癫痫杂志

癫痫杂志

丙戊酸钠缓释片与托吡酯治疗新诊断成人症状性癫痫疗效和生活质量的比较研究

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目的 比较丙戊酸钠缓释片(VPA)与托吡酯(TPM)对新诊断成人症状性癫痫患者的疗效和生活质量的影响。 方法 采用前瞻性随机对照方法,将 2014 年 9 月—2016 年 12 月就诊于四川省人民医院神经内科的 200 例新诊断成人症状性癫痫患者,随机分为 VPA 组(n=110)和 TPM 治疗组(n=90),评价用药 1 年后两种药物的疗效、保留率、不良反应以及对患者生活质量的影响。 结果 治疗 1 年后,VPA 总有效率为 69.1%,无发作率 38.2%;TPM 总有效率为 62.2%,无发作率 42.2%,均无统计学差异。两组 1 年后的保留率分别为 69.1%、65.6%,无统计学差异。VPA 不良反应发生率明显低于 TPM(9.1% vs. 20%,P<0.05)。生活质量:两组患者治疗 1 年后的生活质量均较治疗前基线有显著改善,VPA 对情绪和认知功能改善明显优于 TPM。 结论 VPA 与 TPM 对成人新诊断症状性癫痫治疗 1 年后疗效和保留率无显著差异;TPM 的不良反应发生率明显高于 VPA 组;治疗 1 年后,VPA 与 TPM 均可以明显改善患者总体生活质量,且 VPA 对情绪和认知功能改善明显优于 TPM。

Objective The study was performed to compare the efficacy and effect on quality of life of sodium valproate (VPA) sustained-release tablets versus topiramate (TPM) in newly diagnosed adult symptomatic epilepsy. Methods This is aprospective, randomized controlled trial on 200 patients newly diagnosed as adult symptomatic epilepsy in Sichuan Province People’s Hospital druing September 2014 to December 2016. The patients were randomly divided into VPA group (n=110) and TPM group (n=90). Then we evaluated the efficacy, retention rate, adverse reactions, and quality of life of the two groups after one year of treatment. Results The total effective rate of VPA group was 69.1%, and the rate of no seizures was 38.2%; the total effective rate of TPM was 62.2%, and the rate of no seizures was 42.2%. No statistically significant difference in the effective rate and no seizure rate was found between the two groups. There was no statistical difference in the retention rate between the two groups(69.1% vs. 65.6%, P>0.05) . The incidence of adverse reactions of VPA was significantly lower than that of TPM (9.1%vs. 20%, P<0.05). The quality of life of the two groups was significantly improved from baseline before treatment. VPA group showed significantly better performance than TPM group on mood and cognitive improvement (P<0.05). Conclusion ① There was no significant difference in efficacy and retention rate between VPA sustained-release tablet and TPM on adult patients with symptomatic epilepsy after one year's treatment; ② The incidence of adverse reactions of TPM group was significantly higher than that of VPA group; ③ VPA sustained-release tablets and TPM can significantly improve the overall quality of life of patients, and VPA sustained-release tablets is significantly better than topiramate on the improvement of emotional and cognitive function.

关键词: 新诊断成人症状性癫痫; 丙戊酸钠缓释片; 托吡酯; 疗效; 生活质量

Key words: Newly diagnosed adult symptomatic epilepsy; Sodium valproate sustained release tablets; Topiramate; Curative effect; Quality of life

引用本文: 习志洁, 程涛, 司丽丽, 肖小嫱, 吴冬梅, 孙红斌. 丙戊酸钠缓释片与托吡酯治疗新诊断成人症状性癫痫疗效和生活质量的比较研究. 癫痫杂志, 2018, 4(4): 324-329. doi: 10.7507/2096-0247.20180053 复制

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