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目的系统评价丙戊酸钠与苯妥英钠治疗癫痫持续状态的疗效。方法计算机检索Medline、Embase、Pub Med图书馆、中文期刊全文数据库(CNKI)、万方数据库和维普等数据库(检索时限均从建库至2013年9月),收集国内外关于丙戊酸钠与苯妥英钠片治疗癫痫的随机对照实验。按照Cochrane系统评价的要求,制定纳入与排除标准,由3名研究者独立进行纳入研究的方法学质量评价和有效数据提取,采用Rev Man 5.2软件进行Meta分析。结果共纳入6个RCT,430例患者。Meta分析结果显示,丙戊酸钠组与苯妥英钠组在癫痫控制有效率方面效果类似[P=0.56>0.05,OR=1.14,95%CI=(0.73,1.76)];丙戊酸钠组与苯妥英钠组在治疗癫痫的复发率方面效果也类似[P=0.91>0.05,OR=0.97,95%CI=(0.54,1.72)]。结论当癫痫患者进行治疗时,可以考虑选用丙戊酸钠或苯妥英钠进行治疗。受纳入研究数量及质量限制,本系统评价结果尚需更多高质量、大样本、多中心随机对照实验验证。
Objective To evaluate the efficacy of sodium valproate and phenytoin in the treatment of status epilepticus. Methods The databases of Medline, Embase, Pub Med, Chinese Journal Full-text Database (CNKI), Wanfang Database and Vip Database were searched by computer (search period was from September to September 2013) Randomized controlled trial of phenytoin sodium tablets in the treatment of epilepsy. According to the Cochrane review, a methodological quality assessment and validated data extraction for inclusion and exclusion criteria, independent of the three investigators were included and Meta-analysis was performed using Rev Man 5.2 software. Results A total of 6 RCTs and 430 patients were enrolled. Meta-analysis showed that the efficacy of sodium valproate group and phenytoin sodium group in the control of epilepsy was similar (P = 0.56> 0.05, OR = 1.14, 95% CI = (0.73,1.76)]; sodium valproate group and Phenytoin sodium group in the treatment of epilepsy recurrence rate is also similar (P = 0.91> 0.05, OR = 0.97,95% CI = (0.54,1.72)]. Conclusion When epilepsy patients for treatment, consider the choice of sodium valproate or phenytoin treatment. Subject to the number of studies and quality limitations, the results of this systematic review need more high-quality, large sample, multicenter randomized controlled trials.