Effect of sodium valproate combined with phenytoin sodium on the epileptiform discharge and cognitive function in patients with refractory epilepsy / 新乡医学院学报

ABSTRACT

Objective To investigate the effect of sodium valproate combined with phenytoin sodium on the epileptiform discharge and cognitive function in patients with refractory epilepsy (RE).Methods A total of 213 patients with RE were selected from February 2011 to February 2015 in the Third Affiliated Hospital of Xinxiang Medical University.The patients were divided into phenytoin sodium group,sodium valproate group and combined treatment group according to the treatment methods,71 cases in each group.The patients in the phenytoin sodium group were treated with phenytoin sodium,the patients in the sodium valproate group were treated with sodium valproate,and the patients in the combined treatment group were treated with phenytoin sodium and sodium valproate.The electroencephalogram and cognitive function score of the patients in the three groups were performed before treatment and six months after treatment,and the therapeutic effect was evaluated.The improvement of electroencephalogram,cognitive function score and clinical effect were compared among the three groups.Results The total effective rate in the combined treatment group,phenytoin sodium group and sodium valproate group was 80.28％ (57/71),60.56％ (43/71) and 59.15％ (42/71) respectively,the total effective rate in the combined treatment group was significandy higher than that in the phenytoin sodium group and sodium valproate group (x2 =8.412,9.596;P ＜ 0.05),but there was no significant difference in the total effective rate between phenytoin sodium group and sodium valproate group (x2 =0.003,P ＞ 0.05).The improvement rate of electroencephalogram in the combined treatment group,phenytoin sodium group and sodium valproate group was 80.28％ (57/71),63.38％ (45/71) and 60.56％ (43/71) respectively,the improvement rate of electroencephalogram in the combined treatment group was significantly higher than that in the phenytoin sodium group and sodium valproate group(x2 =7.520,8.412;P ＜ 0.05),but there was no significant difference in the improvement rate of electroencephalogram between phenytoin sodium group and sodium valproate group (x2 =0.070,P ＞ 0.05).There was no significant difference in the scores of total intelligence quotient,language intelligence quotient and performance intelligence quotient in the three groups before treatment (P ＞ 0.05).The scores of total intelligence quotient,language intelligence quotient and performance intelligence quotient after treatment were significantly higher than those before treatment in the three groups (P ＜0.05).After treatment,the scores of total intelligence quotient,language intelligence quotient and performance intelligence quotient in the combined treatment group were significantly higher than those in the phenytoin sodium group and sodium valproate group(P ＞ 0.05);but there was no significant difference in the scores of total intelligence quotient,language intelligence quotient and performance intelligence quotient between the phenytoin sodium group and sodium valproate group (P ＞ 0.05).Conclusion Phenytoin sodium combined with sodium valproate can effectively control the epileptiform discharge,improve the cognitive function and improve the therapeutic effect in RE patients.