小剂量托吡酯治疗Tourette综合征疗效观察

Effect of low-dose topiramate on Tourette syndrome

目的:探讨托吡酯治疗Tourette综合征的临床效果及合适剂量。方法:本组79例Tourette综合征患儿均应用托吡酯单药治疗,起始剂量0.5mg·kg-1.d-1,滴定法加量,每周加量0.5mg·kg-1.d-1,最大剂量为3mg·kg-1.d-1,2次/d,用药3个月后依据抽动控制情况评定疗效,并观察药物不良反应。结果:79例中除2例出现明显药物不良反应而退出观察外,余77例于治疗后2～4周症状均获显著改善,抽动完全控制47例(61.03%),显效24例(31.16%),无效6例(7.79%),总有效率为92.19%。治疗早期3例出现疲乏,3例体重下降,2例出汗减少,继续用药后症状有所缓解,患儿均能耐受并逐渐缓解。结论:托吡酯治疗Tourette综合征疗效好,所需剂量小,不良反应轻,可作为治疗该病的首选药物之一。

Objective： To determine the effect of low-dose topiramate on Tourette syndrome and its appropriate dosage. Methods： Seventy-nine children patients with Tourette syndrome were treated using topiramate solely, the initial dose was 0.5 mg ·kg^-1·d^-1, and the following dose of therapy was on the base of initial dose giving added dose of 0.5 mg·kg^-1·d^-1 weekly through titration, the maximal dose was 3 mg·kg^-1·d^-1, 2 times daily, the efficacy was evaluated after 3 months medication according to the improvement of tic, side effects of the drug were observed. Results： Two patients pulled out treatment due to markedly side effects of drug, symptoms of 77 patients improved significantly after 2 ~4 weeks therapy, tics disappeared in 47 eases （61.03%）, effectual rate was 31.16 % （24 cases）, 6 cases （7.79%） had no effect, total effective rate was 92.19%. Three eases happened fatigue in early time of therapy, 3 eases had weight loss, and 2 eases presented decreased sweating , these adverse reactions remitted in the following medication and they tolerated gradually. Conclusion： Topiramate has good efficacy on the treatment of Tourette syndrome and may be the primary choice of medication, with merits of small dosage and mild side effects.