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???org.dspace.app.webui.jsptag.ItemTag.dcfield??? | Value | Language |
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dc.contributor.advisor | 劉宏輝 | |
dc.contributor.author | Chen-Bang Chiang | en |
dc.contributor.author | 江震邦 | zh_TW |
dc.date.accessioned | 2021-06-13T00:13:13Z | - |
dc.date.available | 2008-08-08 | |
dc.date.copyright | 2007-08-08 | |
dc.date.issued | 2007 | |
dc.date.submitted | 2007-07-27 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/28588 | - |
dc.description.abstract | 研究目的:癲癇症為一種慢性神經性疾病,不僅疾病本身,治療方法所引起的副作用亦會造成病人生活品質、認知功能、心理情緒狀態造成影響。Levetiracetam,中文品名為優閒,為目前台灣最新一代抗癲癇藥品,其具有良好的治療效果、特殊性的藥理作用機轉與病人對藥物的耐受度高,因此常用以癲癇發作控制不佳或無法忍受其他藥品的副作用的輔助治療。本研究的目的為探討在癲癇發作控制不佳或無法忍受其他藥品負作用的台灣癲癇病患使用LEV是否能改善病人的生活品質、認知功能與心理情緒狀態,並且評估LEV藥物療效。
研究方法:此研究為前瞻、開放性、單一群組觀察性研究,在台大醫院、長庚醫院、彰化基督教醫院與花蓮慈濟醫院四家醫院收納一年內癲癇發作次數超過四次或無法忍受藥品副作用的病人,給予LEV藥物治療,且在使用前與使用後三個月給予病人填寫癲癇生活品質量表-10(QOLIE-10)、簡易智能量表(MMSE)與修訂版症狀量表-90(SCL-90R)藉以評估病人生活品質、認知功能與心理情緒狀態。 結果:在所有完成三個月治療且前後測評估的77位病患,可發現有統計上顯著性的改善生活品質、認知功能與心理情緒狀態。在LEV治療之後,病人在QOLIE-10項目中的「社會功能」、「認知功能」、「藥物的影響」與「總分」有顯著性的改善,且在癲癇發作次數減少一半以上的病人,改善的情形更為明顯。此外,病人在MMSE中的項目「短期記憶」、「語言理解能力」與「總分」改善情形較為明顯。在SCL-90R有「強迫症」、「憂慮」與「焦慮」項目中,病人在此三個項目都可發現具有顯著性的改善。而療效部分,可發現LEV確實可以顯著性的降低病人癲癇發作次數(中位數)由7降至3。此外,併用藥品數目與LEV藥物療效對於病人的生活品質具有顯著性的影響,但對於改善認知功能與心理情緒狀態卻是由於藥物本身作用結果所導致。 結論:癲癇病患使用LEV確實可以改善生活品質、認知功能與心理情緒狀態,且確實可以控制病人的癲癇發作次數。 | zh_TW |
dc.description.abstract | Objective: Epilepsy is a chronic neurologic disease. Not only the disease itself, but also the treatment may have a significant impact on patient’s quality of life, cognitive function, psychological and emtional status. Levetiracetam is the newest anti-epileptic drugs (AEDs) in Taiwan, and it has good efficacy, unique mechanism of action from other AEDs and good tolerablility for patients. Therefore, it is often used as alternative drug because of the lack of efficacy or poor tolerability of their current AEDs. The objective of the study was to assess the impact of LEV on quality of life, cognitive function, psychological and emotional status in Taiwanese patients who their current AEDs have poor efficacy or poor tolerability and also assess its efficacy on seizure control.
Method: This perspective, open-label, signle-arm observational study is conducted in National Taiwan University Hospital, Chang Gung Memorial Hospital Changhua Christian Hospital and Hualien Tzu Chi General Hospital. The patients who are recruited should meet one of the following inclusion criterions: minimal seizure frequency should be equal or more than 4 times in past one year regardless of seizure types, or can’t tolerate current AEDs. All of the patients will be gived LEV treatment and administrated the QOLIE-10, MMSE and SCL-90R to assess their quality of life, cognitive function, and psychological and emotional status, respectively in baseline and three- month treatment end. Result: For all 77 patients who completed the QOLIE-10, MMSE and SCL-90R, at baseline and 3 month treatment period, a significant improvement was noted in quality of life, cognitive function, psychological and emotional stautus. The performance of patients in 「social function」, 「cognitive function」,「medicational effect」and 「total score」 QOLIE-10 subitems were statistically improved. Furthermore , patients’ cognitive function in 「short term memory」「language comprehension」「total score 」in MMSE were also found improved significantly. Finally, 「obessive compulsive disease」「depression」and「anxiety」in SCL-90R, patients were also improved significantly. In addition, the seizure frequency (median) was reduced from 7 to 3 in three-month periods. In addition, the number of AEDs concurrent used and LEV efficacy had significant impact on patient’s improvement in quality of life. However, the improvement in cognitive function, psychological and emotional status may be probably because of the nature of the LEV. Conclusion: LEV controlled seizure attacks in epileptic patients in Taiwan. Furthermore, after treatment of LEV, quality of life, cognitive function, psychologic and emotional status of patients significantly improved. | en |
dc.description.provenance | Made available in DSpace on 2021-06-13T00:13:13Z (GMT). No. of bitstreams: 1 ntu-96-R94451008-1.pdf: 873755 bytes, checksum: 286aa470018d5bac6bb5820c5aea54fd (MD5) Previous issue date: 2007 | en |
dc.description.tableofcontents | 中文摘要 i
Abstract ii 內容目錄 iv 圖目錄 vii 表目錄 viii 中英對照表 x 第一章 緒論 1 1.1 癲癇症 1 1.2 癲癇症對生活品質、認知功能、情緒心理方面的影響 1 1.3 抗癲癇藥物 3 1.4 Levetiracetam 4 第二章 研究目的 8 第三章 研究材料 9 3.1 藥物 9 3.2 評估測試工具 9 3.3 藥物基本性質與藥理、藥物動態學 9 3.4 問卷介紹 11 第四章 實驗方法 14 4.1 研究設計與流程 14 4.2 研究樣本 14 4.3 研究資料收集 15 4.4 統計分析 15 第五章 研究結果 20 5.1 受試病人基本資料 20 5.2 藥物治療前後,受試者生活品質改變評估 22 5.3 藥物介入前後,受試者認知功能改變評估 23 5.4 藥物治療前後,受試者情緒與心理狀態改變評估 23 5.5 藥物治療前後,受試者癲癇發作次數改變分析評估 23 5.6 不同reduction rate對生活品質的影響 24 5.7 不同reduction rate對認知功能的影響 25 5.8 不同reduction rate對心理情緒狀態的影響 25 5.9 影響病人使用藥物前QOLIE-10因子分析 25 5.10 影響病人使用藥物前認知功能因子分析 28 5.11 影響病人使用藥物前SCL-90R因子分析 30 5.12 病人使用藥物影響生活品質的因子分析 31 5.13 病人使用藥物影響認知功能的因子分析 34 5.14 病人使用藥物影響情緒與心理狀態的因子分析 37 5.15 認知功能與生活品質間的關係 40 第六章 討論 41 第七章 研究限制 51 7.1 研究設計與流程 51 7.2 問卷的選擇 51 7.3 未來研究建議 53 第八章 結論 55 參考文獻 56 附錄 1:LEV與piracetam 結構 90 附錄 2:癲癇生活品質表(QOLIE-10) 91 附錄 3:簡易智能狀態測驗 (MMSE) 93 附錄 4:SCL-90R問卷 94 附錄 5:國外研究使用LEV抗癲癇藥物對生活品質影響 96 附錄 6:LEV對認知功能影響的研究 98 附錄 7:測試工具 100 圖目錄 圖 1:研究基本架構模式圖 61 圖 2:研究進行流程圖 62 圖 3:受試者人數 63 圖 4:併用藥物名稱與人數分佈 64 表目錄 表 1:QOLIE-10項目與所包含題目個數 66 表 2:MMSE各項目名稱與包含分數 67 表 3:SCL-90R各項目名稱及問卷題號與題數配對表 68 表 4:受試者基本資料(N=77) 69 表 5:藥物治療前後,受試者生活品質平均分數差異分析 70 表 6:藥物治療前後,受試者認知功能平均分數分析 71 表 7:藥物治療前後,受試者情緒與心理狀態平均分數分析 72 表 8:LEV治療前後發作次數比較 73 表 9:不同reduction rate 人數與比例(N=77) 73 表 10:在不同reduction rate下,生活品質前後差異比較 (N=77) 74 表 11:比較不同reduction rate對生活品質的影響 75 表 12:在不同reduction rate下,認知功能前後差異比較 76 表 13:比較不同reduction rate對認知功能的影響 77 表 14:在不同reduction rate下,心理情緒狀態前後差異比較 78 表 15:比較不同reduction rate對心理情緒狀態的影響 79 表 16:多因子逐步性迴歸分析影響病人使用藥物前生活品質因子分析 80 表 17:多因子逐步迴歸分析影響病人使用藥物前認知功能因子分析 81 表 18:多因子逐步迴歸分析影響病人使用藥物前情緒與心理狀態因子分析 83 表 19:使用藥物後影響生活品質進步的因子 85 表 20:使用藥物後影響認知功能進步的因子 86 表 21:使用藥物後影響心理情緒狀態進步的因子 87 表 22:認知功能與生活品質相關性 89 | |
dc.language.iso | zh-TW | |
dc.title | Levetiracetam治療癲癇病患之療效、生活品質、
認知功能、心理與情緒之研究 | zh_TW |
dc.title | The Impact of Levetiracetam on Efficacy, Quality of Life, Cognition, Psychology and Emotion in Patients with Epilepsy in Taiwan | en |
dc.type | Thesis | |
dc.date.schoolyear | 95-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 陳秀熙,吳禹利,花茂棽 | |
dc.subject.keyword | 癲癇症,優閒,療效,生活品質,認知功能,情緒與心理, | zh_TW |
dc.subject.keyword | epilepsy,levetiracetam,efficacy,quality of life,cognitive function,emotion and psychology, | en |
dc.relation.page | 105 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2007-07-28 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床藥學研究所 | zh_TW |
Appears in Collections: | 臨床藥學研究所 |
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