【作者】 刘健；

【导师】 潘以正；

【作者基本信息】 浙江大学 ， 神经病学， 2003， 硕士

【摘要】 目的 探讨托吡酯治疗Tourette综合征(TS)的疗效和安全性。方法 将53例TS患儿按病例编号分为试验组(35例)和对照组(18例)。试验组予托吡酯治疗，滴定法加量，每周增加25mg，最大剂量不超过150mg；对照组使用氟哌啶醇(1.5～6mg／d)，共治疗24周。试验组3例脱落，对照组2例脱落。采用美国耶鲁YGTSS综合量表、副反应量表(TESS)，于治疗前、治疗8周末、24周末对两组进行评估。结果治疗8周末时治疗组有效率为72.0％，高于对照组37.5％(P=0.001)。试验组YGTSS总分[(28.06±14.45)分)低于对照组[(40.00±20.90)，P<0.05]；减分率[(48.10±22.80)％]高于[(33.17±31.90)％，P>0.05]。24周末时有效率为81.2％，高于对照组56.2％(P<0.001)。试验组YGTSS总分[(24.96±16.28)分]低于对照组[(36.50±21.08)；P<0.05]；减分率[(52.90±24.49)％]高于对照组[(34.63±32.58)％；P<0.05)。试验组的副发应评分8周末[(4.88±3.67)分]低于对照组[(6.25±4.06)分；P<0.05]，24周末[(2.81±2.66)分]低于对照组[(3.58±3.90)分；P<0.05)。结论 托吡酯能有效改善TS的运动、发声抽动和综合损伤效应，副作用相对较轻。更多还原

【Abstract】 Objective The aim of this study was to determine the efficacy and safety of treating Tourette’s syndrome with topiramate. Methods A open-controlled study was carried out. Fifty-three patients who met the DSV--IV-R criteria for TS was involved in the study. Subjects received 24-week medication cycles of topiramate (50-150mg/d) and control with haloperidol (1.5-6mg/d). The efficacy was assessed by the Yale Global Tic Severity Scale (YGTSS) and the safety assessed with the Treatment Emergent Symptom Scale. Measures were assessed at base line and on weeks 8,24 of the study. Results Forty- eight subjects completed the protocol. Thirty-two subjects treated with topiramate and sixteen ones with haloperidol. Three dropped with toperamate, two dropped for severe extrapyramidal adverse reaction with haloperidol. The efficacy of the research group was significantly better than the control group. 8 weeks later, the effective rate was 72.0% in the research group as 37.5% in the control. The total YGTSS score showed significance (P<0.05) though no difference in the decrease rate .24 weeks later ,the effective rate was 81.2% in the research group as 56.2% in the control ,both the total YGTSS score and decrease rate showed significance (P<0.05).The adverse reaction in the research group was milder than the control both at the end of 8 weeks and 24 weeks (P<0.05). Conclusion It’s an effective and safe new method for treating Tourette’s syndrome with topiramate.更多还原