肝豆扶木汤联合吞咽训练对Wilson病吞咽障碍的疗效观察

Clinical Efficacy of Gandou Fumu Decoction Combined with Swallowing Training on Wilson's Disease with Dysphagia

  • 摘要:
    目的 观察肝豆扶木汤联合吞咽训练对痰瘀互结型Wilson病患者吞咽障碍的临床疗效。
    方法 选取安徽中医药大学第一附属医院脑病中心2021年10月至2024年10月收治的68例Wilson病吞咽障碍患者,分为治疗组和对照组各34例,对照组予以驱铜和吞咽训练等基础治疗,治疗组在基础治疗上加服肝豆扶木汤。观察2组患者治疗前后中医证候积分、吞咽功能评估量表(SSA)评分、洼田饮水试验(WST)评分、功能性经口摄食量表(FOIS)评分、Barthel量表评分、24 h尿铜含量以及血清超氧化物歧化酶(SOD)和丙二醛(MDA)水平变化。
    结果 治疗后,2组患者中医证候积分、SSA、WST量表评分及血MDA水平均显著降低(P<0.05,P<0.01),治疗组优于对照组(P<0.05);2组FOIS、Barthel量表评分、24 h尿铜含量及血清SOD水平均显著提高(P<0.05,P<0.01),治疗组优于对照组(P<0.05)。
    结论 肝豆扶木汤联合吞咽训练可显著提高痰瘀互结型Wilson病吞咽障碍患者的吞咽功能并促进尿铜排出,其机制可能与提高机体抗氧化应激水平有关。

     

    Abstract:
    OBJECTIVE To observe the clinical efficacy of Gandou Fumu Decoction (GDFMD) combined with swallowing function training on Wilson's disease with dysphagia of phlegm stasis type.
    METHODS Sixty-eight WD patients in The First Affiliated Hospital of Anhui University of Chinese Medicine were randomly equally divided into a control group (34 cases) and a treatment group (34 cases) during October 2021 to October 2024. Control group patients were treated with basic therapy such as copper drainage and swallowing training, while patients in the treatment group received additional GDFMD. The scores of traditional Chinese medicine (TCM) syndrome scores, Water Swallow Test (WST), Standardized Swallowing Assessment (SSA), Functional Oral Intake Scale (FOIS), Barthel Scale were observed before and after the treatment. 24-hour urinary copper, superoxide dismutase (SOD) and malondialdehyde (MDA) levels were measured in both groups.
    RESULTS After treatment, the TCM syndrome scores, SSA, WST scale scores and blood MDA levels of the two groups of patients were significantly reduced (P < 0.05, P < 0.01), and the treatment group was better than the control group (P < 0.05); FOIS, Barthel scale scores, 24-hour urine copper content and serum SOD level in both groups were significantly increased (P < 0.05, P < 0.01), and the treatment group was better than the control group (P < 0.05).
    CONCLUSION The combined therapy of Gandou Fumu Decoction with swallowing training can improve the swallowing function on Wilson's disease with dysphagia of phlegm stasis type and enhance the copper removing. The mechanism may be related to improving the level of antioxidant stress.

     

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