癫痫指南和共识解读.pptVIP

指南和专家共识回顾与解读 NICE 指南（2004年）是英国国家临床最佳研究所 公布的权威的、全面的、可靠的临床抗癫痫药物指南 英国健康协会指南（1999年） ANN 指南（2004年）是美国神经病学会公布的旨在评估新型抗癫痫药物的指南 ??Welcome to the National Institute for Health????????????????????and Clinical Excellence website ??????NICE is the independent organization responsible for providing??????national guidance on the promotion of good health and??????the prevention and treatment of ill health. On 1 April 2005 NICE joined with the Health Development Agency to becomethe new National Institute for Health and Clinical Excellence(also to be known as NICE).  Clinical Excellence????????????????Public Health Excellence NICE was set up as a Special Health Authority for England and Wales on 1 April 1999. Its role is to provide patients, health professionals and the public with authoritative, robust and reliable guidance on current ‘best practice’. (.uk/) NICE指南建议首选传统型抗癫痫药物新型抗癫痫药物仅用于传统抗癫痫药物治疗无效的患者 目前仍缺乏高质量的临床试验支持新药单药治疗比传统药物更有效 研究中的药物副作用和耐受性并未提供足够多且一致的结果支持新药优于传统药物 仅9项比较新药和老药单药治疗新诊断癫痫患者生活质量的研究，未提供强有力的证据支持新药提高患者生活质量 传统抗癫痫药物单药治疗费用更便宜 Ref: National Institute for Health and Clinical Excellence. Technology appraisal guidance 76: newer drugs for epilepsy in adults. Available at: .uk/TA076guidance. Accessed July 5, 2005. NICE指南中抗癫痫药物单药治疗全面性癫痫的选用原则 　 首选药物 次选药物 避免药物 失神发作 丙戊酸钠，乙琥胺 拉莫三嗪，托吡酯 卡马西平，加巴喷丁，替加宾，氨己烯酸 肌阵挛发作 丙戊酸钠 拉莫三嗪，左乙拉西坦，托吡酯 卡马西平，加巴喷丁，替加宾，氨己烯酸 强直－阵挛发作 丙戊酸钠 左乙拉西坦，托吡酯 　 失张力发作 丙戊酸钠，拉莫三嗪 左乙拉西坦，托吡酯 　 National Institute of Clinical Excellence. 英国健康协会指南 UK Ministry of Health Scottish Intercollegiate Guidelines Network Drug of First Choice Second Choice Drug Drugs to Avoid 失神 Valproate Ethosuximide Lamotrigine Carbamazepine Phenytoin 典型失神 Valproate -- -- 肌阵挛发作 Valproate Lamotrigine Phenobarbital Primidone -- 强直-阵挛发作 Valproate Lamotrigine Phenobarbital Primidone -- 失张力发作 Valproate -- -- UK Ministry of Health. May 1999. Scottish Intercollegiate Guidelines Network. Edinburgh: 1997. 英国健康协会指南 UK Minis