本文關(guān)鍵詞： 肝豆狀核變性 濕熱內(nèi)蘊證 肝豆湯加減 治療結(jié)果　出處：《中國全科醫(yī)學(xué)》2017年28期 　論文類型：期刊論文

【摘要】：目的了解肝豆湯加減治療濕熱內(nèi)蘊型肝豆狀核變性(Wilson病)的臨床療效,并探討其作用機制。方法選取2016年1—8月在安徽中醫(yī)藥大學(xué)第一附屬醫(yī)院腦病中心住院治療的濕熱內(nèi)蘊型Wilson病患者78例,采用隨機數(shù)字表法分為對照組和觀察組,各39例。兩組患者入院后均以谷胱甘肽、二巰丙磺酸鈉保肝驅(qū)銅為基礎(chǔ)治療,觀察組在基礎(chǔ)治療的同時采用清熱解毒、通腑利尿之中藥肝豆湯加減治療,兩組患者均以4周為1個療程。比較兩組患者治療前后的中醫(yī)證候積分、血清同型半胱氨酸(Hcy)水平、血清肝纖維化標志物[透明質(zhì)酸酶(HA)、Ⅳ型膠原(Ⅳ-C)、Ⅲ型前膠原(PCⅢ)、層粘連蛋白(LN)]水平及中醫(yī)證候療效。結(jié)果治療前兩組患者中醫(yī)證候積分比較,差異無統(tǒng)計學(xué)意義(P0.05);治療后觀察組患者中醫(yī)證候積分低于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。兩組患者中醫(yī)證候療效比較,差異無統(tǒng)計學(xué)意義(P0.05)。治療前兩組患者血清Hcy水平比較,差異無統(tǒng)計學(xué)意義(P0.05);治療后觀察組患者血清Hcy水平低于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。治療前兩組患者血清HA、Ⅳ-C、PCⅢ、LN水平比較,差異無統(tǒng)計學(xué)意義(P0.05);治療后觀察組患者血清HA水平低于對照組,差異有統(tǒng)計學(xué)意義(P0.05);但治療后兩組患者血清Ⅳ-C、PCⅢ、LN水平比較,差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論在進行西醫(yī)綜合保肝驅(qū)銅治療的同時,臨床辨證使用肝豆湯加減治療濕熱內(nèi)蘊型Wilson病可以改善患者的臨床癥狀,調(diào)節(jié)血清肝纖維化標志物和Hcy水平,改善肝功能。其作用機制為通過通腑利尿法競爭性抑制銅離子在胃腸道的吸收,同時增加體內(nèi)多余銅的排泄,從而減輕銅毒導(dǎo)致的臟器功能損傷。
[Abstract]:Objective to investigate the clinical efficacy of Gandou decoction in the treatment of Wilson's disease of liver lenticular degeneration with damp-heat accumulation. Methods 78 cases of Wilson's disease with internal heat and dampness were selected from 2016 to August in the Encephalopathy Center of the first affiliated Hospital of Anhui University of traditional Chinese Medicine. The patients were divided into control group (39 cases) and observation group (39 cases). The two groups were treated with glutathione and sodium dimercaptopropanesulfonate after admission. Observation group in the basic treatment at the same time by clearing heat and detoxification, Fufu diuretic traditional Chinese medicine Gandou decoction treatment, the two groups of patients with 4 weeks as a course of treatment. Compared the two groups of patients before and after treatment of TCM syndromes integral. Serum homocysteine (Hcyl) level, serum hepatic fibrosis markers. [The level of hyaluronidase, type 鈪，

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