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目的探讨托吡酯(TPM)治疗Tourette综合征的临床效果及合适剂量。方法Tourette综合征患儿79例予TPM口服,剂量从0.5mg/(kg.d)开始,渐增加至3mg/(kg.d),2次/d,于治疗前及治疗后3个月应用耶鲁抽动症整体严重程度量表(YGTSS)评估疗效,观察药物不良反应。结果除1例出现药物不良反应和2例剂量增加至3mg/(kg.d)无效果而退出观察外,余76例于治疗后2～4周症状均获显著改善,治疗前后YGTSS分值:运动性抽动分数19.63±3.09和5.05±1.74,发声性抽动分数18.95±2.56和4.82±1.94,综合损害分数24.21±5.89和10.42±3.69,严重度总分62.21±5.81和22.26±4.81。治疗前后YGTSS各分值比较均有显著差异(Pa<0.001)。76例中3例出现疲乏,1例嗜睡,2例注意力不集中,继续用药后症状消失,均不影响治疗。结论TPM治疗Tourette综合征疗效好,所需剂量小,不良反应轻,可作为治疗该病的首选药物之一。
Objective To investigate the clinical effect and appropriate dosage of topiramate (TPM) in the treatment of Tourette’s syndrome. Methods A total of 79 children with Tourette’s syndrome were given TPM orally. The dosage was increased from 0.5mg / (kg · d) to 3mg / (kg · d), twice daily, before and 3 months after treatment Yale tic disorder overall severity scale (YGTSS) to assess the efficacy of adverse drug reactions observed. Results Except one case of adverse drug reactions and 2 cases of dose increased to 3mg / (kg.d) no effect and exit the observation, the remaining 76 cases 2 to 4 weeks after treatment were significantly improved symptoms, before and after treatment YGTSS score: The scores of motor tics were 19.63 ± 3.09 and 5.05 ± 1.74, the tonic tics were 18.95 ± 2.56 and 4.82 ± 1.94 respectively, the total scores of injury were 24.21 ± 5.89 and 10.42 ± 3.69, and the scores of severity were 62.21 ± 5.81 and 22.26 ± 4.81. Before and after treatment YGTSS scores were significantly different (Pa <0.001). Of the 76 patients, 3 were fatigue, 1 were drowsiness, 2 were inattention, and the symptoms disappeared after continued treatment, which did not affect the treatment. Conclusion TPM treatment of Tourette syndrome efficacy, the required dose is small, mild adverse reactions, can be used as the drug of choice for the disease.