Traditional Chinese Medicine Syndrome Type Distribution Of Newly Diagnosed Adult Symptomatic Epilepsy And The Comparative Study Of Efficacy And Quality Of Life Of The Patients Between Sodium Valproate Sustained Release Tablets And Topiramate

Objective:To compare the efficacy of sodium valproate sustained-release tablets with topiramate in the treatment of patients with newly diagnosed adults symptomatic epilepsy and to compare their improvement of quality of life,and To explore the distribution of TCM syndromes in newly diagnosed symptomatic epilepsy in adults.Methods:This study used experimental prospective randomized method,and included 200 patients with newly diagnosed adult patients with symptomatic epilepsy,who were randomly divided into sodium valproate group and topiramate(n=110)treatment group(n=90).At 12 months,we assessed the curative effect,retention rate and adverse reaction rate of two kinds of drugs and also valuated patients,quality of life.Analyses were also performed to identify factors associated with patients,quality of life.In addation,we observed the regularities of distribution of TCM syndromes of all patients by collecting patients,TCM symptoms,tongue and pulse combinging with the four methods of diagnosis.Result:Curative effect:The total effective rate of valproic acid sustained-release tablets and topiramate were 69.1% and 62.2%,while the seizurue-free rate of sodium valproate sustained-release tablets and topiramate were 38.2% and 42.2% after one year of treatment.There were no statistically significant difference in two groups of total effective rate and seizurue-free rate.There was also no significant difference in the efficacy of sodium valproate sustained-release tablets and topiramate in the treatment of partial seizure,but the efficacy of valproic acid sustained-release tablets in the treatment of general seizures was better than that of the topiramate group(P =0.04).There was no significant difference between the two groups in the efficacy of different sex,age,course of disease and frequency of seizure.Morever,the two groups were no significant difference about the 1-year retention rate,valproic acid group69.1%,and the topiramate group 65.5%.The incidence of adverse reactions in topiramate group was significantly higher than that in valproic acid sustained-release tablets group,valproic acid group:9.1%(10/110),topiramate group: 20%(18/90),P <0.05.In addition,the incidence of adverse effects of topiramate was significantly higher than that of valproic acid when the course of epilepsy less than 5 years(25%/ 9.2%,P <0.05).The incidence of adverse reactions of topiramate in adult patients was significantly higher than that in valproate(27.1%/10%,P <0.05).But elderly patients with epilepsy and patients whose disease duration duration more than 5 years had no obvious difference between two groups of adverse drug reactions.We observed adverse reactions of Sodium pentoxylate sustained-release tablets included: menstrual disorders,weight gain,hair loss,liver enzyme abnormalities;And topiramate included: memory loss,weight loss,diplopia.Quality of life:Two groups of patients quality of life improved significantly after one year of trearment than baseline before.The patients of sodium valproate group in terms of overall quality of life,mood,energy,and anxiety about seizures were significantly improved than baseline before,but no significant improvement in worry about side effects of drugs.While the patients of topiramate group had no significant improvement in cognitive function and worry about side effects of drugs.There was no significant difference in the overall quality of life,energy,cognitive function,social function,and worry about side effects of drugs and seizures in the two groups,but the mood improvement in the sodium valproate group was more better than the topiramate group after one year of treatment.Factors affecting the quality of life include: the frequency of seizures,epilepsy course,antiepileptic drugs adverse reactions and clinical efficacy.TCM syndrome type distribution characteristics: the TCM syndromes distri bution of newly diagnosed adult symptomatic epilepsy is mainly composed of wind-phlegm stagnation Syndrome,Phlegm-Fire Disturbing Brain Syndrom and Blood Stasis Blocking the Brain Syndrom.In addition,the pattern of Blood Stasis Blocking the Brain Syndrom has increased,but the deficiency of Qi and bloo-d Syndrom and the deficiency of liver and kidney Yin Syndrom are obviously lower than that in the past.Conclusion:1.The total effective rate and seizure-freel rate of sodium valproate sustained release tablets and topiramate were no significantly difference.However,sodium valproate sustained-release tablets was better than topiramate in the efficacy of generalized seizure.2.The retention rate was no significant difference between sodium valproate sustained release tablets and topiramate.3.The incidence of adverse effects in topiramate group was significantly higher than that in valproic acid sustained-release tablets.But the incidence of adverse reactions in two kinds of drugs had no obvious difference between elder patients with epilepsy and patients whose disease duration more than 5 years.Sodium valproate sustained-release tablets with characteristic adverse reactions include: menstrual disorders,weight gain,hair loss,liver enzyme abnormalities;The characteristic adverse reactions of topiramate are: memory deterioration,weight loss and diplopia.4.Both sodium valproate sustained-release tablets and topiramate can significantly improve the quality of life after one year of treatment.But the sodium valproate sustained-release tablets was significantly better than topiramate in the improvement of mood.The factors affecting the quality of life include: the frequency of seizures,epilepsy course,antiepileptic drugs adverse reactions and clinical efficacy.5.The distribution of new syndromes of symptomatic epilepsy in adults is mainly composed of wind-phlegm stagnation Syndrome,Phlegm-Fire Distur bing Brain Syndrom and Blood Stasis Blocking the Brain Syndrom.