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目的观察拉莫三嗪单药或添加治疗成人癫痫的疗效和安全性。方法选取医院神经内科癫痫专科门诊确诊的成人癫痫患者38例,治疗分为3个阶段:(1)基线期:行脑电图、头颅MRI等明确癫痫的类型并给予抗癫痫药物如卡马西平、丙戊酸钠等治疗12周;(2)拉莫三嗪加量期:初始剂量25 mg/d,7 d后加量至50 mg,分2次服用,每7天加量25 mg,逐渐加量至100~200 mg/d,分2次服用,维持治疗12周;(3)原有抗癫痫药物减量期:对于疗效良好者,原服用抗癫痫药物的剂量每周减少1/4,直至减完为止。结果拉莫三嗪加量期和原有抗癫痫药物减量期患者总有效率分别为86.8%和81.6%,差异无统计学意义(P>0.05);38例使用拉莫三嗪观察到疗效的患者中,出现不良反应6例,发生率为15.8%,给予对症处理后均缓解,无重度不良反应发生。结论拉莫三嗪对成人癫痫的疗效良好,且不良反应较轻,药物依从性好。
Objective To observe the efficacy and safety of lamotrigine monotherapy or add-on treatment of adult epilepsy. Methods Thirty-eight adult patients with epilepsy were selected from Department of Neurology, Epilepsy specialist outpatient department. The treatment was divided into three stages: (1) Baseline: The type of epilepsy was determined by electroencephalogram (EEG), cranial MRI and antiepileptic drugs such as carbamazepine , Valproate sodium for 12 weeks; (2) lamotrigine plus period: the initial dose of 25 mg / d, 7 d after the dose to 50 mg, 2 times taken, every 7 days plus 25 mg, Gradually increase the dose to 100-200 mg / d, taking 2 times, maintaining treatment for 12 weeks; (3) the original antiepileptic drug reduction period: for good effect, the original dose of antiepileptic drugs decreased by 1 / 4, until the reduction is completed. Results The total effective rates of lamotrigine plus period and original antiepileptic drugs were 86.8% and 81.6%, respectively, with no significant difference (P> 0.05). The efficacy of lamotrigine was observed in 38 cases Of patients, there were 6 cases of adverse reactions, the incidence was 15.8%, given symptomatic treatment were relieved, no serious adverse reactions. Conclusion Lamotrigine has a good effect on adult epilepsy with less adverse reactions and good drug compliance.