通腑养髓方治疗Wilson病疗效观察

Clinical Effect of Tongfu Yangsui Decoction in Treatment of Wilson's Disease

目的评价通腑养髓方治疗Wilson病(Wilson’s disease,WD)的临床疗效。方法将58例患者随机分为治疗组(28例,采用通腑养髓方及西医常规治疗)和对照组(30例,采用西医常规治疗),疗程均为4周;治疗前后分别采用统一肝豆状核变性评分量表(united Wilson’s disease rating scale,UWDRS)对患者肝脏症状、神经系统症状和精神症状进行评分,根据治疗前后Goldstein分级变化判定疗效,根据总胆汁酸、总胆红素、丙氨酸转氨酶、天冬氨酸转氨酶、谷氨酰转肽酶、白蛋白水平评价两组患者治疗前后肝功能;采用日常生活能力(activities of daily living,ADL)量表评价治疗前后患者生活自理能力水平。结果与治疗前比较,治疗组患者UWDRSⅠ部分、Ⅲ部分总分及UWDRS总分、标准分显著降低(P<0.05),且治疗组上述评分降低程度显著大于对照组(P<0.05);治疗组基于Goldstein分级的临床疗效显著优于对照组(P<0.05);治疗组治疗后总胆汁酸复常率显著大于对照组(P<0.05);治疗组治疗后ADL量表评分升高程度显著大于对照组(P<0.05)。结论通腑养髓方可有效改善患者神经精神系统症状,改善患者日常生活活动能力,部分改善肝脏功能,明显提高临床疗效。

Objective To investigate the clinical effect of Tongfu Yangsui Decoction in the treatment of Wilson's Disease(WD).Methods A total of 58patients with WD were randomly divided into treatment group(28patients treated with Tongfu Yangsui Decoction and conventional Western medicine treatment)and control group(30patients treated with conventional Western medicine treatment),and the course of treatment was 4weeks for both groups.The Unified Wilson's Disease Rating Scale(UWDRS)was used to evaluate liver symptoms,nervous system symptoms,and mental symptoms before and after treatment,and clinical outcome was assessed based on the change in Goldstein grade after treatment;liver function was evaluated based on total bile acid,total bilirubin,alanine aminotransferase,aspartate aminotransferase,glutamyl transpeptidase,and albumin before and after treatment;the Activities of Daily Living(ADL)scale was used to evaluate the self-care ability of daily living before and after treatment.Results After treatment,the treatment group had significant reductions in the scores of UWDRSⅠandⅢand the total score and standard score of UWDRS(P<0.05),and the treatment group had significantly greater reductions in the above scores than the control group(P<0.05).Compared with the control group,the treatment group had a significantly better clinical outcome based on Goldstein grade(P<0.05).Compared with the control group,the treatment group had a significantly higher normalization rate of total bile acid and a significantly greater increase in ADL score after treatment(P<0.05).Conclusion For the patients with WD,Tongfu Yangsui Decoction can effectively improve neuropsychiatric symptoms,activities of daily living,and liver function and significantly improve clinical outcome.