肝豆汤治疗湿热内蕴型Wilson病伴快动眼期睡眠行为障碍的临床疗效  

Therapeutic Effect of Gandou Decoction on Wilson's Disease with Dampness Heat Accumulation Accompanied by Rapid Eye Movement Sleep Behavior Disorder

作　　者：徐磊[1,2] 李小敏 王慧 张恩召 陈思宇 韩辉 朱虹[1,2] 王玮 XU Lei;LI Xiaomin;WANG Hui;ZHANG Enzhao;CHEN Siyu;HAN Hui;ZHU Hong;WANG Wei(The First Affiliated Hospital,Anhui University of Chinese Medicine,Hefei 230031,China;Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine of Institute of Health and Medicine,Hefei Comprehensive National Science Center,Anhui University of Chinese Medicine,Hefei 230012,China;Graduate School,Anhui University of Chinese Medicine,Hefei 230038,China)

机构地区：[1]安徽中医药大学第一附属医院,合肥230031 [2]合肥综合性国家科学中心大健康研究院新安医学与中医药现代化研究所,合肥230012 [3]安徽中医药大学研究生院,合肥230038

出　　处：《中国实验方剂学杂志》2024年第8期126-133,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：安徽省重点研究和开发计划项目(1804h08020243);国家自然科学基金项目(81673811)。

摘　　要：目的:探讨肝豆汤治疗湿热内蕴型Wilson病(WD)伴快动眼期睡眠行为障碍(RBD)的疗效。方法:从2019年4月至2023年8月在安徽中医药大学第一附属医院脑病科入院患者中,选取符合纳入标准的湿热内蕴型WD伴RBD患者62例,由计算机分发器随机分为对照组、观察组各31例。对照组予以常规驱铜治疗,观察组在对照组基础上加用肝豆汤治疗。8 d为1个疗程,共3个疗程。比较两组治疗前、后的中医证候积分、RBD筛查问卷(RBDSQ)评分、RBD筛查问卷香港版(RBDQ-HK)评分、多导睡眠图(PSG)参数、24 h尿铜(24 h U-Cu)水平和游离铜(NCC)水平,观察不良反应。结果:最终完成试验病例60例,对照组和观察组各30例。治疗前,两组各项指标比较差异无统计学意义,资料具有可比性。与本组治疗前比较,两组患者中医证侯积分、RBDSQ和RBDQ-HK评分明显降低,24 h U-Cu水平明显增高,NCC水平明显降低(P<0.05,P<0.01);与对照组比较,中医证侯积分、RBDSQ、RBDQ-HK评分和NCC水平观察组改善更优(P<0.05,P<0.01)。与本组治疗前比较,两组总睡眠(TST)时间、睡眠效率(SE)、入睡/快速眼动(REM)潜伏期、N1/N2/REM期占比、微觉醒指数(ARI)和时相性肌电图活动(P-EMG-A)占比明显改善(P<0.05)。与对照组治疗后比较,观察组TST、SE、REM期占比、ARI和P-EMG-A占比改善更明显(P<0.05)。结论:肝豆汤不仅可以改善湿热内蕴型WD伴RBD患者的中医证候,还可以减轻患者的RBD症状。Objective:To explore the clinical efficacy of Gandou decoction in treating Wilson's disease(WD)with dampness heat accumulation accompanied by rapid eye movement(REM)sleep behavior disorder(RBD).Method:From April 2019 to August 2023,62 patients with dampness heat accumulation type WD accompanied by RBD who met the inclusion criteria were selected from the Department of Encephalopathy at the First Affiliated Hospital of Anhui University of Chinese Medicine.They were randomly divided into a control group and an observation group with 31 cases each using a computer distributor.The control group received routine copper removal treatment,while the observation group received additional treatment with Gandou decoction on the basis of the control group.Eight days was one course of treatment,totaling three courses.The scores of traditional Chinese medicine syndromes,RBD screening questionnaire(RBDSQ)scores,RBD questionnaire-Hong Kong(RBDQ-HK)scores,polysomnography(PSG)parameters,24-hour urine copper(24 h U-Cu)levels,and non-ceruloplasmin-bound copper(NCC)levels between the two groups before and after treatment were compared,and adverse reactions were observed.Result:Sixty trial cases were ultimately completed,with 30 cases in each group.Before treatment,there was no statistically significant difference in various indicators between the two groups,and thus they were comparable.Compared with those before treatment,the traditional Chinese medicine syndrome scores,RBDSQ scores and RBDQ-HK scores of the two groups were significantly reduced,the 24 h U-Cu levels were significantly increased,and the NCC levels were significantly reduced(P<0.05,P<0.01).Compared with the control group,the observation group showed better improvement in traditional Chinese medicine syndrome scores,RBDSQ scores,RBDQ-HK scores,and NCC levels(P<0.05,P<0.01).Compared with those before treatment,the total sleep time(TST),sleep efficiency(SE),sleep/REM latency,the proportion of N1/N2/REM stages,arousal index(ARI),and proportion of phasic electromyographic

关 键 词：肝豆汤 湿热内蕴型 WILSON病 快动眼期睡眠行为障碍 

分 类 号：R242[医药卫生—中医临床基础] R2-031[医药卫生—中医学] R287R259R256.23