RESUMEN
Objective::To observe the clinical efficacy of Gandouling decoction on hepatic function of patients with phlegm and blood stasis type Wilson's disease. Method::From January 2015 to December 2017, totally 72 cases of phlegm and blood stasis type Wilson's disease admitted to Encephalopathy Center in the First Affiliated Hospital of Anhui University of Chinese Medicine were randomly divided into treatment group and control group, with 36 cases in each group. Patients in both groups were injected with sodium dimercaptopropane sulfonate for routine treatment. At the same time, patients in control group received Hugan Tablets, and patients in treatment group received Gandouling decoction for a total of 6 treatment courses. Before and after treatment, traditional Chinese medicine(TCM)syndrome effective rate, serum enzyme index [alanine aminotransferase(ALT), aspartate aminotransferase (AST), alkaline phosphatase(AKP)], bilirubin metabolism index [total bilirubin(TBIL)], liver fibrosis index [laminin(LN), hyaluronic acid(HA), collagen type IV(CⅣ), procollagen type Ⅲ peptide(PⅢP)]and blood coagulation index [fibrinogen (FBG), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) ]were observed. Result::TCM syndrome effective rates of treatment group and control group were 86.11%(31/36) and 63.98%(23/36) respectively, with a significant difference between two groups (P<0.05). ALT, AST, AKP, TBIL decreased in two groups after treatment (P<0.01), and the effects of ALT, AST, AKP, TBIL in treatment group were significantly better than those in control group (P<0.01), liver fibrosis index decreased in both groups after treatment (P<0.01), and the effect in treatment group was significantly better than that in control group (P<0.01). Blood coagulation indexes were improved to different degrees in both groups (P<0.05, P<0.01), and there were significant differences between treatment group and control group in decreasing PT, APTT, TT levels (P<0.05, P<0.01) and increasing FBG level (P<0.01). Conclusion::Gandouling decoction can significantly improve hepatic function of patients with phlegm and blood stasis type Wilson's disease, which is manifested in improving serum enzymes and bilirubin indexes, reversing liver fibrosis, promoting clotting factors and reducing bleeding tendency, in order to delay the progress of the disease and improve the life quality of patients.
RESUMEN
Objective:To explore the curative effect and mechanism of Tongnao pill in the treatment of senile posterior circulation ischemic vertigo with phlegm and blood stasis type. Method:The 80 elderly patients with posterior circulation ischemic vertigo (phlegm and blood stasis type) admitted to Gansu Provincial Hospital of Traditional Chinese Medicine were selected as the research subjects and were randomly divided into two groups according to the hospital admission number. Those with odd numbers were classified into control group and those with even numbers were classified into observation group, with 40 cases in each group. All of the patients in both groups were given basic treatment, and the patients in control group additionally received intravenous infusion of vinpocetine on the basis of basic treatment, while the patients in observation group additionally received Tongnao pill on the basis of the treatment in control group. The clinical efficacy, traditional Chinese medicine (TCM) syndrome score, European Evaluation of Vertigo(EEV) score, dizziness handicap inventory-screening (DHI-S) score, vertebral basilar artery average blood flow velocity(Vm) and pulsatility index(PI), hemodynamic changes[mean arterial pressure(MAP), central venous pressure(CVP), right atrial pressure (RAP), left atrial pressure(LAP), cardiac output(CO), cardiac stroke volume(SV)], changes in blood viscosity and blood lipid levels，symptom disappearance time, and safety of the two groups were compared. Result:The total effective rate in the observation group was 95.00% (38/40), significantly higher than 75.00% (30/40) in the control group (χ2=4.804, P<0.05). After treatment, the symptoms were significantly improved in both groups (P<0.05), and the scores of dizziness, nausea and vomiting, tinnitus and deafness, tiredness and fatigue in the observation group were lower than those in the control group (P<0.05), the EEV and DHI-S scores were decreased significantly in both groups(P<0.05), and such scores in the observation group were significantly lower than those in the control group(P<0.05), the Vm of bilateral vertebral artery (VA) and basilar artery (BA) on both sides were significantly increased in both groups, while the PI was significantly reduced (P<0.05), and these two indicators in the observation group were better than those in the control group (P<0.05), the MAP, CVP, RAP and LAP were significantly reduced in both groups after treatment, while the CO and SV were increased after treatment(P<0.05), and the SV of the observation group was significantly higher than that of the control group(P<0.05). The high blood viscosity, low blood viscosity, plasma viscosity and TG, TC, LDL-C levels were decreased significantly while HDL-C increased significantly in both groups (P<0.05), and the blood viscosity and blood lipid levels in the observation group were significantly better than those in the control group(P<0.05). The time to disappearance of dizziness, nausea, vomiting, tinnitus and deafness, malaise, fatigue, and confused mind in observation group was less than that in the control group (P<0.05), no serious adverse events occurred in both groups. Conclusion:Tongnao pills for the treatment of senile posterior circulation ischemic vertigo (phlegm and blood stasis type) can significantly alleviate the symptoms of vertigo, improve hemorrheology, increase the blood flow velocity of the vertebrobasilar artery, improve the abnormal blood supply to the brain, and improve the quality of life for patients, with fewer adverse reactions, high safety, and good therapeutic effect. Therefore, it is worth to be applied in clinical use.