苯巴比妥(Phenobabital,PB)、苯妥英钠(Pheny-tion,PHT)、卡马西平(Carbamazepine,CBZ)和丙戊酸钠(Valproate,VPA)目前仍是临床上常用的抗癫痛药物(AED),在临床治疗中当单一AED疗效欠佳时常常联合用药。本文就这4种AED之间的相互作用及作用机制作一简要概述。1 PB+PHT 在抗癫痫治疗中,二者合用是传统的用药方法。二者均是药酶诱导剂,相互作用较复杂。冯春荣等报道,长期合用,大多数患者PHT达不到有效治疗浓度,停PB后PHT血浓度又逐渐上升,原因可能是PB加速了PHT代谢。沈鼎烈等报道3例,血清PHT游离浓度(FC)与总浓度(TC)比值,由单用时 Phenobabital (PB), Pheny-tion (PHT), Carbamazepine (CBZ) and Valproate (VPA) are still the most commonly used antiepileptic drugs AED), often in combination with medication in clinical treatment when the efficacy of a single AED is poor. This article gives a brief overview of the interactions and mechanisms of these four AEDs. 1 PB + PHT in the anti-epileptic treatment, the combination of the two is the traditional method of treatment. Both are drug inducer, the interaction is more complicated. Feng Chunrong and other reports, long-term cooperation, the majority of patients with PHT can not reach the effective treatment concentration, PHT blood concentration after stopping PB and gradually increased, the reason may be PB accelerated PHT metabolism. Shen Dinglie and other reports of 3 cases, the serum PHT free concentration (FC) and the total concentration (TC) ratio, when used alone