卡马西平治疗前庭阵发症的疗效及安全性

Efficacy and safety of Carbamazepine in treatment of vestibular complications

目的分析卡马西平治疗前庭阵发症的有效性和安全性。方法选取2013年6月至2017年6月我院神经内科收治的前庭阵发症患者82例，根据用药不同将其分为卡马西平组（CBZ）31例、卡马西平＋倍他司汀组（CBZ＋BMT）26例和奥卡西平＋倍他司汀组（OXC＋BMT）25例。用药3个月后比较3组患者临床疗效、发作频率、眩晕程度及不良反应。 结果CBZ组治愈14例、好转13例，治疗有效率为87.1%（27/31）；CBZ＋BMT组治愈18例、好转7例，治疗有效率为96.2%（25/26）；OXC＋BMT组治愈15例、好转8例，治疗有效率为92.0%（23/25）；3组治疗有效率差异无统计学意义（χ^2＝0.783，P＝0.129）。用药治疗3个月后，3组患者中CBZ＋BMT组发作频率和眩晕程度最低，CBZ组发作频率和眩晕程度最高（均P〈0.05）。CBZ组共发生不良反应16例，占51.6%；CBZ＋BMT组发生不良反应8例，占30.8%；OXC＋BMT组发生不良反应4例，占16.0%。结论卡马西平与奥卡西平治疗前庭阵发症疗效相似，联合倍他司汀疗效显著，且安全可靠。

ObjectiveTo evaluate the efficacy and safety of Carbamazepin（CBZ）compared with Oxcarbazepine（OXC）therapy for vestibular paroxysmia. MethodsEighty-two patients with vestibular paroxysmia were admitted during June 2013 and June 2017 in this study.According to the agents administered, all patients were divided into the CBZ group（n=31）, CBZ＋ Betahistine（BMT）group（n=26）and OXC＋ BMT group（n=25）. The clinical efficacy, frequency, vertigo and adverse reactions of three groups were compared after 3 months follow-up.ResultsIn CBZ group, 14 cases were cured, 13 were improved, and the effective rate was 87.1%.In CBZ＋ BMT group, 18 cases were cured, 7 were recovered, and the effective rate was 96.2%.In OXC＋ BMT group, 15 cases were cured, 8 cases were recovered, and the effective rate was 92.0%.There was no significantly difference in effective rate among the three groups（χ^2=0.783, P=0.129）. Meanwhile, the CBZ＋ BMT group had the lowest frequency of vestibular paroxysmia and vertigo degree, while the CBZ group was the highest; the difference in the frequency and vertigo degree between groups was statistically significant（P〈0.05）. Furthermore, the incidences of side-effects were 51.6%（n=16）, 30.8%（n=8）and 16.0%（n=4）in the CBZ group, CBZ＋ BMT group and OXC＋ BMT group, respectively.ConclusionsThe effect of Carbamazepine and Oxcarbazepine for vestibular paroxysmia is similar, and is safely and significantly improved when combined with Betahistine.