口服“纯中药”患儿的抗痫西药血浓度监测  

Blood levels monitoring of antiepileptic drug in epileptic children with "pure Chinese medicine"

作　　者：王丽[1] 徐中西[1] 

机构地区：[1]北京大学第一医院,北京100034

出　　处：《儿科药学杂志》2005年第3期1-3,共3页Journal of Pediatric Pharmacy

基　　金：国家自然基金部分资助项目(30440076)

摘　　要：目的:用治疗药物监测(TDM)方法监测口服“纯中药”患儿的抗痫西药血浓度,及时发现和调整患儿的不合理用药。方法:凡是临床上出现药物中毒、无法解释的药理现象或者怀疑服有中药掺杂西药的癫痫患者,用HPLC法和PLIA法监测其血药浓度,并动态地观察疗效。结果:45例服用“纯中药”的癫痫患儿,血清中检测出1￣5种常用抗痫西药,其中苯巴比妥最多(42例),其次为卡马西平、丙戊酸钠、苯妥英纳和氯硝西泮,有些已达中毒浓度。这种现象给病人造成极大的诊疗困难、中毒危险、心理创伤及经济损失。结论:TDM对怀疑服用暗加西药的“纯中药”者,具有合理用药的重要指导作用。Objective: To identify the antiepileptic drugs (AEDs) in adulterated 'pure Chinese medicine' and modulate the unreasonable drug therapy. Methods: Epileptic children with clinical toxicity, in-explainable pharmacologic phenomenon, or under suspicion of toxicity were clinically examined with therapeutic drug monitoring (TDM). Their blood levels were determined immediately by HPLC and PLIA. Results: 45 children with epilepsy taken 'pure Chinese medicine' were examined and one to five kinds of antiepileptic drugs were found in their serum. Based on the numbers found out, the order of AEDs was phenobarbital, carbamazepine, valproate, phenytoin and clonazepam. For some of them, the amounts had already reached the toxicity level. Conclusion: TDM is valuable in determining AEDs in 'pure Chinese medicine' and helps in deciding direct a scientific therapy.

关 键 词：中药 抗癫痫药 血浓度监测 假药 

分 类 号：R97[医药卫生—药品]