肝豆汤联合二巯基丙磺酸钠对湿热内蕴型肝豆状核变性患者的影响  

Effect of Gandou Decoction Combined with Sodium Dimercaptopropane Sulfonate in Treatment of Wilson's Disease with Damp-heat Syndrome

作　　者：张静[1] 方媛[2] 崔圣伟 李良勇[1] 陈怀珍[1] 吴云虎[1] 

机构地区：[1]安徽中医药大学第一附属医院,合肥230031 [2]安徽中医药大学,合肥230038

出　　处：《中国实验方剂学杂志》2017年第17期190-194,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81102592);安徽省高校省级自然科学研究项目(KJ2013Z170)

摘　　要：目的:探讨肝豆汤联合二巯基丙磺酸钠治疗对湿热内蕴型肝豆状核变性患者的安全性及疗效性的影响。方法:回顾性分析湿热内蕴型肝豆状核变性患者245例,其中治疗组125例,对照组120例,治疗组为中药肝豆汤联合二巯基丙磺酸钠治疗,对照组选择单独应用二巯基丙磺酸钠治疗;在治疗前、治疗后分别进行globleassessment scale(GAS)评分,并观察24 h尿铜、肝功能、肾功能、白细胞、血小板等指标。结果:两组患者在治疗后,GAS评分均明显下降,其中以治疗组改善明显(P<0.05);两组患者肝功能均得到明显改善,其中治疗组改善明显(P<0.05),治疗后治疗组驱铜效果明显优于对照组(P<0.05)。治疗4个疗程后对照组出现明显白细胞减少,治疗组无变化,两组患者具有明显差异(P<0.05)。治疗后治疗组出现20例不良反应,对照组42例,主要为神经系统损害、白细胞减少、胃肠道反应、肝功能损害等,两组患者比较差异明显(P<0.05)。结论:肝豆汤联合二巯基丙磺酸钠治疗肝豆状核变性具有明显的改善神经功能、改善肝功能、提高驱铜疗效作用,并可有效防止单独西药驱铜治疗引起的白细胞减少,安全有效。Objective： To investigate the efficacy and safeness of Gandou decoction combined with sodium dimercaptopropane sulfonate in the treatment of Wilson＇s disease （WD） with damp-heat syndrome. Method： Totally 245 WD patients were collected and divided into two groups： treatment group （125 cases） and control group （120 cases）. The treatment group was treated with Gandou decoction combined with sodium dimercaptopropane sulfonate, while the control group was treated with sodium dimercaptopropane sulfonate alone. Before and after treatment, global assessment scale （GAS） was used to score. The clinical and laboratory parameters were observed. Result： After 4 courses of treatment, patients in two groups showed obvious alleviations in neurological symptoms, and the score of GAS in treatment group decreased more obviously. The treatment group also showed alleviations in laboratory indexes, like asalanine aminotrans （ALT） , aspertate transaminase （AST） and 24-hour urinary, compared with control group. White blood cell were found to be unchanged in treatment group, but greatly dropped in control group. Adverse reaction was reported, with obvious differences between two groups. The commonest adverse reactions were leukocytopenia, hepatic impairment, abdominal discomfort and neurological deterioration. Conclusion： The regimen of Gandou decoction combined with sodium dimercaptopropane sulfonate is an effective and safe therapy for patients of WD with damp-heat syndrome.

关 键 词：肝豆状核变性 肝豆汤 二巯基丙磺酸钠 湿热内蕴型 GAS评分 

分 类 号：R287[医药卫生—中药学] R742.4[医药卫生—中医学]