我国农村地区607例癫痫患者应用丙戊酸钠治疗效果评价

Efficacy assessment of sodium valproate in treating 607 patients with epilepsy in rural China

目的观察基层医生使用国产丙戊酸钠（VPA）治疗癫痫的可行性、疗效及其不良反应。方法癫痫患者来自湖北省天门市和广西田东县农村地区。由县、乡级医生按规定的人选标准筛选病例，并使用VPA治疗和随访。疗效评估以发作频率与治疗前的变化为标准，其中无发作、显效和有效三者之和为总有效率。结果入组607例癫痫患者接受治疗随访，男性395例，女性212例，其中579例随访满12个月。患者中全面强直一阵挛性发作517例（85．2％），失神发作20例（3．3％），其余70例（11．5％）为部分性发作、单纯强直、阵挛、肌阵挛或失张力发作。服药满3个月、6个月、12个月时癫痫发作完全控制的患者分别有270例（45．5％）、249例（42．3％）和238例（41．1％），总有效率三个时段分别为65．2％、75．4％和85．5％。治疗随访期间共有58例出现困倦、嗜睡、疲乏、头晕等不良反应。治疗随访期间有19例（3．1％）先后脱组。结论VPA是一种疗效较好、严重不良反应少、基层医生比较容易掌握的广谱抗癫痫药，同苯巴比妥一样适合在我国农村地区推广应用。

Objective To observe the efficacy and the side-effects of sodium valproate （VPA） in patients with epilepsy in rural China. Methods Epilepsy patients were selected from rural areas of Tianmen in Hubei province and Tiandong county in Guangxi province according to the inclusion and exclusion criteria. Efficacy evaluation standard depending on the change of seizure frequency compared with the situation prior to entering the treatment group. Among the treated patients, no seizures, seizure reduced 〉 75%, seizure reduced 50%--75% sums for the total effective rate. Results All 607 patients with epilepsy were treated and followed up, the male were 395 （65.1%） female 212 （34.9%）, and 579 patients were treated for 12 months. Patients with generalized tonic-clonic seizures were 517 （85.2%）, absence seizures 20 （3.3%） and the other types of seizures 70 （ 11.5% ） including simple partial seizures, tonic, clonic, myoclonic or atonie seizures etc. The completed control of seizures （without any seizures） during the period after taking 3 months, 6 months, 12 months were 270 （45.5%） , 249 （42. 3% ） and 238 （41.1%） respectively. The total effective rates in the three periods were 65.2%, 75.4% and 85.5% respectively. The 58 patients in the total group showed side-effects during the follow-up period, mainly including drowsiness, lethargy, fatigue, dizziness, headache and tremor. Nineteen patients （3.1%） quitted the treatment group. Conclusions The VPA is an effective antiepileptic drug and no more severe side-effects. It is the same as Phenobarbital and suitable to be used in rural areas of China.