在印度南部农村地区使用巴比塔尔或胺控制:Yelandur研究
K S Mani1, G Rangan, H V Srinivas
1Indian Epilepsy Association, Chapter, Bangalore, India.
Lancet (London, England)
|May 10, 2001
概括
在农村地区早期治疗是可以实现的. 经过培训的初级保健医生和巴比他改善了控制,为欠发达国家展示了实际的解决方案.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 是一种可治疗的神经疾病,需要早期干预.
- 在农村,欠发达地区,获得专门的神经治疗的机会是有限的,延迟了治疗.
- 这项研究探讨了南印度农村管理的实用方法.
研究的目的:
- 评估农村控制非随机试验的可行性和有效性.
- 确定在资源有限的环境中成功长期治疗的关键因素.
主要方法:
- 一项非随机试验,涉及135名患有部分或普遍性强力-克隆性发作的患者.
- 治疗费诺巴比他,费尼托因或两者,由初级保健医生和卫生工作者每天服用一次.
- 结果以至少2年没有发作 (终端缓解) 来衡量,并进行治疗意图分析.
主要成果:
- 终端缓解率在符合条件的患者中不到30次的发作为58%至66%,而在不符合条件的患者中超过30次的发作为6-16%.
- 严格的药物遵守和早期治疗是2年缓解的重要预测因素.
- 与phenytoin (43%) 相比,Phenobarbital的副作用较少 (4%),主要是牙增生症.
结论:
- 在农村,不太发达的国家使用现有资源,早期控制是实际和有效的.
- 关键的成功因素包括训练有素的初级保健医生,卫生工作者,负担得起的,患者的合规性,教育和随访.
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