肝豆扶木汤治疗肝肾亏虚型Wilson病患者的临床疗效及舌诊参数研究

Clinical efficacy and tongue diagnosis parameters of Gandou Fumu Decoction in treating patients with Wilson Disease of liver-kidney deficiency

目的探讨肝豆扶木汤治疗肝肾亏虚型Wilson病(WD)患者的临床疗效及舌诊参数。方法选择108例肝肾亏虚型WD患者作为研究对象,按照随机数字表法分为两组,对照组应用常规西药保肝排铜治疗,观察组在对照组治疗的基础上加用肝豆扶木汤,比较两组患者治疗前后中医证候积分、APRI评分、FIB-4指数和Apo-A1/Apo-B比值水平,并分析其与肝肾亏虚型WD患者舌诊参数的相关性。结果与本组治疗前相比,治疗后两组患者的中医证候积分、APRI评分、FIB-4指数均下降(P<0.01),Apo-A1/Apo-B比值水平较治疗前上升(P<0.01),且治疗后观察组各项指标水平均优于对照组(P<0.01);与本组治疗前相比,治疗后两组患者的舌边-左、舌边-右和舌根部Lab-a值均下降(P<0.01),Lab-L值均升高(P<0.01),且治疗后观察组Lab-a值下降水平及Lab-L值升高水平均优于对照组(P<0.01)。肝肾亏虚型WD患者的舌边-左、舌边-右和舌根部Lab-a值积分与中医证候积分、APRI、FIB-4水平呈正相关,与Apo-A1/Apo-B比值水平呈负相关;Lab-L值积分与中医证候积分、APRI、FIB-4水平呈负相关,与Apo-A1/Apo-B比值水平呈正相关。结论肝豆扶木汤对于肝肾亏虚型WD治疗具有一定的效果,可降低中医证候积分、APRI评分和FIB-4指数,升高Apo-A1/Apo-B比值水平,且上述指标均与舌诊参数中的Lab-a和Lab-L值积分具有一定的相关性,通过对舌诊参数的研究能够提高对肝肾亏虚型WD患者证型判断的准确性和临床疗效评价的说服力。

Objective To investigate the clinical efficacy and tongue diagnosis parameters of Gandou Fumu Decoction in treating patients with Wilson Disease(WD)of liver-kidney deficiency.Methods A total of 108 patients with WD of liver-kidney deficiency were selected.They were divided into two groups according to the Random Number Table Method.The control group received conventional Western medicine for liver protection and copper excretion,while the observation group received Gandou Fumu Decoction in addition to the control treatment.Comparative analysis was performed on the Traditional Chinese Medicine Syndrome scores,APRI scores,FIB-4 indexes and Apo-A1/Apo-B ratio levels before and after treatment between the two groups.Correlation analysis was conducted between these indicators and tongue diagnosis parameters in patients with WD of liver-kidney deficiency.Results Post-treatment,both groups exhibited decreased Traditional Chinese Medicine Syndrome scores,APRI scores and FIB-4 indexes(P<0.01).Conversely,the Apo-A1/Apo-B ratio levels increased compared to pre-treatment levels(P<0.01).The observation group demonstrated superior outcomes compared to the control group in all assessed indicators post-treatment(P<0.01).Lab-a values of the margin of the tongue(left and right)and the root of the tongue decreased,while Lab-L values increased significantly in both groups post-treatment(P<0.01).The observation group showed better reduction in Lab-a values and increase in Lab-L values compared to the control group(P<0.01).Lab-a scores were positively correlated with Traditional Chinese Medicine Syndrome scores,APRI and FIB-4 levels,while negatively correlated with Apo-A1/Apo-B ratio levels.Lab-L scores exhibited negative correlations with Traditional Chinese Medicine Syndrome scores,APRI,FIB-4 levels,and positive correlations with Apo-A1/Apo-B ratio levels in patients with WD of liver-kidney deficiency.Conclusion Gandou Fumu Decoction has a good clinical efficacy on the treatment of patients with WD of liver-kidney deficiency,which can significantly reduce Traditional Chinese Medicine Syndrome scores,APRI scores and FIB-4 indexes,and increase the Apo-A1/Apo-B ratio.These indicators are correlated with Lab-a and Lab-L scores in tongue diagnosis parameters.Studying tongue diagnosis parameters enhances the accuracy of syndrome type judgment and the persuasiveness of clinical efficacy evaluation for patients with WD of liver-kidney deficiency.