test. The curative effect was observed. Results Topiramate as a drug addicted to treat refractory epilepsy, the total effective rate of 58%, 22% of patients with seizures stopped. The efficiency of complex partial seizures up to 69%, also have some effect on other types of attacks. The efficacy of adults in this group is better than children. The average effective dose was (12 3 9 ± 47 9) mg / d in adults and (36 ± 1 2) mg · kg -1 · d -1 in children, which was significantly lower than that reported in foreign countries. Some patients get the best effect after reduction. Side effects mainly manifested as poor appetite, weight loss and nervous system performance, its occurrence and dosage and the rate of increase related. Conclusion Topiramate as a added drug has a good curative effect on refractory epilepsy, the dosage should be mastered during use.