对于成年癫痫患者，使用哪种药物：苯妥英还是丙戊酸盐？
Which drug for the adult epileptic patient: phenytoin or valproate?
作者信息
Turnbull D M, Howel D, Rawlins M D, Chadwick D W
出版信息
Br Med J (Clin Res Ed). 1985 Mar 16;290(6471):815-9. doi: 10.1136/bmj.290.6471.815.
Abstract
A series of 140 previously untreated patients with tonic-clonic or partial seizures were randomised to receive either phenytoin or sodium valproate. There was no difference between the treatment groups in pretreatment variables that might influence outcome. Sodium valproate and phenytoin in the treatment of tonic-clonic or partial seizures showed no difference in efficacy as regards time to two year remission or time to first seizure. When the possible prognostic factors were studied, including history and results of clinical examination and investigations before treatment; the only factor which influenced the proportion of patients achieving two year remission was type of seizure. Patients with a clinical history of partial seizures did significantly less well than those with a history of tonic-clonic seizures only. This study showed no major difference in efficacy between sodium valproate and phenytoin in adults with recent onset of epilepsy, irrespective of the type of seizures that the patient suffered.
摘要
140名既往未接受过治疗的强直阵挛性发作或部分性发作患者被随机分组，分别接受苯妥英钠或丙戊酸钠治疗。在可能影响治疗结果的预处理变量方面，治疗组之间没有差异。丙戊酸钠和苯妥英钠在治疗强直阵挛性发作或部分性发作时，在达到两年缓解时间或首次发作时间方面疗效无差异。在研究包括治疗前病史、临床检查及检查结果等可能的预后因素时，唯一影响达到两年缓解的患者比例的因素是发作类型。有部分性发作临床病史的患者比仅有强直阵挛性发作病史的患者预后明显要差。这项研究表明，对于近期发病的成人癫痫患者，无论其所患癫痫发作类型如何，丙戊酸钠和苯妥英钠在疗效上没有重大差异。
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本文引用的文献
1
Phenobarbitone in previously untreated epilepsy.苯巴比妥用于既往未治疗的癫痫。
J Neurol Neurosurg Psychiatry. 1980 Apr;43(4):365-8. doi: 10.1136/jnnp.43.4.365.
2
Tables of the number of patients required in clinical trials using the logrank test.使用对数秩检验的临床试验所需患者数量表。
Stat Med. 1982 Apr-Jun;1(2):121-9. doi: 10.1002/sim.4780010204.
3
Early prognosis of epilepsy.癫痫的早期预后
Br Med J (Clin Res Ed). 1982 Dec 11;285(6356):1699-701. doi: 10.1136/bmj.285.6356.1699.
4
Sodium valproate and cognitive functioning in normal volunteers.丙戊酸钠与正常志愿者的认知功能
Br J Clin Pharmacol. 1981 Dec;12(6):819-24. doi: 10.1111/j.1365-2125.1981.tb01313.x.
5
Plasma concentrations of sodium valproate: their clinical value.
Ann Neurol. 1983 Jul;14(1):38-42. doi: 10.1002/ana.410140107.
6
A double-blind study comparing carbamazepine with phenytoin as initial seizure therapy in adults.一项比较卡马西平和苯妥英钠作为成人初始癫痫治疗药物的双盲研究。
Neurology. 1983 Jul;33(7):904-10. doi: 10.1212/wnl.33.7.904.
7
Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples.需要对每位患者进行长期观察的随机临床试验的设计与分析。II. 分析与示例。
Br J Cancer. 1977 Jan;35(1):1-39. doi: 10.1038/bjc.1977.1.
8
Carbamazepine as a single drug in the treatment of epilepsy. A prospective study of serum levels and seizure control.卡马西平单药治疗癫痫。血清水平与癫痫控制的前瞻性研究。
J Neurol Neurosurg Psychiatry. 1978 Oct;41(10):907-12. doi: 10.1136/jnnp.41.10.907.
9
One drug for epilepsy.一种治疗癫痫的药物。
Br Med J. 1978 Feb 25;1(6111):474-6. doi: 10.1136/bmj.1.6111.474.
10
Remission of seizures and relapse in patients with epilepsy.
Epilepsia. 1979 Dec;20(6):729-37. doi: 10.1111/j.1528-1157.1979.tb04857.x.
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