Beijing Neurosurgical Institute, 6 Tiantan Xi Li, Beijing 100050, PR China.
Epilepsy Res. 2012 Dec;102(3):201-5. doi: 10.1016/j.eplepsyres.2012.06.004. Epub 2012 Jul 17.
Sodium valproate (VPA) is a broad-spectrum anti-epileptic drug usually well tolerated. We conducted a pilot study to assess the feasibility, efficacy and side-effects of VPA in the treatment of convulsive epilepsy in primary care settings in rural China as an alternative to phenobarbital.
People with convulsive epilepsy were identified at primary health care level and provided with VPA monotherapy. Local trained physicians identified participants, managed treatment, and carried out the follow-up, whilst diagnoses were confirmed by a neurologist. Participants were followed for 12 months. Efficacy was assessed from the percentage reduction in seizure frequency and by retention of treatment. Tolerability was assessed by reports of treatment-emergent effects.
Of 532 people enrolled, 512 completed the assessment. Most (431 people, 84%) had a decrease in seizure frequency of at least 50% and 218 became seizure-free. Treatment retention was 96% at one year. VPA was well tolerated and only 47 people reported adverse events which were mostly mild. Only two people discontinued VPA due to side-effects.
In this 12-month assessment, VPA had favourable efficacy, few side effects and overall good acceptability. It was also relatively cheap. VPA is, therefore, a suitable alternative to phenobarbital as treatment of convulsive epilepsy in rural areas of China.
丙戊酸钠（VPA）是一种广谱抗癫痫药物，通常具有良好的耐受性。我们进行了一项试点研究，以评估 VPA 在农村中国基层医疗环境中治疗惊厥性癫痫的可行性、疗效和副作用，作为苯巴比妥的替代疗法。
在初级卫生保健一级确定惊厥性癫痫患者，并给予 VPA 单药治疗。当地培训的医生确定参与者、管理治疗并进行随访，而诊断则由神经科医生确认。参与者随访 12 个月。疗效通过发作频率减少的百分比和保留治疗来评估。通过报告治疗中出现的副作用来评估耐受性。
在纳入的 532 人中，有 512 人完成了评估。大多数（431 人，84%）的发作频率至少减少了 50%，218 人无发作。一年时的治疗保留率为 96%。VPA 具有良好的耐受性，只有 47 人报告了不良反应，大多为轻度。只有 2 人因副作用而停用 VPA。
在这项为期 12 个月的评估中，VPA 具有良好的疗效、较少的副作用和总体良好的可接受性。它也相对便宜。因此，VPA 是中国农村地区治疗惊厥性癫痫的苯巴比妥的合适替代药物。
