Objective:Acoustic radiation force impulse(ARFI)was applied to measure Shear wave velocity(SWV)of liver in patients with Wilson's disease(WD).To investigate the relationship between SWV and the serological indexes...Objective:Acoustic radiation force impulse(ARFI)was applied to measure Shear wave velocity(SWV)of liver in patients with Wilson's disease(WD).To investigate the relationship between SWV and the serological indexes of liver fibrosis,such as type Ⅳ collagen(CⅣ),hyaluronic acid(HA),type Ⅲ procollagen peptide(PⅢNP),laminin(LN),APRI score(Asparate Aminotransfer to Platelet Ratio Index),and FIB-4 index(FIB-4 index).The clinical efficacy of GandouTang(GDT)in the treatment of liver fibrosis in WD with damp-heat internalization was also observed.Methods:80 cases of WD patients who met the inclusion criteria were randomly divided into the treatment group and the control group,with 40 cases in each group.The control group was treated with Sodium Dimercaptopropylsulfonate(DMPS)and the treatment group was additionally treated with the traditional Chinese medicine GDT.One course for 8 days,a total of 6 courses.The levels of SwV and four serological indicators of liver fibrosis(PⅢNP,HA,CⅣ,LN),APRI score and FIB-4 index were compared before and after treatment.Pearson correlation test was used to analyze the correlation between SWV and HA,CⅣ,LN,PⅢNP,APRI score and FIB-4 index.The effects of GDT on SWV,liver fiber,APRI and FIB-4 were evaluated according to the treatment plan.Results:①The SWV was positively correlated with FIB-4(r=0.83),APRI(r=0.82),HA(r=0.87),CⅣ(r=0.71),LN(r=0.85)and PINP(r=0.77).②Before treatment,there were no significant differences in SWV level,PⅢNP,HA,CⅣ,LN,APRI and FIB-4 levels between two groups(P>0.05).After treatment,the levels of PⅢNP,HA,LN,SWV,APRI and FIB-4 in both groups were significantly decreased(P<0.05,P<0.01),and the levels in the treatment group were lower than those in the control group.There were no significant specific changes in CⅣ level(P>0.05).Conclusion:SWV value can reflect the degree of WD liver fibrosis,and is positively correlated with HA,PⅢNP,CⅣ,LN,FIB-4 index and APRI score.On the basis of the treatment of protecting liver and expelling copper with western medicine,plus the treatment of traditional Chinese medicine GDT can effectively improve the degree of liver fibrosis in WD patients with damp-heat accumulation.展开更多
目的系统评价奥氮平对比利培酮治疗阿尔茨海默病精神行为症状的有效性和安全性,旨在为临床合理用药提供循证参考。方法计算机检索PubMed、Embase、Cochrane library、中国知网、万方数据库、维普数据库和中国生物医学文献数据库,收集各...目的系统评价奥氮平对比利培酮治疗阿尔茨海默病精神行为症状的有效性和安全性,旨在为临床合理用药提供循证参考。方法计算机检索PubMed、Embase、Cochrane library、中国知网、万方数据库、维普数据库和中国生物医学文献数据库,收集各数据库自建库至2020年8月发表的奥氮平(试验组)对比利培酮(对照组)治疗阿尔茨海默病精神行为症状的随机对照试验(RCT)。筛选文献,提取数据,使用Cochrane系统评价员手册偏倚风险评估工具进行文献质量评价,采用Rev Man 5.3软件进行meta分析。结果共纳入13项RCT,共计1448例患者。meta分析结果显示,试验组总有效率[RR=1.14,95%CI(1.06,1.23),P=0.0008]显著高于对照组,治疗2周后[WMD=-2.67,95%CI(-3.79,-1.55),P<0.00001]、4周后[WMD=-2.83,95%CI(-4.02,-1.65),P<0.00001]的试验组阿尔茨海默病病理行为评定量表评分均显著低于对照组;两组治疗8周后的阿尔茨海默病病理行为评定量表评分[WMD=-1.40,95%CI(-4.34,1.54),P=0.35]及简易智力状态检查量表评分[WMD=1.01,95%CI(-1.73,3.76),P=0.47]比较,差异无统计学意义。试验组锥体外系反应发生率[RR=0.52,95%CI(0.34,0.80),P=0.003]、失眠发生率[RR=0.49,95%CI(0.32,0.76),P=0.002]均显著低于对照组,两组头痛、乏力、视物模糊、激惹、肝功能、体质量增加、嗜睡发生率比较,差异均无统计学意义(P>0.05)。结论奥氮平治疗阿尔茨海默病精神行为症状的效果优于利培酮,锥体外系反应和失眠发生率低于利培酮。展开更多
基金Training Program for Young Qhuang Scholars[Chinese Medicine Education Letter(2022)No.256]Key Research and Development Program of Anhui Province(No.202204295107020001)+1 种基金Anhui Young Leaders Reserve Talent Project[No.4,Middle Development(2022)]National Natural Science Foundation of China(No.81973825,82104783)。
文摘Objective:Acoustic radiation force impulse(ARFI)was applied to measure Shear wave velocity(SWV)of liver in patients with Wilson's disease(WD).To investigate the relationship between SWV and the serological indexes of liver fibrosis,such as type Ⅳ collagen(CⅣ),hyaluronic acid(HA),type Ⅲ procollagen peptide(PⅢNP),laminin(LN),APRI score(Asparate Aminotransfer to Platelet Ratio Index),and FIB-4 index(FIB-4 index).The clinical efficacy of GandouTang(GDT)in the treatment of liver fibrosis in WD with damp-heat internalization was also observed.Methods:80 cases of WD patients who met the inclusion criteria were randomly divided into the treatment group and the control group,with 40 cases in each group.The control group was treated with Sodium Dimercaptopropylsulfonate(DMPS)and the treatment group was additionally treated with the traditional Chinese medicine GDT.One course for 8 days,a total of 6 courses.The levels of SwV and four serological indicators of liver fibrosis(PⅢNP,HA,CⅣ,LN),APRI score and FIB-4 index were compared before and after treatment.Pearson correlation test was used to analyze the correlation between SWV and HA,CⅣ,LN,PⅢNP,APRI score and FIB-4 index.The effects of GDT on SWV,liver fiber,APRI and FIB-4 were evaluated according to the treatment plan.Results:①The SWV was positively correlated with FIB-4(r=0.83),APRI(r=0.82),HA(r=0.87),CⅣ(r=0.71),LN(r=0.85)and PINP(r=0.77).②Before treatment,there were no significant differences in SWV level,PⅢNP,HA,CⅣ,LN,APRI and FIB-4 levels between two groups(P>0.05).After treatment,the levels of PⅢNP,HA,LN,SWV,APRI and FIB-4 in both groups were significantly decreased(P<0.05,P<0.01),and the levels in the treatment group were lower than those in the control group.There were no significant specific changes in CⅣ level(P>0.05).Conclusion:SWV value can reflect the degree of WD liver fibrosis,and is positively correlated with HA,PⅢNP,CⅣ,LN,FIB-4 index and APRI score.On the basis of the treatment of protecting liver and expelling copper with western medicine,plus the treatment of traditional Chinese medicine GDT can effectively improve the degree of liver fibrosis in WD patients with damp-heat accumulation.
文摘目的系统评价奥氮平对比利培酮治疗阿尔茨海默病精神行为症状的有效性和安全性,旨在为临床合理用药提供循证参考。方法计算机检索PubMed、Embase、Cochrane library、中国知网、万方数据库、维普数据库和中国生物医学文献数据库,收集各数据库自建库至2020年8月发表的奥氮平(试验组)对比利培酮(对照组)治疗阿尔茨海默病精神行为症状的随机对照试验(RCT)。筛选文献,提取数据,使用Cochrane系统评价员手册偏倚风险评估工具进行文献质量评价,采用Rev Man 5.3软件进行meta分析。结果共纳入13项RCT,共计1448例患者。meta分析结果显示,试验组总有效率[RR=1.14,95%CI(1.06,1.23),P=0.0008]显著高于对照组,治疗2周后[WMD=-2.67,95%CI(-3.79,-1.55),P<0.00001]、4周后[WMD=-2.83,95%CI(-4.02,-1.65),P<0.00001]的试验组阿尔茨海默病病理行为评定量表评分均显著低于对照组;两组治疗8周后的阿尔茨海默病病理行为评定量表评分[WMD=-1.40,95%CI(-4.34,1.54),P=0.35]及简易智力状态检查量表评分[WMD=1.01,95%CI(-1.73,3.76),P=0.47]比较,差异无统计学意义。试验组锥体外系反应发生率[RR=0.52,95%CI(0.34,0.80),P=0.003]、失眠发生率[RR=0.49,95%CI(0.32,0.76),P=0.002]均显著低于对照组,两组头痛、乏力、视物模糊、激惹、肝功能、体质量增加、嗜睡发生率比较,差异均无统计学意义(P>0.05)。结论奥氮平治疗阿尔茨海默病精神行为症状的效果优于利培酮,锥体外系反应和失眠发生率低于利培酮。
