托吡酯治疗儿童多发性抽动症疗效评估  

Value of topiramate in treating tourette syndrome

作　　者：常健[1] 赵红霞[1] 李海波[1] 鲁继荣[1] 杨立彬[1] 

机构地区：[1]吉林大学第一医院儿科,130021

出　　处：《中国妇幼保健》2006年第9期1211-1213,共3页Maternal and Child Health Care of China

基　　金：吉林省科技厅资助课题(20030430)

摘　　要：目的：探讨托吡酯治疗多发性抽动症的疗效及安全性。方法：采用病例对照和自身对照的开放性研究。对确诊的65例患儿随机分为研究组41例（予托吡酯治疗，按0．5-1mg／kg／d剂量口服，至临床症状消失或达到目标剂量4-6mg／kg／d）和对照组24例（于氟哌啶醇治疗，按1mg／d口服，最大剂量不超过6mg／d）共治疗48周。研究组又分为幼儿组（17例）、年长儿组（23例）及按发作形式分为肢体抽动组（13例）、头面部抽动组（19例）和混合组（8例）。对研究对象于治疗前与治疗中（4、8、24、48周）进行耶鲁抽动症整体严重度量表（YGTSS）和不良反应量表（TESS）评估。结果：①治疗第8周末研究组有效率为87．5％，高于对照组（40％；Z=-3．475；P〈0．01）。研究组YGTSS总分[（42．56±14．48）分]低于对照组[（57．15±19．78）分；P〈0．05]；减分率[（60．18±24．48）％]高于对照组[（37．17±23．28）％；P〈0．05]。治疗第48周末，研究组有效率为90％，高于对照组（60％；Z=-4，805；P〈0．01）．研究组YGTSS总分[（21．26±13．38）分]低于对照组[（34．52±23．18）分；P〈0．01]；减分率[（85．15±15．53）％]高于对照组[（60．35±24．68）％；P〈0．05]。②治疗第24周末肢体抽动组有效率90％，高于混合组（54％；Z=-2．013；P〈0．05）和头面部抽动组（76．9％；Z=-2.235；P〈0．05）。肢体抽动组YGTSS总分[（24.76±17．38）分]低于混合组[（38．16±21．41）分；P〈0．05]；减分率[（91．23±21．58）％]高于混合组[（80．75±34．08）％；P〈0．05]。幼儿组有效率95％，高于年长儿组（82．6％；Z=-1.879；P〈0．05）。幼儿组YGTSS总分[（24．36±16．48）分]低于年长儿组（（30．89±10．76）分；P〈0．05]；减分率[（86．74±35．78）％]高于年长儿组[（79．85±33．78）％；P〈0．05]。③第48周末研究组TESObjective： To determine the efficacy and safety of topiramate in treating tourette syndrome （TS） . Methods： Sixtyfive patients who met with the DSV - Ⅳ criteria for TS were investigated hy open - controlled study. The 41 of total patients were treated with topiramate （ from 0. 5 - 1 mg kg d - 1 to 4 - 6 mg kg d - 1 ） as the research group, and the others were treated with haloperidol （ 1 mg/d, no more than 6 mg/d） as control group. During 48 weeks of treatment, the efficacy was assessed by the Yale Global Tie Severity Scale （YGTSS） and the safety were evaluated by Treatment Emergent Symptom Scale （TESS）. All patients were also divided into subgroups by age and the style of outbreak. Results： The efficacy in the research group was significantly better than that in control group, with response rates of 87. 5% and 40. 0% respectively after 8 - week treatment, and the YGTSS total scorce in research group was significantly lower than that in control group （P 〈 0. 05） . After 48 - week treatment, there were more higher response rate （90% vs 60% ）, lower YGTSS total score, and higher reduction rate of YGTSS score in research group than in control group （ all P 〈 0. 05） . The efficacy in limb group and younger group was better than that in the other groups respectively. The adverse reactions in the topiramate group were milder than that in control group at the end of 8 - week and 48 - week treatment （ P 〈 0. 05） . Conclusion ： It is effective and safe of topiramate in treating tourette syndrome, especially for some subset.

关 键 词：多发性抽动症 托吡酯 氟哌啶醇 

分 类 号：R985[医药卫生—药品]