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目的观察加用及单用托吡酯二种方式治疗老年癫痫间患者的临床疗效和副反应,探讨单用托吡酯更快、更有效的给药方式。方法老年癫痫间患者124人,分为加用组(A组)52例患者,在服用卡马西平或苯妥英钠的基础上加用托吡酯25mg/d,增量25mg/周至200mg/d;单药组72例患者按初始剂量及加量速度不同又分为M1、M2、M3组,M1组患者托吡酯25mg/d,增量25mg/周至200mg/d;M2组患者托吡酯初始剂量50mg/d,增量25mg/周至200mg/d;M3组患者托吡酯初始剂量50mg/d,增量25mg/3d至200mg/d。结果各组患者托哟酯总有效率分别为加用组82.7%,单药组初始剂量25mg/d组82.6%,初始剂量50mg/d,增量25mg/周组84.0%,初始剂量50mg/d,增量25mg/3d组70.8%,加用组和M1、M2组单用托吡酯总有效率比较无明显差异(P>0.05)。发生率比较高的副反应为感觉异常、食欲差和头痛。结论可单用托吡酯并给予较大初始剂量(50mg/d),以25mg/周速度增量治疗老年癫痫间。
Objective To observe the clinical effects and side effects of combined use of topiramate alone and two ways to treat elderly patients with epilepsy and to explore the faster and more effective administration mode of topiramate alone. Methods A total of 124 elderly patients with epilepsy were divided into two groups: group A (52 patients) and topiramate (25 mg / d), with an increase of 25 mg / week to 200 mg / d on the basis of carbamazepine or phenytoin. Group 72 patients were divided into M1, M2, M3 group according to the initial dose and the rate of increase, topiramate 25mg / d in M1 group, increment 25mg / week to 200mg / d; topiramate in M2 group initial dose 50mg / d The amount of 25mg / week to 200mg / d; M3 group patients with topiramate initial dose of 50mg / d, an increase of 25mg / 3d to 200mg / d. Results The total effective rate of patients receiving each group was 82.7% of the combined group, the initial dose of monotherapy group 25mg / d group 82.6%, the initial dose 50mg / d, the increment 25mg / week group 84.0%, the initial dose 50mg / d , And 25.8 mg / 3d in the increment group were 70.8%. There was no significant difference (P> 0.05) in the total effective rate of topiramate alone and M1 and M2 groups. Side effects of higher incidence of abnormal sensations, poor appetite and headache. Conclusion Topiramate can be used alone and given a larger initial dose (50mg / d), with an increase of 25mg / week in the treatment of senile epilepsy.