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目的:测定服用抗癫痫中药制剂患者血清西药成分的浓度,以利于其合理应用。方法:2006年9月至2007年9月176例服用抗癫痫中药制剂的癫痫患者纳入研究,其中男102例,女74例,年龄3～63岁,平均年龄(26.27±11.67)岁;患病时间1～42年,平均(11.9±8.7)年。采用荧光偏振免疫法测定患者空腹血清苯妥英、苯巴比妥、丙戊酸和卡马西平的浓度。结果:176份血样中,174份含有1种或1种以上上述西药成分。2例服用化风丹和琥珀抱龙丸患者的血样中未检出西药成分。132例单用中药制剂,44例联用中西药制剂。169例患者的病情未得到控制,其中9例患者苯巴比妥的血浓度超出有效浓度上限。9例中有2例出现嗜睡和智力下降。结论:临床使用抗癫痫中药制剂应加强血药浓度监测,以利于合理用药。
OBJECTIVE: To determine the concentration of western medicine in patients taking antiepileptic Chinese traditional medicine, in order to facilitate its rational application. Methods: From September 2006 to September 2007, 176 epileptic patients taking antiepileptic Chinese medicines were included in the study, including 102 males and 74 females, aged from 3 to 63 years (mean age, 26.27 ± 11.67 years) Time of 1 to 42 years, an average of (11.9 ± 8.7) years. The concentrations of phenytoin, phenobarbital, valproic acid and carbamazepine in fasting serum were measured by fluorescence polarization immunoassay. Results: Of the 176 blood samples, 174 contained one or more of the above western medicines. Two cases of patients taking Fufeng Dan and Baomeilong pills did not detect western medicine. 132 cases of single Chinese medicine preparations, 44 cases combined with Western medicine. 169 patients were out of control and 9 of them had blood levels of phenobarbital above the effective concentration limit. Two of nine patients developed lethargy and mental decline. Conclusion: The clinical use of antiepileptic Chinese medicine should strengthen the monitoring of plasma concentration in order to facilitate rational drug use.