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目的了解沧州市农村地区惊厥型癫痫患者苯巴比妥治疗、非苯组药物治疗的显效率及依从性。方法对沧州市沧县、献县、肃宁县和泊头市癫痫患者服用苯巴比妥、非苯药物正规治疗后,观察疗效、依从性,并对统计数据进行分析。结果苯巴比妥入组管理患者共2 320人,入组前患者平均发作频率(18.71±35.87)次/a;入组管理后,经过3、6、9和12个月的规范治疗,显效率分别为60.33%、69.36%、79.34%、84.28%。示范点癫痫患者在第1年时间内,服药显效率呈上升趋势,服药满6个月和1年疗效差异有统计学意义(χ2=1212.1,P<0.05)。患者病情得到了明显缓解,癫痫发作频率显著降低,药物不良反应随疗程的延长而减少。有269名患者不同时期退组,退组主要原因是疗效差、不能耐受不良反应和依从性差。结论苯巴比妥治疗惊厥型癫痫表现出良好的治疗效果;不良反应以轻度为主,随疗程延长不良反应减少;以后工作中要加强项目管理,及时随访,及时给患者调整药量;对患者及家属反复强调遵从医嘱的重要性,提高患者依从性,加强癫痫防治科普知识的宣传。在农村开展癫痫防治管理项目是可行的,可有效控制病情。
Objective To understand the efficacy and compliance of phenobarbital in patients with convulsive epilepsy in rural areas of Cangzhou City. Methods The patients with epilepsy in Cangxian County, Xianxian County, Suning County and Botou City of Cangzhou City were treated with phenobarbital and non-benzene drugs formally. The curative effect and compliance were observed and the statistical data were analyzed. Results A total of 2 320 patients were enrolled in the phenobarbital group. The mean frequency of attacks was (18.71 ± 35.87) times / a before enrollment. After administration of the phenobarbital standard therapy, the patients were treated for 3, 6, 9 and 12 months The efficiencies were 60.33%, 69.36%, 79.34%, 84.28% respectively. In the first year, the effective rate of taking medicine was on the rise in the patients with demonstration epilepsy. There was a significant difference in efficacy between 6 months and 1 year after medication (χ2 = 1212.1, P <0.05). The patient’s condition has been significantly alleviated, seizure frequency was significantly reduced, adverse drug reactions decreased with the course of treatment. There are 269 patients retreated at different times, the main reason for withdrawal is poor efficacy, can not tolerate adverse reactions and poor compliance. Conclusion Phenobarbital treatment of convulsive epilepsy showed good therapeutic effect; adverse reactions with mild mainly with treatment to reduce the adverse reactions to reduce; in the future to strengthen project management, timely follow-up, timely adjustment to the patient dose; Patients and their families repeatedly stressed the importance of compliance with medical advice, improve patient compliance, and strengthen the publicity of popular science knowledge of epilepsy prevention and treatment. Epilepsy in rural areas to carry out management projects is feasible, can effectively control the disease.