基于GAS量表评分Wilson病中西医结合长期驱铜治疗疗效的多中心研究  

Multi-center Study of Wilson Patients, Decoppering Treatment by Combining Traditional Chinese and Western Medicine based on GAS

作　　者：孙长龙 程楠 王训 韩咏竹 洪铭范 蔡永亮[4] 任明山[5] 潘发明[6] 胡纪源 SUN Changlong;CHEN Nan;WANG Xun;HAN Yongzhu;HONG Minfan;CAI Yongliang;REN Mingshan;PAN Famingo;HU Jiyuanz(Anhui University of Chinese Medicine Anhui Hefei 230061,China;Institute of Neurology Hospital Affiliated of Anhui university of Chinese Medicine, Anhui Hefei 230061, China;The First Affiliated Hospital of Guangdong＇Pharmaceutical College, Guangdong Guangzhou 510080, China;The First Affiliated Hospital of Anhui University of Chinese Medicine, Anhui Hefei 230031, China;Anhui Provincial Hospital, Anhui Hefei 230061, China;Anhui Medical University, Anhui Hefei 230031, China)

机构地区：[1]安徽中医药大学,安徽合肥230061 [2]安徽中医药大学神经病学研究所附属医院,安徽合肥230061 [3]广州药学院第一附属医院神经内科,广东广州510080 [4]安徽中医药大学第一附属医院神经内科,安徽合肥230061 [5]安徽省立医院神经内科,安徽合肥230061 [6]安徽医科大学公共卫生学院,安徽合肥230061

出　　处：《中医药临床杂志》2018年第5期893-898,共6页Clinical Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(NO.81673948);安徽省卫生厅医学科研重点项目(NO.2010A016)

摘　　要：目的:观察多中心Wilson病(WD)患者在中西医结合长期驱铜治疗前后WD综合评定量表(GlobleAsessmentScale,GAS)各项目评分的改变并评估其疗效,为建立疗效好、不良反应小的WD长期综合治疗方案提供循证医学依据。方法:参与研究的4个中心共纳入1001例WD确诊患者,随机分成青霉胺(PCA)组、二巯基丁二酸(DMSA)组、肝豆片组和中西医结合组(肝豆片+PCA/DMSA)4组(各组按1︰1︰1︰3平行设计,各组的条件除了治疗方案不同外,其他条件完全相同)。在首次入院时、维持治疗1年时(第2次入院时)、维持治疗2年时(第3次入院时)进行GAS量表各项目(GAS-L、C、M、O项目及神经功能)评分,通过治疗前后自身比较及组间比较,评估各组患者的疗效。结果:各治疗组WD患者GAS各项目评分均较治疗前明显降低,在维持治疗2年时的疗效较维持治疗1年时更为明显,尤以中西医结合组评分改善最显著。结论:4种长期驱铜治疗方法均可改善WD患者的病情,中西医结合长期驱铜治疗的疗效更为显著,是目前WD患者长期治疗最有效的方案。Objective： By-observing the scores change in each item of GAS （Global Assessment Scale） for muhi- center Wilson＇ s disease（WD） patients before and after long-term decoppering treatment by combining Traditional Chinese and Western medicine and evaluating the therapeutic effect, to provide evidence-based medical basis for long- term comprehensive treatment scheme for WD with good curative effect and low side effects. Method： In this study, all of the 1001 cases of WD patients are from the 4 participating centers .Firstly, sufferers were randomly divided into four groups： PCA group（single with penicillamine therapy）, DMSA group （single dimercaptosuccinic acid capsule in treat- ing）, Gandou Pian group （single Gandou Pian treatment） and traditional Chinese and Western medicine combined group （PCA/DMSA alternating ＋ Gandou Plan treatment） （Each group was designed parallel to 1：1：1：3. The conditions of each group were the same except the treatment scheme）.Then record the score of each items（GAS-L, C, M, O and neu- ral function score） in GAS for each suffer at different time, which included the first-time hospitalization, maintenance treatment for 1 year（the second-time hospitalization）, maintenance treatment for 2 year （the third-time hospitalization）. Finally, compare suffers＇ scores in intra group and inter group, and evaluate therapeutic effect for each sufferer. Result： The scores of GAS in each treatment group of WD patients were significantly lower than before, and the therapeutic ef- fect of maintenance treatment for 2 years was more obvious than that of 1 year, especially for the traditional Chinese and Western medicine combined group . Conclusion： Four kinds of the long-term deeoppering treatment methods can improve the condition of WD patients. The combination of traditional Chinese and Western medicine has a more sig- nificant effect on long-term decoppering treatment, which is the best treatment scheme for WD patients at present.

关 键 词：WILSON病 中西医结合治疗 多中心研究 GAS量表 疗效 

分 类 号：R259[医药卫生—中西医结合]