| Background:Epilepsy is a disease of brain, and the prevalence is approximately 5 to 8 cases per 1,000 population. It may increase healthcare costs and decrease the independence and quality of patients’ life, for the seizure recurrently happens without any sign. About 70%-80% epilepsy patients can control the seizures after taking AEDs, but 20%-30% epilepsy patients are resistant to multiple AEDs after rational therapy.Increasing the dose of medication or drug combination therapy has an increased risk of adverse reactions. Exorbitant price and unknown efficacy makes it difficult to put surgery into universal application. Therefore more and more patients want to find another method such as TCM to treat this disease. Traditional Chinese medicine is effective in the treatment of epilepsy. The diagnosis of epilepsy, differentiation of symptoms and evaluation of therapy all lack general standards. Many people, especially some medical doctor, don’t accept that TCM is effective. Professor considers that phlegm, qi and depression are the most common factors of refractory epilepsy. The effectiveness of this treatment is obvious. This study evaluated the effectiveness and safety of traditional Chinese medicine Chai Bei Zhi Xian Decoction, to lay a effective and safe proposal for clinical treatment.A systematic review of Traditional Chinese Medicine treating epilepsyObjective:Use systematic review to analyse the effectiveness of TCM treating epilepsy. The results can be an evidence for clinical treating.Methods:Design scientific and effective information retrieval strategy. Retrieve the database, such as PubMED, CNKI, VIP, CBM and Wangfang, to get as many articals as possible. The methods of retrieving were using "Epilepsy" "Chinese medicine" or "TCM", and "clinical" or "effectiveness". All of the articles are publishing from Jan.2000 to Jan.2015. The qualities of these articles are measured by new Jadad. The intervening measure, the duration, the objects, the designing of experiment, the results and the sdandard are what we need to ger. Statistical review used RevMan 5.3 software to analyse.Results:Fifty-five eligible trials with 5751 patients and kinds of intervention including placebo, contributed to the analysis.Forty-three TCM combined with AEDs comparator trials were identified, the remaining 12 trials being TCM vs AEDs trials. All of the trails are published in China.Only thirteen trails describe random sequence generation, three trails describe blinding of outcome and participants, six trails have complete outcome data, Accordiong to improved Jadad scales, only 5 trails are high-quality ones.TCM combined with AEDs is compared with AEDs. The result of brain-traumatic epilepsy, Z= 6.32 (P< 0.01),95%CI[1.97,3.63]. there exists statistically difference; For peidiatric epilepsy, Z=5.34 (P< 0.01),95%CI[3.04,11.04]. there exists statistically difference; The result of epilepsy after cerebral infarction is Z= 4.19 (P< 0.01).95%CI [1.88,5.67], and there is statistically difference; For intractable epilepsy. Z= 4.75 (P< 0.01),95%CI[1.94,4.94], there exists signaficant difference; The result of status epilepticus is Z= 2.95 (P< 0.01), 95%CI [1.70,13.99], and the difference is statistical.The trail of TCM compared with AEDs, the results of pediatric epilepsy is Z=6.15(P< 0.01), 95%CI [12.33,5.13], and there exists significant difference. There is only one trail of brain-traumatic epilepsy. For unclassified epilepsy, I2=66%, there exists inhomogeneity, so meta-analysis can not be used. The result is TCM is better than AEDs.Conclution:Even though all the results show that TCM or combining treatment are better, than AEDs,the scientificalness of the research is need to be evaluated again, for all the articles are not well good, and the qualities are very bad.A clinical trail of Chai Bei Zhi Xian Decoction treating intractable epilepsyObjective:By evaluating the effectiveness and safety of traditional Chinese medicine Chai Bei Zhi Xian Decoction, the research is design to create an effective, acceptable and operational treatment of Chinese traditional medicine for intractable epilepsy.Methods:Patients with intractable epilepsy are from Neurology Department in Dongfang Hospital Affiliated to Beijing University of Chinese Medicine and the 3rd Hospital Affiliated to Beijing University of Chinese Medicine, during Jan.2013 to Dec.2014, who had stagnation of stupum and Qi syndrome. All patients took their AEDs the same as before, and then took traditional Chinese formula Chai Bei Zhi Xian Decoction twice a day. Four weeks were one course of treatment, the whole duration lasted 3 courses and 12 weeks. The seizure frequency 4 weeks before the treatment was taken as the baseline, then compare the frequency between 4 weeks,8 weeds and 12 weeks after treatment.Results:The total number was 40, but among them, one fallen off, and one lost follow-up. In the end, the total number decreased to 38. Then the controlling situation of seizures was observed after treatment. Nonparametric test has been used to analyze the changes of seizures. The results showed that there existed significant statistic difference between 4 weeks before treating and 4 or 8 or 12 weeks after treating, for P<0.01.But the difference between 4 weeks after treatment and 8 weeks after treatment was not statistically different, for P= 0.920>0.05. The difference between 4 weeks after treatment and 12 weeks after treatment was not statistic either, for P= 0.200>0.05. Moreover, the difference between 8 weeks after treatment and 12 weeks after treatment was still not statistic, for P=0.268>0.05. Four weeks later, the treatment of 23 patients was effective, and the total effectiveness is 60.5%. And then after 2 months the treatment of 28 patients was effective, and the total effectiveness changed to 73.7%. Twelve weeks later, the effectiveness of the treatment was 76.3%,29 patients benefited from it. With the help of X2 test, the result was P=0.295>0.05. So there was no obviously statistic difference. For the patients with different kinds of seizures and different clinical courses, the treatment of Chai Bei Zhi Xian Decoction was effective. By X2 test, the result was P=0.455>0.05 and P=1.00>0.05. Therefore the treatments of different kinds of seizures and different durations were not statistically different.Conclusion:Chai Bei Zhi Xian Decoction can be used as a treatment for intractable epilepsy patients, and it can control the seizure of intractable epilepsy. |
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