肝豆灵片辅助治疗肝豆状核变性步态障碍痰瘀互结证60例临床观察
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摘要
目的观察肝豆灵片辅助治疗肝豆状核变性(WD)步态障碍痰瘀互结证的临床疗效。方法将120例WD步态障碍痰瘀互结证患者采用随机数字表法分为对照组和治疗组,各60例。对照组在常规低铜饮食和保肝治疗的基础上予以排铜治疗,治疗组在对照组治疗方法的基础上联合肝豆灵片治疗。8 d为1个疗程,4个疗程后比较2组治疗前后的改良Young量表评分、步态障碍测试结果[包括"起立—行走"时间(TUG)和Tinetti量表评分]及24 h尿铜含量。结果治疗后2组改良Young量表评分明显降低,TUG明显缩短,Tinetti量表评分、24 h尿铜含量明显升高,与同组治疗前比较差异均有统计学意义(P<0.05或P<0.01),且治疗组对各项指标的改善作用明显优于对照组,2组比较差异均有统计学意义(P<0.05或P<0.01)。结论肝豆灵片辅助治疗WD步态障碍痰瘀互结证可明显改善患者的步态障碍及临床症状,延缓病情进展,值得临床推广应用。
Objective To observe the clinical efficacy of Gandouling Pian(肝豆灵片) in adjuvant treatment of Westphal-Strumpell disease(WD) with symptoms of gait disorder and phlegm accumulating with stagnation.Methods Totally 120 patients of WD with symptoms of gait disorder and phlegm accumulating with stagnation were divided into control group and treatment group according to random number table,with 60 in each.The control group was given the copper discharging treatment based on the routine low copper diet and liver-protective treatment,and the treatment group was combined with Gandouling Pian on the basis of the treatment of the control group.Eight days constituted a course of treatment.After 4 courses of treatment,the modified Young Rating Scale scores,gait disorder assessment results [including Timed"Up & Go"Test(TUG) and Tinetti Rating Scale scores]and 24 h urinary copper content of the 2 groups before and after treatment were compared.Results After treatment,the modified Young Rating Scale scores decreased significantly,TUG significantly shortened,Tinetti Rating scale scores and 24 h urinary copper content significantly increased,there was statistically significant difference compared with the same group before treatment(P<0.05 or P<0.01),moreover,the improvement of indicators of the treatment group was significantly superior to that of the control group,there was statistically significant difference between the two groups(P<0.05 or P<0.01).Conclusion It can significantly improve the gait disorder and clinical efficacy to use Gandouling Pian in adjuvant treatment of the patients of WD with symptoms of gait disorder and phlegm accumulating with stagnation,and delay the progression of disease,which is worthy of clinical promotion and application.
Objective To observe the clinical efficacy of Gandouling Pian(肝豆灵片) in adjuvant treatment of Westphal-Strumpell disease(WD) with symptoms of gait disorder and phlegm accumulating with stagnation.Methods Totally 120 patients of WD with symptoms of gait disorder and phlegm accumulating with stagnation were divided into control group and treatment group according to random number table,with 60 in each.The control group was given the copper discharging treatment based on the routine low copper diet and liver-protective treatment,and the treatment group was combined with Gandouling Pian on the basis of the treatment of the control group.Eight days constituted a course of treatment.After 4 courses of treatment,the modified Young Rating Scale scores,gait disorder assessment results [including Timed"Up & Go"Test(TUG) and Tinetti Rating Scale scores]and 24 h urinary copper content of the 2 groups before and after treatment were compared.Results After treatment,the modified Young Rating Scale scores decreased significantly,TUG significantly shortened,Tinetti Rating scale scores and 24 h urinary copper content significantly increased,there was statistically significant difference compared with the same group before treatment(P<0.05 or P<0.01),moreover,the improvement of indicators of the treatment group was significantly superior to that of the control group,there was statistically significant difference between the two groups(P<0.05 or P<0.01).Conclusion It can significantly improve the gait disorder and clinical efficacy to use Gandouling Pian in adjuvant treatment of the patients of WD with symptoms of gait disorder and phlegm accumulating with stagnation,and delay the progression of disease,which is worthy of clinical promotion and application.
引文
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[13]张卫平,董亚茹,蒋毅,等.肝豆状核变性28例临床分析[J].陕西医学杂志,2010,39(4):506-507.
[14]陈佳琳,姚声涛,郭宗铎,等.TNF-α在实验性蛛网膜下腔出血后早期脑损伤中的作用[J].第三军医大学学报,2011,33(15):1620-1622.
[15]江婵娟,王莉,杨婷婷,等.皮质下缺血性血管病认知损害与其他皮下损害临床特点的关系[J].中华老年医学杂志,2014(33):116-120.
[16]沈斌,鲍远程,蒋怀周,等.肝豆灵对Wilson病模型大鼠肝组织RNA-122表达的影响[J].安徽中医药大学学报,2014,33(6):50-53.
[17]李秋红,李廷利,黄莉莉,等.中药抗氧化的作用机理及评价方法研究进展[J].时珍国医国药,2008,19(5):1257-1258
[2]Gow P J,Smallwood R A,Angus P W,et al.Diagnosis of Wilson's disease:an experience over three decades[J].Gut,2000,46(3):415-419.
[3]杨任民,杨兴涛,鲍远程,等.肝豆状核变性临床分型的初步探讨[J].天津医学,1983,11(5):288-291.
[4]杨任民.肝豆状核变性[M].合肥:安徽科学技术出版社,1995:48-49.
[5]Berry W R,Darley F L,Aronson A E.Dysarthria in wilson's disease[J].J Speech Hearing Res,1974,17(2):169-183.
[6]朱云波,宋磊,田竹,等.以构音障碍为首发症状的肝豆状核变性2例分析[J].中华中西医学杂志,2010,8(3):28-29.
[7]Roberts E A,Schilsky M L.Diagnosis and treatment of wilson disease:up-date[J].Hepatology,2008,47(6):2089-2111.
[8]杨文明,鲍远程,张波,等.肝豆状核变性诊疗方案[J].中医药临床杂志,2012,24(11):1130-1131.
[9]中华医学会神经病学分会帕金森病及运动障碍学组,中华医学会神经病学分会神经遗传病学组.肝豆状核变性的诊断与治疗指南[J].中华神经科杂志,2008,41(8):566-569.
[10]周香雪,李珣桦,黄海威,等.肝豆状核变性神经症状评价量表-改良Young量表[J].中国神经精神疾病杂志,2011,37(3):171-175.
[11]Shumway-Cook A,Brauer S,Woollacott M.Predicting the probability for falls in community-dwelling older adults using the timed up&go test[J].Phys Ther,2000,80(9):896-903.
[12]Canbek J,Fulk G,Nof L,et al.Test-retest reliability and construct validity of the tinetti performance oriented mobility assessment in people with stroke[J].J Neurol Phys Ther,2013,37:14-19.
[13]张卫平,董亚茹,蒋毅,等.肝豆状核变性28例临床分析[J].陕西医学杂志,2010,39(4):506-507.
[14]陈佳琳,姚声涛,郭宗铎,等.TNF-α在实验性蛛网膜下腔出血后早期脑损伤中的作用[J].第三军医大学学报,2011,33(15):1620-1622.
[15]江婵娟,王莉,杨婷婷,等.皮质下缺血性血管病认知损害与其他皮下损害临床特点的关系[J].中华老年医学杂志,2014(33):116-120.
[16]沈斌,鲍远程,蒋怀周,等.肝豆灵对Wilson病模型大鼠肝组织RNA-122表达的影响[J].安徽中医药大学学报,2014,33(6):50-53.
[17]李秋红,李廷利,黄莉莉,等.中药抗氧化的作用机理及评价方法研究进展[J].时珍国医国药,2008,19(5):1257-1258