艾灸联合肝豆汤改善Wilson病早期脾功能亢进的临床研究

Clinical study of the effects of moxibustion combined with Gandou Decoction on improving early hypersplenism in Wilson disease

目的探讨艾灸联合肝豆汤改善Wilson病早期脾功能亢进的疗效。方法选取2016年10月-2020年5月在安徽中医药大学第一附属医院脑病中心住院的60例Wilson病伴有早期脾功能亢进患者,采用随机数字表法分为对照组和观察组各30例。对照组静脉输注二巯基丙磺酸钠注射液,1次/d, 6次/疗程,间歇期2 d;观察组在对照组治疗的基础上加用穴位艾灸和肝豆汤治疗,8 d为1个疗程,2组均治疗2个疗程。2个疗程结束后,观察2组患者临床症状、WBC、RBC、PLT、Hb及肝功能指标变化。结果 (1)治疗2个疗程末,对照组的总有效率为63.3%,而观察组的总有效率达到90.0%,显著优于对照组,差异有统计学意义(χ^(2)=5.963,P=0.015);(2)2组WBC、RBC、PLT、Hb第1和第2疗程水平与治疗前比较差异均有统计学意义(均P<0.01)。与对照组比较,观察组治疗前和第1疗程WBC、RBC、PLT、Hb水平差异无统计学意义(均P>0.05),第2疗程各指标明显高于对照组(均P<0.05);(3)2组各疗程ALT、AST、Alb水平与治疗前比较差异均有统计学意义(均P<0.01)。与对照组比较,观察组治疗前ALT、AST、Alb和第1疗程Alb水平差异无统计学意义(均P>0.05),观察组ALT、AST第1疗程、第2疗程均低于对照组(均P<0.05),Alb水平第2疗程明显高于对照组(P<0.01)。结论艾灸联合肝豆汤能够改善Wilson病早期脾功能亢进患者的临床症状。

Objective To explore the clinical effects of moxibustion combined with Gandou Decoction on improving the early hypersplenism of patients with Wilson disease(WD).Methods Sixty patients with WD and early hypersplenism were selected from October 2016 to May 2020.They were randomly divided into a control group and an observation group,with 30 cases in each group.The patients in both groups were administered with sodium dimercaptopropionic acid injection once a day for six times a week.The patients in the observation group were treated with additional moxibustion and Gandou Decoction,a course of treatment that lasted for 8 days.Both groups were treated for 2 weeks.The Clinical efficacy and changes in WBC,RBC,PLT,Hb and liver function index(ALT,AST,Alb and Alb levels)were observed after two courses of treatment.Results The clinical efficacy in the observation group(90.0%)was significantly better than that in the control group(63.3%,χ^(2)=5.963,P=0.015).The levels of WBC,RBC,PLT and Hb in the first and second courses of treatment in both groups were significantly different from those before treatment(all P<0.01).No significant difference was observed in WBC,RBC,PLT and Hb levels before treatment and after the first course of treat-ment in the observation group compared with those in the control group(all P>0.05),and these indicators in the obser-vation group after the second course of treatment were significantly higher than those in the control group(all P<0.05).The levels of ALT,AST and Alb in each course of treatment in both groups were significantly different from those before treatment(all P<0.01).Compared with those in the control group,no significant difference was found in the levels of ALT,AST,Alb and Alb in the observation group after the first course of treatment(all P>0.05).After the first and second courses of treatment,the levels of ALT and AST in the observation group were lower than those in the control group(all P<0.05).Moreover,the level of Alb level in the observation group after the second course of treatment was significantly higher than that in the control group(P<0.01).Conclusion Moxibustion combined with Gandou Decoc-tion can improve the clinical symptoms of WD patients with early hypersplenism.