肝豆状核变性中医证型与统一Wilson病评定量表相关性分析  

Correlation analysis between the TCM syndromes of hepatolenticular degeneration and unified Wilson’s disease rating scale

作　　者：张娟[1] 王云宝 谢道俊[1] 鲍远程[1] 韩辉[1] 董婷[1] 周磊[1] 黄晓峰[1] 陈宏 马莹 ZHANG Juan;WANG Yunbao;XIE Daojun;BAO Yuancheng;HAN Hui;DONG Ting;ZHOU Lei;HUANG Xiaofeng;CHEN Hong;MA Ying(Department of Neurology,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei,Anhui 230038,China;Graduate School,Anhui University of Chinese Medicine,Hefei,Anhui 230038,China)

机构地区：[1]安徽中医药大学第一附属医院神经内科,安徽合肥230038 [2]安徽中医药大学研究生院,安徽合肥230038

出　　处：《安徽医药》2020年第7期1309-1312,共4页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金面上项目(81774299);安徽省自然科学基金面上项目(170805MH199);安徽省重点研究和开发计划项目(1804h08020243)。

摘　　要：目的探讨肝豆状核变性(又称威尔逊病,Wilson Disease,WD)病人中医证型与统一Wilson病评定量表相关性。方法纳入2016年8月至2018年9月在安徽中医药大学第一附属医院住院的肝豆状核变性病人80例,对其进行中医证候辨证分型,进行统一Wilson病评定量表评分。采用方差分析、二元logistic回归分析探讨不同中医证型WD与统一Wilson病评定量表评分的相关性。结果 80例病人中,痰瘀互结证是最为常见的中医证型,其次为湿热内蕴证。痰瘀互结证(36.82±21.13)分的神经功能评分高于脾肾阳虚证(12.25±14.40)分,且低于肝气郁结证(59.5±22.74)的神经功能评分,差异有统计学意义;肝气郁结证的神经功能评分明显高于脾肾阳虚证,差异有统计学意义;湿热内蕴证(5.33±1.85)分及脾肾阳虚证(5.50±2.28)分的肝脏功能评分均高于痰瘀互结证(3.51±1.59)分,均差异有统计学意义;肝气郁结证(9.67±2.34)分精神症状评分高于痰瘀互结证(2.00±1.73)分、湿热内蕴证(2.67±2.35)分及脾肾阳虚证(1.50±1.62)分,差异有统计学意义。神经功能评分与痰瘀互结证呈正相关(OR=1.767,P<0.05)而与脾肾阳虚证呈负相关(OR=0.849,P<0.05),肝脏功能评分与湿热内蕴证、脾肾阳虚证与呈正相关(OR=1.384,P<0.05,OR=2.976,P<0.05),而与痰瘀互结证呈负相关(OR=0.516,P<0.05),精神症状评分与肝气郁结证呈正相关(OR=3.128,P<0.05)。结论 Wilson病不同中医证型之间的统一Wilson病评定量表功能评分具有一定的差异性,并且不同中医证型与统一Wilson病评定量表功能评分具有一定相关性。Objective To investigate the correlation between the TCM syndromes of hepatolenticular degernation and Unified Wilson’s Disease Rating Scale in Wilson disease(WD)patients.MethodsA total of 80 patients of WD patients in the First Affiliated Hospital of Anhui University of Chinese Medicine from August 2016 to September 2018 were included,and their TCM syndromes were classified into different types to score the Unified Wilson Disease Rating Scale.Variance analysis and binary Logistic regression analysis were used to explore the correlation between theTCM syndromes and Unified Wilson’s Disease Rating Scale in WD patients.ResultsAmong the 80 patients,phlegm-stasis syndrome was the most common TCM syndrome,followed by dampness-heat syndrome.The score of nerve function in the syndrome of phlegm-stasis(36.82±21.13)points was higher than that in the syndrome of Pi-Shen yang deficiency(12.25±14.40)points,and lower than that in the syndrome of liver-qi stasis(59.5±22.74)points,and the difference was statistically significant.The neurological function score of liver-qi stasis syndrome was significantly higher than that of Pi-Shen yang deficiency syndrome,and the difference was statistically significant.The liver function scores of damp-heat syndrome(5.33±1.85)points and Pi-Shen yang deficiency syndrome(5.50±2.28)points were higher than those of phlegm-stasis syndrome(3.51±1.59)points,and the differences were statistically significant.The scores of mental symptoms of liver-qi stasis syndrome(9.67±2.34)points were higher than those of phlegm-stasis syndrome(2.00±1.73)points,damp-heat syndrome(2.67±2.35)points and Pi-Shen yang deficiency syndrome(1.50±1.62)points.Neurological function score was positively correlated with syndrome of phlegm-stasis(OR=1.767,P<0.05)and negatively correlated with syndrome of Pi-Shen yang deficiency(OR=0.849,P<0.05).Liver function score was positively correlated with syndrome of damp-heat(OR=1.384,P<0.05)and Pi-Shen yang deficiency(OR=2.976,P<0.05),and negatively correlated with syndro

关 键 词：肝豆状核变性/中医病机 湿热 脾肾阳虚 Wilson病评定量表 中医证型 相关性 

分 类 号：R277.7[医药卫生—中医学]