Meta-analysis On The Clinical Effects And Experience Of Classical Formulas In The Treatment Of Epilespy

Objective: To systematically evaluate the clinical effects and safety of Classical Formulas in the treatment of Epilepsy,summarize experience of the Classical Formulas in the treatment of Epilepsy in Yu Shangzhen Guangdong provincial famous traditional Chinese medicine(TCM)studio and report some proven cases,in order to provide evidence-based medical evidence support and share experience for the Classical Formulas in the treatment of Epilepsy.Methods: 1.According to the approach of evidence-based medicine,searched and collected the randomized controlled trials(RCTs)about Classical Formulas in the treatment of Epilepsy in the databases: Cochrane Library,MEDLINE,Pub Med,CNKI,CBMdisc,VIP,Wanfang database,selected the literature and collected the indicators of each included studies,including clinical effective rate,epileptic seizures frequency per month,number of patient with abnormal EEG,drug safety.Meta-analysis of relevant data were performed by using Revman 5.3 and Stata SE12.0 software.2.Collected the medical records of epileptics treated in Yu Shangzhen Guangdong provincial famous TCM studio from February 2017 to February 2019,standardized and analyzed the data,summarized the experience of Classical Formula in the treatment of Epilespy,and reported three typical cases.Results: 1.A total of 13 RCTs of Classical Formula combined with antiepileptic drugs in the treatment of Epilepsy involving 869 patients were included,and the Classical Formulas were all contain bupleurum.Meta analysis of the clinical effective rate showed:(1)The clinical effective rate of Chaihu Guizhi decoction combined with antiepileptic drugs treatment group was superior to the control group,and the difference was statistically significant[RR=1.29,95% CI(1.13,1.47),P<0.001].(2)The clinical effective rate of Chaihu Jia Longgu Muli decoction combined with antiepileptic drugs treatment group was superior to the control group,and the difference was statistically significant[RR=1.27,95% CI(1.17,1.38),P<0.001].(3)The clinical effective rate of Classical Formulas contain bupleurum combined with antiepileptic drugs treatment group was superior to the control group,and the difference was statistically significant[RR=1.28,95% CI(1.19,1.37),P<0.001].The result of Meta analysis showed that the change of epileptic seizures frequency per month in 5 included trials was of significant differences(P<0.05),and the same result was observed in the change of the decreasing number of patients with abnormal EEG in 4 included trials.Given that the participants in the included studies were very few and publication bias was existed,the results need further study.2.Statistics of Yu Shangzhen Guangdong provincial famous TCM studio Epilepsy case syndrome,sorted by pathogenic factors(ordered from most to least)were phlegm,wind,heat,and blood stasis;sorted by the function imbalance viscera and bowels(ordered from most to least)were spleen,liver,kidney,and heart;sorted by six-meridian syndrome differentiation(ordered from most to least)were lesser yang disease syndrome,greater yin disease syndrome,reverting yin disease syndrome,and yang brightness disease syndrome.Frequency of Classical Formulas used in the prescriptions(ordered from most to least)were Huangqi Jianzhong decoction,Chaihu Jia Longgu Muli decoction,Guizhi Fuling pill,Shaoyao Gancao decoction,Wumei pill,Sini powder,Shenqi pill,Huanglian Ejiao decoction,Xiao Chanhu decoction,and Chaihu Guizhi Ganjiang decoction.According to the statistics,the person-time of patients using the Classical Formulas contain bupleurum was the highest used with Classical Formulas in the treatment of epilepsy,which was consistent with the literature reports that the Classical Formulas contain bupleurum was the most frequently used in the treatment of epilepsy.Regarding the efficacy,the patients with no epileptic seizure within 1 year had no epileptic seizure occurrence after using Classical Formulas and antiepileptic drugs dosage reduction,and the patients with epileptic seizure within 1 year had epileptic seizure reduction after using Classical Formulas.Conclusions: The effective rates of Chaihu Guizhi decoction,Chaihu Jia Longgu Muli decoction and Classical Formulas contain bupleurum combined with antiepileptic drugs in the treatment of Epilespy were superior to using the antiepileptic drugs alone,with the possibility of reducing epileptic seizures frequency and promoting the return of normal EEG.Furthermore,the safeties of using these Classical Formulas combined with antiepileptic drugs in the treatment of Epilespy were superior to or equal to using the antiepileptic drugs alone.Considering that the included studies were all focusing on Classical Formulas contained bupleurum,and were of narrow coverage,low-quality,publication bias existence,more extensive and high-quality studies are needed to support the present conclusions.Yu Shangzhen Guangdong provincial famous TCM studio had accumulated rich experience in terms of using Classical Formulas to treat Epilepsy.Mentor Yu Shangzhen’s Classical Formulas in the treatment of Epilepsy were effective through her accurate syndrome differentiation.Her experience of syndrome differentiation and Classical Formulas usage are worth learning.