摘要
目的观察广西部分农村地区癫癎发病情况,并通过治疗有效率和保留率评价丙戊酸钠单药治疗疗效。方法由经过培训的全科医师采用统一调查表的方式对广西部分农村地区已明确诊断或可疑癫癎的部分人群进行筛查,再由神经科医师复查确诊入组。采用治疗有效率和治疗保留率评价丙戊酸钠单药治疗效果。结果癫癎患者309例,病因明确者86例(27.83%);随访>6个月者134例,显效76例(56.72%),有效34例(25.37%),无效20例(14.93%),恶化4例(2.99%)。其中,全面性强直-阵挛发作治疗总有效率为83.51%(81/97),部分继发性全面性发作87.50%(14/16),单纯部分性发作71.43%(5/7),复杂部分性发作60%(6/10),失神发作100%(3/3),其他类型100%(1/1);治疗第6、12及18个月时,治疗保留率分别为97.73%(302/.309)、97.09%(300/309)和83.50%(258/309)。共30例患者出现不良反应,依次为乏力、嗜睡、记忆力减退、肝功能异常、头晕、体质量增加、食欲亢进、头痛、震颤、脱发、步态不稳及食欲不振;不良反应总发生率为9.71%。结论广西农村地区癫癎患者发病年龄及性别分布与全国其他农村地区相似。治疗保留率作为评价抗癫癎药物长期治疗效果的指标,与治疗有效率联合应用能够综合反映丙戊酸钠的治疗效果,丙戊酸钠具有向广西更多农村及条件相似地区临床推广应用的价值。
Objective To investigate the general state, effective rate and continuous treating rate of sodium valproate （VPA） in epilepsy in rural area of Guangxi Autonomous Region. Methods In part of the rural area of Guangxi Autonomous Region, patients diagnosed as definited or suspected epilepsy were screened with unified questionnaires by trained general practitioners and confirmed by neurologists. The effective rate and continuous treating rate were used to assess the efficacy of sodium valproate for epilepsy. Results Out of 309 patients with epilepsy, there were 86 cases （27.83%） with definite causes, and 134 cases followed more than 6 months. There were 76 cases （56.72%） with significant efficiency, 34 cases （25.37%） efficiency and 20 cases （14.93%） inefficacy. Four cases （2.99%） presented exacerbation. The total effective rate in generalized tonic-clonic seizure （GTCS） was 83.51% （81/97）, partial secondary generalized seizure was 87.50% （14/16）, simple partial seizure （SPS） was 71.43% （5/7）, complex partial seizure （CPS） was 60% （6/10）, absence seizure was 100% （3/3）, and other type was 100% （1/1）. The continuous treating rate on the 6th, 12th and 18th month of therapy was 97.73% （302/309）, 97.09% （300/ 309） and 83.50% （258/309）, respectively. There were 30 cases had adverse reaction. The adverse reactions included asthenia （20%）, somnolence （13.33%）, hypomnesia （10%）, liver dysfunction （10%）, dizziness （10%）, weight gain （6.67%）, excessive appetite （6.67%）, headache （6.67%）, tremor （6.67%）, baldness （3.33%）, instability of gait （3.33%） and anorexia （3.33%）. The incidence rate of adverse reaction was 9.71%. Conclusion There are no significant differences of the age of onset and sex distribution of epilepsy in rural area of Guangxi Autonomous Region between those in domestic other rural areas of our country. The continuous treating rate can be used as the index to assess long-term efficacy of antiepi
出处
《中国现代神经疾病杂志》
CAS
2010年第6期657-661,共5页
Chinese Journal of Contemporary Neurology and Neurosurgery
基金
中国抗癫癎协会中国农村地区癫癎防治管理项目
关键词
癫痫
丙戊酸
流行病学研究
药物疗法
Epilepsy
Valproic acid
Epidemiologic studies
Drug therapy
