摘要
目的:观察肝豆扶木颗粒对肝肾亏虚兼痰瘀互结型Wilson病(WD)患者的临床疗效。方法:将安徽中医药大学第一附属医院90例符合要求的WD患者随机分为观察组(45例)和对照组(45例)。对照组使用二巯丙磺钠常规治疗,治疗组在常规治疗基础上加用肝豆扶木颗粒,共治疗4个疗程(32 d)。观察治疗前后两组患者中医证候积分、临床有效率、24 h尿铜、铜蓝蛋白(CER)、肿瘤坏死因子-α(TNF-α),白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)和丙二醛(MDA)水平。结果:与本组治疗前比较,治疗后两组患者中医证候积分均显著下降(P<0.01),且观察组中医证候积分下降水平显著低于对照组(P<0.01)。对照组总有效率为57.78%(26/45),观察组总有效率为82.22%(37/45),观察组总有效率高于对照组,差异具有统计学意义(χ^(2)=6.402,P<0.05)。与本组治疗前比较,两组患者治疗后CER差异无统计学意义,24 h尿铜显著升高(P<0.01),且治疗后观察组24 h尿铜明显高于对照组(P<0.05)。两组患者治疗后TNF-α、IL-1β和IL-6水平显著降低(P<0.01);治疗后观察组TNF-α、IL-1β和IL-6水平显著低于对照组(P<0.01);对照组患者治疗后SOD水平升高,MDA水平下降(P<0.01),GSH-Px水平差异无统计学意义;观察组SOD和GSH-Px水平升高,MDA水平下降(P<0.01);治疗后观察组SOD和GSH-Px水平高于对照组,MDA水平低于对照组(P<0.05,P<0.01)。结论:肝豆扶木颗粒治疗WD肝肾亏虚兼痰瘀互结患者,能显著改善患者中医证候积分,提高临床疗效,增强驱铜效果,具有抑制炎症和抗氧化应激作用。
Objective:To observe the clinical efficacy of Gandou Fumu granules(GDFM)in the treatment of Wilson disease(WD)with liver-kidney deficiency and phlegm-blood stasis.Method:Ninety WD patients in The First Affiliated Hospital of Anhui University of Chinese Medicine were randomly divided into a control group(45 cases)and a treatment group(45 cases).All patients were treated with sodium 2,3-dimercaptopropane-1-sulfonate(DMPS),while those in the treatment group received additional GDFM.All patients were treated for four courses(32 days).The traditional Chinese medicine(TCM)syndrome scores,clinical effective rate,24 h urinary copper,ceruloplasmin(CER),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)and malondialdehyde(MDA)levels of the two groups before and after treatment were observed.Result:After treatment,the TCM syndrome scores of the two groups decreased(P<0.01),and the score of TCM syndrome in the treatment group was lower than that of the control group(P<0.01).The total effective rate of the treatment group was 82.22%(37/45),higher than 57.78%(26/45)of the control group(χ^(2)=6.402,P<0.05).There was no significant difference in CER before and after treatment in both groups.The post-treatment 24 hour urinary copper increased(P<0.01),which was higher in the treatment group than that in the control group(P<0.05).The TNF-α,IL-1β,and IL-6 levels were significantly reduced in both groups after treatment(P<0.01),and the above indicators in the treatment group were significantly lower than those in the control group(P<0.01).After treatment,the SOD level increased and the MDA level decreased in the control group(P<0.01),while no significant difference in GSH-Px level was observed.The SOD and GSH-Px levels increased and the MDA level decreased in the treatment group(P<0.01).After treatment,SOD and GSH-Px levels of the treatment group were higher than those in the control group,while the MDA level was lower than that in the control group(P<0.05,P<0.01).Conclusion:GDFM can improve the TCM syndrome score and clinical efficacy,enhance the copper removing effect,and inhibit the inflammatory response and antioxidative stress in the treatment of WD with liver and kidney deficiency and phlegm-blood stasis.
作者
唐露露
杨文明
董婷
张静
陈怀珍
汪瀚
魏涛华
江海林
杨悦
TANG Lu-lu;YANG Wen-ming;DONG Ting;ZHANG Jing;CHEN Huai-zhen;WANG Han;WEI Tao-hua;JIANG Hai-lin;YANG Yue(The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Postgraduate Education,Anhui University of Chinese Medicine,Hefei 230038,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2022年第12期127-132,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金面上项目(81973825)
国家自然科学基金青年基金项目(82104783)
安徽省自然科学基金青年基金项目(2108085QH366)。
关键词
肝豆扶木颗粒
肝豆状核变性
WILSON病
肝肾亏虚
痰瘀互结
Gandou Fumu granules
hepatolenticular degeneration
Wilson disease
liver and kidney deficiency
phlegm-blood stasis
