方向，金珊，鲍远程，陈怀珍（安徽中医药大学第一附属医院脑病中心，安徽合肥230061）

·针推经络·

清热利胆解毒方联合驱铜治疗对Wilson病患者神经系统症状及肝纤维化指标的影响

方向，金珊，鲍远程，陈怀珍
（安徽中医药大学第一附属医院脑病中心，安徽合肥230061）

目的观察清热利胆解毒方联合驱铜治疗对Wilson病患者神经系统症状及肝纤维化指标的影响。方法80例Wilson病患者随机分为清热利胆解毒方中药联合西药治疗组（观察组）和西药治疗对照组（对照组），共治疗62 d。观察两组治疗前后神经系统症状积分、24 h尿铜及肝纤维化指标变化。结果2组患者治疗后神经系统症状积分、24 h尿铜均有显著改善（P＜0.01），观察组改善较对照组更为明显（P＜0.05）；2组患者肝纤维化指标治疗前后无变化（P＞0.05）。结论清热利胆解毒方能明显改善Wilson病患者神经系统症状及降低24 h尿铜水平。

Wilson病；清热利胆解毒方；神经系统症状；肝纤维化

〔Abstract〕ObjectiveTo observe the therapeutical effect of Qingre Lidan Jiedu prescription combined with copper antagonists on neurological symptoms and hepatic fibrosis indicators in patients with Wilson's disease.Methods Eighty patients were randomly divided into a traditional Chinese medicine combined with western medicine group（observation group）and western medicine group（control group），the treatment cycle was for 62 d.The nervous symptom score，24 h urinary copper and hepatic fibrosis markers were observed before and after treatment.Results The nervous symptom score and 24 h urinary copper in two groups were remarkably improved after treatment（P＜0.01），and the observation group decreased more significantly than control group（P＜0.05）.No difference was found in hepatic fibrosis markers for both groups before and after the treatment（P＞0.05）.Conclusions Qingre Lidan Jiedu prescription can significantly improve the neurological symptoms and decreased the 24 h urinary copper levels.

〔Keywords〕Wilson's disease；Qingre Lidan Jiedu prescription；neurological symptoms；liver fibrosis

Wilson病（Wilson’s disease，WD）又称肝豆状核变性，是一种常染色体隐性遗传的铜代谢障碍疾病，以儿童、青少年多发。WD的主要临床症状多表现为神经系统及肝脏损害，可见以双上肢为主的震颤、言语含糊不清、吞咽障碍、肌僵直及黄疸、腹水等表现［1］。清热利胆解毒方又名肝豆汤［2］，是根据WD中医铜毒内聚、肝胆湿热内蕴的主要病机，立清热解毒、利胆燥湿、通腑利尿之法应用于WD的治疗，获得了良好的治疗效果［3］。本研究通过对清热利胆解毒方联合驱铜治疗对WD患者神经系统症状和肝纤维化血清学指标的影响，进一步明确清热利胆解毒方对WD治疗作用的可能机制。……