苯巴比妥单药治疗四川省某农村地区癫痫7年效果评价

目的了解苯巴比妥单药治疗农村地区惊厥型癫痫的有效性及安全性。方法对2005年-2012年纳入绵阳市游仙区、三台县农村地区1326例惊厥型癫痫患者,给予苯巴比妥单药治疗,起始剂量为每晚60mg/次。日服用最大剂量不超过210mg/日。观察其疗效、不良反应。结果 49.4%的患者未规律服药,19.4%的患者从未治疗过,仅31.2%的患者接受了正规治疗。86.2%的癫痫患者服用苯巴比妥剂量范围在60~150mg/日。服用苯巴比妥第1年有效率68.2%,长期随访发现有效率在第3年达67.3%,并在以后随访中稳定在63%左右。治疗后4个月存在消化道症状、共济失调不良反应,随服药时间延长不良反应减轻。结论农村地区癫痫诊治缺口巨大,苯巴比妥单药治疗农村地区惊厥型癫痫表现出良好的疗效和安全性,应在农村地区加强癫痫患者诊治管理及相关知识普及。

Evaluation of phenobarbital monotherapy in the treatment of epilepsy in a rural area of Sichuan province for 7 years

Objective To observe the efficacy and safety of phenobarbital monotherapy in the treatment of convulsive epilepsy in rural areas. Methods Take phenobarbital to the convulsion patients in the rural areas of Youxian district and Santai county, Mian- yang. To observe its efficacy, adverse reactions, compliance and the data were statistically analyzed. Results All the 1326 patients were included. 72.3% patients diagnosed as epilepsy before treatment, 49.4% patients took medicine unregulayly, 19.4% of the pa- tients had never been treated, only 31.2% of the patients received regular treatment. The phenobarbital dose of 86.2% epileptic pa- tients range within 60 ～ 150mg, male patients require higher doses of phenobarbital for seizure control. Effective rate of taking pheno- barbital monotherapy is up to 68.2% in the first year, serious adverse reactions existed in the first three months. Drug adverse reaction significantly reduced with prolonged taking phenobarbital. The compliance was over 90% after treatment for four months. Effective rate of phenobarbital treatment was 67.3% in third years with long term follow - up and the rate stabilized at around 63% in later follow - up. 553 cases withdrawed from group at different stages, 282 cases （51%） withdrawed in the first year. The main reasons of withdra- wing from group in the first year were poor effect, drop - out, refusing to take medicine. However, the reason of withdrawing from group in the group over 1 years were drop - out, replaced with other treatment, death and other factors. Conclusion The diagnostic and treatment gap of epilepsy in rural area is vast. Phenobarbital monotherapy of convulsive epilepsy in rural area showed good efficacy and safety. We should strengthen the diagnosis and treatment administration of the patients with epilepsy and popularization of the relat- ed knowledge.