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Treatment of epilepsy in China Formal or informal? 被引量:5
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作者 Jianming Liu Zhiliang Liu +1 位作者 Tao Chen Ruxiang Xu 《Neural Regeneration Research》 SCIE CAS CSCD 2013年第35期3316-3324,共9页
Antiepileptic drugs are the preferred treatment approach for epileptic patients. However, informal treatment is important for intractable epilepsy. In this study, 500 epileptic patients were recruited from the General... Antiepileptic drugs are the preferred treatment approach for epileptic patients. However, informal treatment is important for intractable epilepsy. In this study, 500 epileptic patients were recruited from the General Hospital of Beijing Military Area Command of Chinese PLA during the period of October 2009 to January 2012. These involved patients that had been medically treated for at least 1 year. Information on the initial treatment and changes to treatment regimens for each patient was collected through questionnaires. The survey results showed that 52.3% of the epileptic patients searched for treatment after the first seizure, and the mean numbers of seizures was 12.8; 59.8% of the epileptic patients were diagnosed at the first visit, and the mean onset time was 17 months after the first seizure. After diagnosis, patients were treated for an average of 20 days, and the median time was 1 day. Formal anti-epileptic drugs were selected as the first treatment regimen by 67.8% of patients, and 77.5% of these drugs were monotherapies. The mean and median numbers of seizure were respectively 36.9 and 3.0 times before the first regimen was changed. The regimen was changed within the first 6 months by 46.6% of patients, and after the first and second years of treatment, the proportions increased to 54.0% and 71.8%, respectively. In total, 78.5% of the regi- mens were changed to informal treatments. The informal treatment of epilepsy in China is common, being initiated by either patients or physicians. Enhancing epileptic treatment services in hospital, improving physicians' professional quality, and strengthening health propaganda may promote the normalization of drug treatment of epilepsy in China. 展开更多
关键词 neural regeneration EPILEPSY intractable epilepsy drug treatment survey NORMALIZATION treatmentregimen nervous system diseases cross-sectional survey retrospective study grants-supportedpaper NEUROREGENERATION
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单耐药和多耐药复治菌阳肺结核个体化治疗效果探讨 被引量:51
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作者 刘宇红 高微微 +7 位作者 李亮 杜建 马艳 舒薇 吕晓亚 谢仕恒 王红红 陈婷 《中华结核和呼吸杂志》 CAS CSCD 北大核心 2018年第1期25-31,共7页
目的 分析和评价复治肺结核单耐药和多耐药个体化治疗效果,并与标准化方案比较,探讨如何规范复治耐药肺结核个体化治疗方案.方法 本研究为前瞻性多中心队列研究,分析2009年7月1日至2016年8月30日国内22家结核病诊疗机构收治的复治菌阳... 目的 分析和评价复治肺结核单耐药和多耐药个体化治疗效果,并与标准化方案比较,探讨如何规范复治耐药肺结核个体化治疗方案.方法 本研究为前瞻性多中心队列研究,分析2009年7月1日至2016年8月30日国内22家结核病诊疗机构收治的复治菌阳肺结核患者254例,按分散随机方法分为3组,所有患者入组后即开始治疗.治疗3个月时根据MTB培养和药敏试验等结果,将耐多药(MDR)、广泛耐药(XDR)、非结核分枝杆菌(NTM)和涂阳培阴肺结核患者排除.个体化组86例,男性62例,女性24例,平均年龄(41±14)岁.接受个体化治疗方案,在复治标准方案[强化期2个月肌内注射链霉素(S),口服异烟肼(H)、利福平(R)、乙胺丁醇(Z)和吡嗪酰胺(E);继续期6个月口服异烟肼、利福平和乙胺丁醇;方案缩写为2SHRZE/6HRE]的基础上,根据药敏试验结果对其中单耐药和多耐药患者的不同耐药种类进行替换,替换后重新计算疗程,总疗程≥12个月;药敏试验没有耐药的患者不进行药物替换,继续2SHRZE/6HRE方案治疗,疗程8个月.复治组86例,男63例,女23例,平均年龄(42±14)岁.接受复治调整方案治疗:强化期4个月,在强化期的前2个月每日肌内注射链霉素,口服利福喷丁2次/w,异烟肼和乙胺丁醇1次/d,吡嗪酰胺3次/d;强化期后2个月间歇肌内注射链霉素0.75 g,3次/w,口服利福喷丁2次/w,异烟肼和乙胺丁醇1次/d,吡嗪酰胺3次/d;继续期4个月口服利福喷丁2次/w,异烟肼和乙胺丁醇1次/d,方案缩写为2HL2 EZS/2HL2EZS3/4HL2E.H剂量体重<50 kg者0.3 g/d,体重≥50 kg者0.4~0.5 g/d;L2剂量0.6g,2次/w,乙胺丁醇0.75,1次/d;吡嗪酰胺0.5g,3次/d.标化组82例,男66例,女16例,平均年龄(42±12)岁.使用国家结核病防治规划推荐的复治肺结核标准化方案,即2HREZS/6HRE.复治组和标化组对单耐药和多耐药患者不进行药物替换,总疗程均为8个月.分别比较不同组别的治疗效果,分析个体化组对多耐药患者药物替换情况,并观察根据患者体重选择H或R剂量的合理性.本研究为多中心回顾性队列研究,采用SPSS 19.0统计软件,计量资料组间比较采用方差分析(正态分布且方差齐)或秩和检验(非正态分布).计数资料采用x2检验或Fisher确切概率检验.P<0.05表示差异有统计学意义.结果 个体化组、复治组与标准化组的治愈率分别为73.3% (63/86)、76.7%(66/86)和50% (41/82),治疗成功率分别为80.2% (69/86)、84.9% (73/86)与62.2% (51/82),失败率分别为8.1% (7/86)、4.7% (4/86)与19.5% (16/82),个体化组与复治组和标准化组比较,上述指标差异均有统计学意义(x2=13.127,P=0.001),但个体化组和复治组比较差异无统计学意义(x2=0.646,P=0.422).个体化组使用R的正规剂量在专科医院仅占38.7%(12/31).满疗程治疗后随访3年,个体化组多耐药患者药物替换的15例中治疗成功10例.结论 对复治肺结核多耐药患者采取不合理的个体化治疗方案将增加治疗失败的风险.适当提高H或R剂量和适当延长强化期,可有效提高复治肺结核治疗的成功率. 展开更多
关键词 结核 个体化治疗方案 标准化治疗方案
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