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目的:分别给予新诊断的复杂部分性发作癫痫患者不同的新型抗癫痫药单药治疗,比较4种抗癫痫新药的总有效率和一年保留率。方法:对253例新诊断的复杂部分性发作及复杂部分性发作继发全面性发作癫痫患者随机给予奥卡西平、托吡酯、左乙拉西坦、拉莫三嗪单药治疗,比较其总有效率和一年保留率,并分析停药原因。结果:4种抗癫痫新药控制癫痫的疗效基本一致,总有效率为75.4%~87.1%,无统计学差异。拉莫三嗪的保留率最高(88.6%),其次为左乙拉西坦(85.3%),托吡酯为68.5%,奥卡西平最低(61.4%)。拉莫三嗪与其他3种抗癫痫新药的保留率有统计学差异(P<0.05),其他3种药物之间无统计学差异。停药或换药的主要原因是癫痫控制无效或加重(28例,42.4%);其次是不良反应(13例,19.7%)及药物价格(10例,15.2%)。结论:4种抗癫痫新药的有效性无明显优劣差异,拉莫三嗪的一年保留率最高,停药原因主要为药物疗效不佳和不良反应。
OBJECTIVE: To separately give different new antiepileptic drugs to newly diagnosed patients with complicated partial seizures and to compare the total effective rate and the one-year retention rate of the four antiepileptic drugs. Methods: 253 cases of newly diagnosed complex partial seizures and complicated partial seizures secondary to comprehensive seizure epilepsy were randomly assigned to receive oxcarbazepine, topiramate, levetiracetam, and lamotrigine monotherapy, and to compare their total Efficiency and one year retention rate, and analyze the reasons for withdrawal. Results: The efficacy of 4 kinds of antiepileptic drugs in controlling epilepsy was basically the same, the total effective rate was 75.4% ~ 87.1%, with no statistical difference. Lamotrigine had the highest retention rate (88.6%), followed by levetiracetam (85.3%), topiramate (68.5%) and oxcarbazepine (61.4%). The retention rates of lamotrigine and other three kinds of antiepileptic drugs were statistically different (P <0.05), and there was no significant difference among the other three drugs. The main reason for stopping or changing pills was ineffective or aggravating epilepsy (28 cases, 42.4%); followed by adverse reactions (13 cases, 19.7%) and drug prices (10 cases, 15.2%). Conclusion: There are no significant differences between the four antiepileptic drugs. The one-year retention rate of lamotrigine is the highest. The main reasons for discontinuation are poor efficacy and adverse reactions.