抗癫痫中药制剂所含西药成分的血浓度测定

Determination of blood concentrations of western medicine compositions contained in traditional Chinese antiepileptic preparations

目的:测定服用抗癫痫中药制剂患者血清西药成分的浓度,以利于其合理应用。方法:2006年9月至2007年9月176例服用抗癫痫中药制剂的癫痫患者纳入研究,其中男102例,女74例,年龄3～63岁,平均年龄(26.27±11.67)岁;患病时间1～42年,平均(11.9±8.7)年。采用荧光偏振免疫法测定患者空腹血清苯妥英、苯巴比妥、丙戊酸和卡马西平的浓度。结果:176份血样中,174份含有1种或1种以上上述西药成分。2例服用化风丹和琥珀抱龙丸患者的血样中未检出西药成分。132例单用中药制剂,44例联用中西药制剂。169例患者的病情未得到控制,其中9例患者苯巴比妥的血浓度超出有效浓度上限。9例中有2例出现嗜睡和智力下降。结论:临床使用抗癫痫中药制剂应加强血药浓度监测,以利于合理用药。

Objective： To determine the serum concentrations of western medicine compositions in patients taking traditional Chinese antiepileptic preparations in order to benefit their rational use. Methods： From September 2006 to September 2007, 176 epileptic patients taking traditional Chinese antiepileptie preparations were enrolled in the study. The patients comprised 102 men and 74 women aged 3 - 63 years [ average age （ 26.27± 11.67 ） ]. Their disease duration was 1 - 42 years [ average disease duration （11.9 ± 8.68） years]. The patients＇ fasting serum phenytoin, phenobarbital, valproate, and carbamazepine concentrations were determined with fluorescence polarization immunoassay. Results： Of 176 blood samples, 174 contained one or more than one the above-mentioned western medicine compositions, but the western medicine composition was not detected in two blood samples from the two patients receiving Huafeng pills and Hupobaolong pills. One hundred and thirty-two patients took traditional Chinese medicine alone and 44 patients took traditional Chinese medicine combined with western medicine. One hundred and sixty-nine epileptic patients＇ condition was not controlled; of them, 9 patients＇ blood phenobarbital level is over the upper limit of effective concentration, and 2 of the 9 patients developed somnolence and decreased mentality. Conclusion： Close monitoring of blood drug concentration should be performed during the clinical use of traditional Chinese antiepileptic preparations for benefit to rational drug use.