中西医结合治疗对肝豆状核变性患者肝硬变及肝脏功能的改善作用

Study on Improvement of Liver Cirrhosis and Liver Function in Hepatolenticular Degeneration Patients Treated with Integrated Traditional and Western Medicine

目的 :观察比较二巯基丙磺酸钠 (DMPS)加中药肝豆片、DMPS、依地酸钙钠 (EDTA) 3组治疗对肝豆状核变性 (HLD)肝硬变及肝脏功能的改善作用。方法 :146例患者随机分为A、B、C 3组 ,分别给予DMPS加中药肝豆片、DMPS、EDTA治疗 8周。观察 3组患者治疗前后肝脏声像图、血清蛋白电泳、2 4h尿铜的变化。结果 :A、B、C 3组肝脏声像图改善率分别为 54 0 %、4 4 0 %、39 1% ;A、B两组血清白蛋白较治疗前明显增高 (P <0 0 1,P <0 0 5) ,而C组较治疗前无明显差异。 3组血清γ球蛋白均较治疗前减低 (P <0 0 5) ;3组 2 4h尿铜排出量均较治疗前显著增高 (P <0 0 1) ,而A、B两组的增高较C组更为明显 (P <0 0 5)。结论 :驱铜治疗可通过减轻肝细胞的铜中毒 ,促进HLD肝硬变及肝脏功能的改善。而DMPS加中药肝豆片治疗的改善作用优于DMPS、EDTA的单纯治疗。

To observe the effects of sodium dimercaptosulphonate (DMPS) plus Gandou tablet, DMPS and calcium disodium ethylene diaminotetraacetate (EDTA) on improving liver cirrhosis and liver function of hepatolenticular degeneration (HLD) patients. Methods: One hundred and forty-six HLD patients were divided into A, B, C three groups, and treated with DMPS plus Gandou tablet, DMPS and EDTA respectively, the therapeutic course was 8 weeks for three groups. The ultrasonography of liver, electrophoresis of serum protein and excretion of urinary copper were observed. Results: The ultrasonography of liver was improved in all groups, the rate of improvement of group A was 54.0%, B was 44.0% and C was 39.1%. The amounts of serum albumin in A and B groups increased (P<0.01,P<0.05), and γ-globulin decreased in all groups (P<0.05). The excretion of urinary copper increased obviously in all groups (P<0.01), and A,B groups increased more than that of C group (P<0.05). Conclusions: The de-copper therapy could improve liver cirrhosis and liver function. The effect of DMPS plus Gandou tablet was better than that of DMPS and EDTA.