癲癇症是一種常見的神經學疾病，其盛行率的研究一直被廣泛的討論著。依不同地域、不同的研究族群、以及不同的研究方法而得到相當程度差異的結果。然而大多數人比較認同而且廣泛引用的盛行率約為0.4%-1.0%。癲癇的治療目前仍以藥物治療為主，約有百分之七十的癲癇患者服用抗癲癇藥物可以得到有效的控制。本研究目的在於利用健保資料庫的資料，觀察2004年抗癲癇藥物的使用情形。並就藥物的使用，配合診斷碼 (ICD-9)的運用，預期能達成下列目的: (1)、估算出國人罹患癲癇的盛行率，並就性別及各年齡層做分析比較。(2)、分析各種抗癲癇藥物的使用情形及計算其使用的劑量。 本研究利用健保資料庫歸人檔擷取2004年「門診處方及治療明細檔」及「門診處方醫令明細檔」，利用所有抗癲癇藥物的代碼及相關的疾病診斷碼估算出癲癇的盛行率,並利用資料庫的年齡層及性別加以分析。同時將資料庫提供每種藥物使用的劑量、處方日數等計算出每種抗癲癇藥物平均每日的處方劑量並加以分析比較。 就健保資料庫估算出2004年國人罹患癲癇的比率為0.44%；其中男性的盛行率(0.49%)明顯高於女性(0.39%)。就各年齡層而言，35歲以上的成年人罹患癲癇症的比率有逐漸增加的趨勢。而35至54歲成年人中，男性罹患癲癇的比率明顯的高於女性。71% 的癲癇患者使用單一種抗癲癇藥物治療。藥物的選擇以處方carbamazepine最多，佔41.9%；其次是phenytoin (29.3%)及valproic acid (17.8 %)。另外29%的癲癇患者使用兩種或是兩種以上的抗癲癇藥物來控制癲癇；carbamazepine 和valproic acid是最常用的藥物組合。大多數的抗癲癇藥物其每日處方劑量均小於世界衛生組織所建議的劑量。而使用在單一藥物治療時的劑量也多較使用於多種藥物共同使用時的劑量低。 Epilepsy is a common chronic neurological disorder. As there are a variety of underlying etiologies and investigation methods, epidemiological profiles vary widely across countries and regions with the reported prevalence rates mostly ranging from 0.4% to 1.0 %. Medical treatment is still the main management of epilepsy. There was about 70% of epileptic patients were well-controlled under the antiepileptic drugs (AEDs) treatment. We obtained four cohort datasets form the NHI research database. Each cohort included 50,000 people randomly sampled form people who had ever been insured under the NHI since 1995. We analyzed the outpatient visits and order files of the cohort dataset in 2004.In our study, a crude prevalence of AEDs use of 0.44% of the population, 0.39% for women and 0.49% for men (P<0.05). The prevalence of AED use was significant higher for men than for women in 35-54 years old (P<0.05). Seventy-one percent (n=518) of the patients used only one antiepileptic drugs, and 29% (n= 212) was used more than 2 AEDs in 2004. The top-ranking regimens were carbamazepine monotherapy, used by 41.9% patients, followed by phenytoin (27.3%) and Valproic acid (17.8%). Valproic acid combined with carbamazepine is most common use with polytherapy. The prescribed daily dose (PDD) of each antiepileptic drugs in our study was mostly lower than the DDD which suggested of WHO. Patients treated with more than one drug usually take each drug in higher dose than patients using the same drugs in monotherapy.
