托吡酯治疗Tourette综合征62例临床观察

Clinical Observation of Topiramate in the Treatment of Tourette Syndrome in 62 Cases

目的探讨托吡酯治疗Tourette综合征(TS)的临床疗效和安全性。方法选取重庆市精神卫生中心收治的TS患者62例,均予托吡酯片口服,剂量为1.0~5.0mg/(kg·d),初始剂量为0.5mg/kg,连续治疗12周。分别采用耶鲁抽动症严重程度量表(YGTSS)和临床疗效总评价量表(CGI)中的病情严重程度分量表(SI)评估患者的抽动严重程度及疗效,采用副反应量表(TESS)评定药品不良反应。结果总有效率为75.81%;患者治疗后的YGTSS评分为(30.19±11.03)分,SI评分为(3.77±0.82)分,明显低于治疗前的(64.10±11.23)分和(5.37±0.93)分(P<0.05);不良反应发生率为12.90%,表现为轻度的食欲下降、记忆力减退等,均未给予治疗,逐渐自行消失。结论托吡酯治疗TS疗效确切,可明显降低抽动症状及病情严重程度。

Objective To investigate the clinical efficacy and safety of topiramate in the treatment of Tourette syndrome(TS).Methods Totally62 patients with TS admitted to Chongqing Mental Health Center were selected and treated with Topiramate Tablets orally at a dose of1.0-5.0 mg/(kg·d)with an initial dose of 0.5 mg/kg,the patients were continuously treated for 12 weeks.The severity of convulsions and the clinical efficacy were evaluated by the Severity of Illness(SI)of Clinical Global Impression(CGI)and Yale Global Tic Severity Scale(YGTSS).The adverse drug reactions were evaluated by the Treatment Emergent Symptom Scale(TESS).Results The total effective rate was 75.81%.After treatment,the YGTSS score and SI score were(30.19±11.03)points and(3.77±0.82)points,respectively,which were significantly lower than(64.10±11.23)points and(5.37±0.93)points before treatment(P<0.05).The incidence of adverse reactions was 12.90%,which showed mild loss of appetite and memory,and they disappeared gradually without treatment.Conclusion Topiramate is effective in the treatment of TS,which can significantly reduce the severity of tic and disease.