苯巴比妥单一用药治疗哈尔滨市癫痫患者1年疗效评价

Evaluation of therapeutic efficiency of phenobarbital monotherapy for 1 year on epilepsy in Harbin city

目的通过2011年黑龙江省哈尔滨市农村癫痫管理防治项目对癫痫病患者用药随访管理,评价癫痫患者苯巴比妥单一用药治疗效果。方法癫痫患者经筛查、复核确定入组。惊厥性癫痫患者进行免费苯巴比妥治疗和随访管理,评价分析药物疗效及不良反应、患者的自我感觉等指标。并进行定期随访,填写随访表,资料均以Epi Date 3.1表格形式录入,使用SPSS 17.0软件对患者在3、6、9、12个月的数据进行分析。结果 2011年共有680例癫痫患者入组管理,男性383人（56.32%）,女性297人（43.68%）。随访管理患者服药剂量主要集中在60-90 mg/d的范围。癫痫患者癫痫平均发作次数由3月到6月时下降明显,而癫痫患者的平均发作人数变化不大。癫痫患者随访管理1年时间治疗有效率呈上升趋势,治疗恶化呈下降趋势,不同疗程患者疗效差异有统计学意义（χ^2=26.45,P〈0.01）,随访满1年479例患者有治疗效果的352人,占73.49%。随访1年里癫痫发作仅仅是短暂意识丧失,没有抽搐的比例明显升高。癫痫患者自我感觉由3月到6月变化最为明显,自我感觉好一些的比例上升最高。服用苯巴比妥药物副作用中共济失调（χ^2=19.41,P〈0.01）、头痛（χ^2=22.52,P〈0.01）、皮疹（χ^2=24.49,P〈0.01）所占比例随时间变化呈现下降,有统计学意义,以共济失调下降最为明显。结论开展苯巴比妥对癫痫患者治疗管理工作,对提高农村癫痫的控制水平是有效、经济、安全和适用的。

Objective To assess the therapeutic efficiency of phenobarbital monotherapy on epilepsy based on the followup management of patients through the management project for the prevention and treatment of epilepsy in rural areas in Harbin city. Methods The patients with epilepsy were determined by screening and review. The free phenobarbital treatment and follow-up management were performed in these convulsive epilepsy patients. The curative efficacy,adverse reactions and sense of patients were analyse and evaluated. The regular follow-up was carried out to fill the follow-up table.The data were input in the form of Epi Date 3. 1,and analysed by using SPSS 17. 0 software. Results In 2011,a total of680 cases of epilepsy patients were managed,included 383 males（ 56. 32%） and 297 females（ 43. 68%）. The dose of phenobarbital in the managed patients was 60 to 90 mg / d. After the treatment,the mean number of seizures dropped significantly,but the number of patients with seizure did not change clearly. The 1 year follow-up showed that an upward trend in the effective rate and down trend in the rate of deterioration,the difference was statistically significant（ χ^2=26. 45,P 〈0. 01）. In the 479 followed patients,352 were effective with a rate of 73. 49%. The rate of patients with only transient loss of consciousness and without convulsion increased. The sense of most patients was improved for 3th to 6th months. Among the complications,the rate of ataxia（ χ^2= 19. 41,P 〈0. 01）,headache（ χ^2= 22. 52,P 〈0. 01） and rash（χ^2= 24. 49,P 〈0. 01） decreased significantly with the continuation of treatment,in which ataxia was more obvious.Conclusion The phenobarbital monotherapy is effective,economic,safe and suitable for epilepsy which should improve the control level of epilepsy in rural areas.