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| 肝豆灵干预肝豆状核变性骨代谢障碍的疗效观察 |
| Clinical effect observation of Gandouling Tablets on bone metabolism in Wilson Disease |
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| DOI：10.3969/j.issn.1006-7108.2021.06.012 |
| 中文关键词: 肝豆状核变性 骨代谢 肝豆灵 细胞因子 |
| 英文关键词:Wilson Disease bone metabolism Gandouling tablets cytokines |
| 基金项目:国家自然科学基金面上项目（81973825）；安徽中医药大学第一附属医院优秀医学人才基金，国家973计划项目(2013CB532001)；“十二五”国家科技支撑计划课题（2012BAI126B01）；第四批全国中医优秀人才项目资助（国中医药办人教发[2017] 124号） |
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| 中文摘要: |
| 目的 探讨应用肝豆灵结合基础支持治疗肝豆状核变性骨代谢障碍的效果及可能作用机制。方法 根据纳入标准共有44例肝豆状核变性骨代谢障碍病患入选，将入选的患者随机划分成两组，18例为肝豆灵组，26例为对照组，两组都提供基础支持，肝豆灵组加用肝豆灵组方。4周后比较两组治疗前后血Ca、1,25-(OH)2D3、BGP、BAP、IL-4、IL-10、TNF-α、IGF-1指标变化。采用24 h尿铜值、UWDRS评分、中医证候积分评定总体疗效。结果 入组的WD患者血Ca、1,25-(OH)2D3、IL-10、IGF-1、IL-4、BGP、BAP、TNF-α较健康组，差异具有统计学意义（P＜0.01）。肝豆灵组经过治疗之后TNF-α、BGP、IGF-1、BAP、1,25-(OH)2D3、血Ca、IL-4各项指标和治疗前相比差异具有统计学意义（P＜0.01），与对照组比较，差异有统计学意义（P＜0.01）。肝豆灵组疗后24 h尿铜值、中医证候积分值与对照组比较，差异有统计学意义（P＜0.01）。肝豆灵组发生不良反应的概率率为11.11 %，对照组发生不良反应的概率为23.07 %，前者概率显著低于后者。结论 肝豆灵联合基础治疗可一定程度改善血Ca、1,25-(OH)2D3、IGF-1、IL-4、BGP、BAP、TNF-α指标，其作用机制可能是通过影响参与骨代谢的细胞因子，促进铜排出，减轻骨代谢紊乱，降低中医证候积分，改善临床症状。 |
| 英文摘要: |
| Objective To observe the therapeutic effect of Gandouling tablet combined with basic treatment on bone metabolism disorder in Wilson Disease and explore its mechanism. Methods 44 patients with bone metabolism disorder in WD were randomly divided into Gln group (18 cases) and control group (26 cases). Both groups were given basic treatment. Gln group was added with GLN. After 4 weeks, the changes of blood Ca, 1,25-(OH) 2D3, BGP, BAP, IL-4, IL-10, TNF - α were compared before and after treatment. 24-hour urine copper value, UWDRS score and TCM syndrome score were used to evaluate the overall efficacy of the patients. Results The levels of blood Ca, 1,25-(OH) 2D3, IL-10, IGF-1, IL-4, BGP, BAP, TNF-α in WD patients were significantly different from those in healthy controls (P< 0.01). The blood Ca, 1,25-(OH)2D3, IGF-1, IL-4, BGP, BAP, TNF-α in Gandouling group after treatment were significantly different from those before treatment (P< 0.01) , and significantly different from those in control group (P< 0.01).There were significant differences between Gandouling group (P< 0.01) and control group (P<0.01) in urinary copper value and TCM Syndrome score 24 hours after treatment. The incidence of adverse reaction in Gandouling group (11.11%) was significantly lower than that in basic treatment group (23.07%). Conclusion Gandouling tablet combined with basic treatment can improve the indexes of blood CA, 1,25-OH 2D3, IGF-1, IL-4, BGP, BAP, TNF-to some extent. The mechanism of Gandouling tablet may be to promote the excretion of copper by affecting the cytokines involved in bone metabolism, reduce the bone metabolism disorder, reduce the traditional Chinese Medicine Syndrome score, and improve clinical symptoms. |
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