肝豆汤加减治疗湿热内蕴型肝豆状核变性的临床疗效研究

发布时间：2018-01-19 01:23

  本文关键词： 肝豆状核变性 湿热内蕴证 肝豆汤加减 治疗结果　出处：《中国全科医学》2017年28期 　论文类型：期刊论文

【摘要】：目的了解肝豆汤加减治疗湿热内蕴型肝豆状核变性(Wilson病)的临床疗效,并探讨其作用机制。方法选取2016年1—8月在安徽中医药大学第一附属医院脑病中心住院治疗的湿热内蕴型Wilson病患者78例,采用随机数字表法分为对照组和观察组,各39例。两组患者入院后均以谷胱甘肽、二巯丙磺酸钠保肝驱铜为基础治疗,观察组在基础治疗的同时采用清热解毒、通腑利尿之中药肝豆汤加减治疗,两组患者均以4周为1个疗程。比较两组患者治疗前后的中医证候积分、血清同型半胱氨酸(Hcy)水平、血清肝纤维化标志物[透明质酸酶(HA)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PCⅢ)、层粘连蛋白(LN)]水平及中医证候疗效。结果治疗前两组患者中医证候积分比较,差异无统计学意义(P0.05);治疗后观察组患者中医证候积分低于对照组,差异有统计学意义(P0.05)。两组患者中医证候疗效比较,差异无统计学意义(P0.05)。治疗前两组患者血清Hcy水平比较,差异无统计学意义(P0.05);治疗后观察组患者血清Hcy水平低于对照组,差异有统计学意义(P0.05)。治疗前两组患者血清HA、Ⅳ-C、PCⅢ、LN水平比较,差异无统计学意义(P0.05);治疗后观察组患者血清HA水平低于对照组,差异有统计学意义(P0.05);但治疗后两组患者血清Ⅳ-C、PCⅢ、LN水平比较,差异无统计学意义(P0.05)。结论在进行西医综合保肝驱铜治疗的同时,临床辨证使用肝豆汤加减治疗湿热内蕴型Wilson病可以改善患者的临床症状,调节血清肝纤维化标志物和Hcy水平,改善肝功能。其作用机制为通过通腑利尿法竞争性抑制铜离子在胃肠道的吸收,同时增加体内多余铜的排泄,从而减轻铜毒导致的脏器功能损伤。
[Abstract]:Objective to investigate the clinical efficacy of Gandou decoction in the treatment of Wilson's disease of liver lenticular degeneration with damp-heat accumulation. Methods 78 cases of Wilson's disease with internal heat and dampness were selected from 2016 to August in the Encephalopathy Center of the first affiliated Hospital of Anhui University of traditional Chinese Medicine. The patients were divided into control group (39 cases) and observation group (39 cases). The two groups were treated with glutathione and sodium dimercaptopropanesulfonate after admission. Observation group in the basic treatment at the same time by clearing heat and detoxification, Fufu diuretic traditional Chinese medicine Gandou decoction treatment, the two groups of patients with 4 weeks as a course of treatment. Compared the two groups of patients before and after treatment of TCM syndromes integral. Serum homocysteine (Hcyl) level, serum hepatic fibrosis markers. [The level of hyaluronidase, type 鈪，

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