Therapeutic Tests of the ADH-Like Effects of Carbamazepine (Tegretol) on Patients with Diahetes Insipidus

Carbamazepine（Tegretol）有類似抗利尿激素之臨床治療試驗

何橈通(L. T. Ho)

《Journal of Medical Sciences》 2卷2期 (1977/12) Pp. 561-573

摘要

國防醫學院內科學系及榮民總醫院內科部用每天200至400毫克劑量之Carbamazepine（TegretoI）治療十位患尿崩症者。其中兩位乃由於腦下垂體切除手術後，一位腦下垂體瘤，一位希漢氏症（Sheehan's syndome），一位空鞍症（Empty sellasyndrome），另五位是原因不明性神經性完全型尿崩症。先將每位病患造成液體平衡後，再進行尿崩症之標準試驗。求出每次之血清滲透壓及自由水之廓清率，並記載其尿滲透壓與血清滲透壓之比例，比較其服藥前後之差異，然後測其差異有無統計學意義。結果顯示此藥對此十位患者均有相當程度之效果，且沒有什麼副作用。同時又發現在第一病例有長期甲狀腺及腎上腺皮質激素缺乏現象時，尿崩症之情況就變得較複雜。此點曾加以討論。

並列摘要

Carbamazepine (tegretol), at doses of 200 to 600 mg daily, has been used in treatment of 10 patients with partial or complete diabetes insipidus (DI). These cases include two patients due to hypophysectomy, one pituitary tumor, one Sheehan's syndrome, one Empty-sella syndrome and five idiopathic complete neurogenic DI. Impairment of liver and renal functions were excluded. In case of long term panhypopituitarism all the DI tests were repeated after an adequate priming with thyroid and adrenal hormones. Each case was tested with standard procedures of DI after attaining fluid balance. Clearance of free water and osmolality as well as the osmolar ratio of urine to serum (U/S osm. ratio) were calculated and compared before and after the administration of Tegretol. Improvement of U/S osm. ratio was observed in all of the 10 cases. No side effects were noted except one who showed mild water excess clinically.