浏览全部资源
扫码关注微信
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 研究生院,合肥 230038
唐露露,博士,从事中医药防治肝豆状核变性研究,Tel:0551-62838703,E-mail:tanglulu618@126.com
杨文明,博士,教授,岐黄学者,主任医师,博士生导师,从事中医药防治神经变性疾病研究,Tel:0551-62838512,E-mail:yangwm8810@126.com
纸质出版日期:2022-06-20,
网络出版日期:2022-04-07,
收稿日期:2021-12-13,
扫 描 看 全 文
唐露露,杨文明,董婷等.肝豆扶木颗粒治疗肝肾亏虚兼痰瘀互结型Wilson病患者的临床疗效[J].中国实验方剂学杂志,2022,28(12):127-132.
TANG Lu-lu,YANG Wen-ming,DONG Ting,et al.Clinical Efficacy of Gandou Fumu Granules on Wilson Disease with Liver-kidney Deficiency and Phlegm-blood Stasis[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(12):127-132.
唐露露,杨文明,董婷等.肝豆扶木颗粒治疗肝肾亏虚兼痰瘀互结型Wilson病患者的临床疗效[J].中国实验方剂学杂志,2022,28(12):127-132. DOI: 10.13422/j.cnki.syfjx.20221292.
TANG Lu-lu,YANG Wen-ming,DONG Ting,et al.Clinical Efficacy of Gandou Fumu Granules on Wilson Disease with Liver-kidney Deficiency and Phlegm-blood Stasis[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(12):127-132. DOI: 10.13422/j.cnki.syfjx.20221292.
目的
2
观察肝豆扶木颗粒对肝肾亏虚兼痰瘀互结型Wilson病(WD)患者的临床疗效。
方法
2
将安徽中医药大学第一附属医院90例符合要求的WD患者随机分为观察组(45例)和对照组(45例)。对照组使用二巯丙磺钠常规治疗,治疗组在常规治疗基础上加用肝豆扶木颗粒,共治疗4个疗程(32 d)。观察治疗前后两组患者中医证候积分、临床有效率、24 h尿铜、铜蓝蛋白(CER)、肿瘤坏死因子-
α
(TNF-
α
),白细胞介素-1
β(
IL-1
β
)、白细胞介素-6(IL-6)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)和丙二醛(MDA)水平。
结果
2
与本组治疗前比较,治疗后两组患者中医证候积分均显著下降(
P
<
0.01),且观察组中医证候积分下降水平显著低于对照组(
P
<
0.01)。对照组总有效率为57.78%(26/45),观察组总有效率为82.22%(37/45),观察组总有效率高于对照组,差异具有统计学意义(
χ
2
=6.402,
P
<
0.05)。与本组治疗前比较,两组患者治疗后CER差异无统计学意义,24 h尿铜显著升高(
P
<
0.01),且治疗后观察组24 h尿铜明显高于对照组(
P
<
0.05)。两组患者治疗后TNF-
α
、IL-1
β
和IL-6水平显著降低(
P
<
0.01);治疗后观察组TNF-
α
、IL-1
β
和IL-6水平显著低于对照组(
P
<
0.01);对照组患者治疗后SOD水平升高,MDA水平下降(
P
<
0.01),GSH-Px水平差异无统计学意义;观察组SOD和GSH-Px水平升高,MDA水平下降(
P
<
0.01);治疗后观察组SOD和GSH-Px水平高于对照组,MDA水平低于对照组(
P
<
0.05,
P
<
0.01)。
结论
2
肝豆扶木颗粒治疗WD肝肾亏虚兼痰瘀互结患者,能显著改善患者中医证候积分,提高临床疗效,增强驱铜效果,具有抑制炎症和抗氧化应激作用。
Objective
2
To observe the clinical efficacy of Gandou Fumu granules (GDFM) in the treatment of Wilson disease (WD) with liver-kidney deficiency and phlegm-blood stasis.
Method
2
Ninety WD patients in The First Affiliated Hospital of Anhui University of Chinese Medicine were randomly divided into a control group (45 cases) and a treatment group (45 cases). All patients were treated with sodium 2,3-dimercaptopropane-1-sulfonate (DMPS), while those in the treatment group received additional GDFM. All patients were treated for four courses (32 days). The traditional Chinese medicine (TCM) syndrome scores,clinical effective rate,24 h urinary copper,ceruloplasmin (CER),tumor necrosis factor-
α
(TNF-
α
),interleukin-1
β
(IL-1
β
),interleukin-6 (IL-6),superoxide dismutase (SOD),glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) levels of the two groups before and after treatment were observed.
Result
2
After treatment, the TCM syndrome scores of the two groups decreased (
P
<
0.01),and the score of TCM syndrome in the treatment group was lower than that of the control group (
P
<
0.01). The total effective rate of the treatment group was 82.22% (37/45), higher than 57.78% (26/45) of the control group (
χ
2
=6.402,
P
<
0.05). There was no significant difference in CER before and after treatment in both groups. The post-treatment 24 hour urinary copper increased (
P
<
0.01), which was higher in the treatment group than that in the control group (
P
<
0.05). The TNF-
α
,IL-1
β
,
and IL-6 levels were significantly reduced in both groups after treatment(
P
<
0.01),and the above indicators in the treatment group were significantly lower than those in the control group (
P
<
0.01). After treatment,the SOD level increased and the MDA level decreased in the control group (
P
<
0.01), while no significant difference in GSH-Px level was observed. The SOD and GSH-Px levels increased and the MDA level decreased in the treatment group (
P
<
0.01). After treatment, SOD and GSH-Px levels of the treatment group were higher than those in the control group, while the MDA level was lower than that in the control group(
P
<
0.05,
P
<
0.01).
Conclusion
2
GDFM can improve the TCM syndrome score and clinical efficacy,enhance the copper removing effect,and inhibit the inflammatory response and antioxidative stress in the treatment of WD with liver and kidney deficiency and phlegm-blood stasis.
肝豆扶木颗粒肝豆状核变性Wilson病肝肾亏虚痰瘀互结
Gandou Fumu granuleshepatolenticular degenerationWilson diseaseliver and kidney deficiencyphlegm-blood stasis
程婷,李祥,黄鹏,等.肝豆状核变性——伏邪致病新论[J].辽宁中医药大学学报,2019,21(8):64-67.
杨文明,张春海,李瑞娟,等.毒邪在肝豆状核变性致病中的作用[J].中国实验方剂学杂志,2009,15(11):109-111.
陈永华,杨文明,汪瀚,等.杨文明关于肝豆状核变性辨治思路及经验撷菁[J].中华中医药杂志,2020,35(4):1843-1846.
沈斌,鲍远程.鲍远程辨证治疗肝风(肝豆状核变性)经验[J].河南中医,2017,37(2):227-229.
SCHILSKY M L.Wilson disease:Diagnosis,treatment,and follow-up[J].Clin Liver Dis,2017,21(4):755-767.
AGGARWAL A,BHATT M.Wilson disease[J].Curr Opin Neurol,2020,33(4):534-542.
SANDAHL T D,LAURSEN T L,MUNK D E,et al.The prevalence of Wilson's disease:An update[J].Hepatology,2020,71(2):722-732.
KALITA J,KUMAR V,CHANDRA S,et al.Worsening of Wilson disease following penicillamine therapy[J].Eur Neurol,2014,71(3/4):126-131.
XIAO Q Q,FAN J G.Advances in the treatment of Wilson disease[J].Chin J Hepatol,2021,29(1):79-82.
杨文明,韩辉,鲍远程,等.中医对肝豆状核变性病因病机及辨证论治的探索[J].北京中医药大学学报:中医临床版,2012,19(4):6-9.
中华医学会神经病学分会神经遗传学组.中国肝豆状核变性诊治指南2021[J].中华神经科杂志,2021,54(4):310-319.
杨文明,鲍远程,张波,等.肝豆状核变性中医临床路径[J].中医药临床杂志,2012,24(11):1127-1129.
胡纪源,周志华,韩咏竹,等.肝豆状核变性患者中医证型与血尿酸、Goldstein分级的关系[J].中国中西医结合杂志,2015,35(11):1335-1339.
杨文明,赵广峰,董婷,等.治疗肝豆状核变性中医药研究进展[J].中国实验方剂学杂志,2008,14(2):71-73.
杨文明,陈彪,鲍远程,等.肝豆状核变性病中医临床思考[J].中国实验方剂学杂志,2004,10(6):66-69.
钱南南,杨文明,魏涛华,等.肝豆状核变性伏毒阻络病因病机探要[J/OL].中国实验方剂学杂志:1-9[2022-04-11].http://kns.cnki.net/kcms/detail/11.3495.R.20220322.1309.014.htmlhttp://kns.cnki.net/kcms/detail/11.3495.R.20220322.1309.014.html.
陈永华,杨文明,汪瀚,等.杨文明关于肝豆状核变性辨治思路及经验撷菁[J].中华中医药杂志,2020,35(4):1843-1846.
唐露露,杨文明.杨文明创肝豆扶木汤治疗肝豆状核变性肝纤维化经验[J].中医药临床杂志,2021,33(10):1878-1880.
杨文明,方芳,汪美霞,等.肝豆扶木汤治疗Wilson病肝纤维化的临床研究[J].中医药临床杂志,2014,26(11):1111-1113.
魏涛华,杨文明,唐露露,等.基于网络药理学探讨肝豆扶木汤治疗肝豆状核变性肝纤维化的作用机制及实验验证[J].中国中西医结合杂志,2021,41(8):981-990.
唐露露,张静,魏涛华,等.肝豆扶木汤对CuCl2诱导的HepG2细胞氧化损伤的保护作用和机制[J].中国实验方剂学杂志,2021,27(12):48-56.
杨文明,唐露露,谢文婷,等.肝豆扶木汤对TX小鼠肝纤维化TGF-β1/Smad信号通路的影响[J].中西医结合心脑血管病杂志,2018,16(4):404-407.
唐露露,刘丹青,李睿,等.肝豆扶木汤对TX小鼠肝纤维化的保护作用及机制研究[J].中国中西医结合杂志,2018,38(12):1461-1466.
唐露露,杨文明,谢文婷,等.肝豆扶木汤对Wilson病肝纤维化TX小鼠肝组织TβRⅠ、TβRⅡ和Smad4表达的影响[J].中华中医药杂志,2019,34(9):4043-4047.
WEI T,HAO W,TANG L,et al.Comprehensive RNA-seq analysis of potential therapeutic targets of Gan-Dou-Fu-Mu decoction for treatment of Wilson disease using a toxic milk mouse model[J].Front Pharmacol,2021,12:622268.
郑雪花,杨君,杨跃辉.没食子酸药理作用的研究进展[J].中国医院药学杂志,2017,37(1):94-98,102.
张育贵,张淑娟,边甜甜,等.芍药苷药理作用研究新进展[J].中草药,2019,50(15):3735-3740.
马纳,李亚静,范吉平.槲皮素药理作用研究进展[J].辽宁中医药大学学报,2018,20(8):221-224.
刘学珍,林军,刘向磊,等.白藜芦醇的药理作用及其微生物合成的研究进展[J].世界临床药物,2015,36(1):56-60.
谭亮,汤秋凯,王守章,等.三七皂苷R1药理作用的研究进展[J].中国药理学通报,2018,34(5):604-607.
江楠,于靖,杨莉,等.中药柴胡皂苷药理作用的研究进展[J].环球中医药,2018,11(5):796-800.
宋莉平,王宇.姜黄素药理作用及机制研究进展[J].中国医药导报,2020,17(20):29-33.
CHEN J,JIANG Y,SHI H,et al.The molecular mechanisms of copper metabolism and its roles in human diseases[J].Pflugers Arch,2020,472(10):1415-1429.
SCHEIBER I F,BRůHA R,DUŠEK P.Pathogenesis of Wilson disease[J].Handb Clin Neurol,2017,142:43-55.
0
浏览量
8
下载量
4
CSCD
关联资源
相关文章
相关作者
相关机构