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ObjectiveTo investigate the clinical efficacy of Gandouling tablet （GDL） on abnormal lipid metabolism in Wilson's disease （WD） and the correlation between the prediction model of hepatic steatosis and the related indexes of lipid metabolism in WD. MethodA total of 86 patients with abnormal lipid metabolism in WD were selected. The 24-hour urine copper， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， serum triglyceride （TG）， total cholesterol （TC）， apolipoprotein B （ApoB）， low density lipoprotein cholesterol （LDL-C）， bile acid （BA）， γ-glutamyl transferase （GGT）， prediction model of hepatic steatosis ［hepatic steatosis index （HSI） and Zhejiang University index （ZJU index）］， ultrasonic attenuation coefficient imaging （ATT）， and traditional Chinese medicine （TCM） syndrome score were statistically analyzed before treatment. Pearson correlation test was used to analyze the correlation between TG， TC， LDL-C， ApoB， ALT， AST， ALT/AST， BA， GGT， TCM syndrome score， ATT， and HIS and ZJU. The patients were divided into an observation group and a control group by random number table method， with 43 cases in each group. The observation group was treated with GDL combined with sodium dimercaptopropane sulfonate （DMPS）， while the control group was only treated with DMPS as a control. After six courses of treatment， 24-hour urine copper， TC， TG， LDL-C， ApoB， HSI， ZJU， ATT， TCM syndrome score， and clinical efficiency before and after treatment were observed and compared between the two groups. The correlation between HSI and ZJU and serum TC， TG， LDL-C， ApoB， ALT， AST， ALT/AST， BA， GGT， TCM syndrome scores， and ATT was analyzed. ResultPearson correlation analysis showed that serum TC （r = 0.811）， TG （r = 0.826）， LDL-C （r = 0.802）， ApoB （r = 0.820）， ALT （r = 0.497）， ALT/AST （r = 0.826）， TCM syndrome score （r = 0.716）， and ATT （r = 0.736） were positively correlated with HSI （P<0.01）， while AST， BA， and GGT had no significant correlation with HSI. TC （r = 0.718）， TG （r = 0.765）， LDL-C （r = 0.667）， ApoB （r = 0.699）， ALT/AST （r = 0.403）， TCM syndrome score （r = 0.666）， and ATT （r = 0.684） were positively correlated with ZJU （P<0.01）. ALT， AST， BA， and GGT had no significant correlation with ZJU. The total effective rate of the observation group was 86.05 （37/43）， and that of the control group was 72.09% （31/43）. The total effective rate of the observation group was higher than that of the control group （Z = -2.301， P<0.05）. After treatment， the 24-hour urine copper of the two groups increased significantly. The levels of TC， TG， LDL-C， and ApoB were significantly decreased， and the HSI， ZJU， and ATT were significantly decreased （P<0.01）. Compared with those in the control group after treatment， the above indexes improved better in the observation group （P<0.05， P<0.01）. ConclusionGDL can effectively improve the level of copper and lipid metabolism in patients with WD， with high clinical safety and good clinical application value. The prediction model of hepatic steatosis can effectively reflect the degree of abnormal lipid metabolism in WD.
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ObjectiveTo investigate the clinical effect of perioperative Gandouling intervention in patients with Wilson’s disease (WD) complicated by splenomegaly and hypersplenism and the changes in related indices. MethodsA total of 60 WD patients with splenomegaly and hypersplenism who were hospitalized in Encephalopathy Center, The First Affiliated Hospital of Anhui University of Chinese Medicine, from July 2016 to July 2018 were enrolled and randomly divided into control group and treatment group, with 30 patients in each group. The patients in the control group were given conventional Western medicine treatment including decoppering for 4 courses (each course of treatment was 8 days), followed by splenectomy and conventional decoppering at the end of week 1 after surgery for 2 courses; the patients in the treatment group were given Gandouling in addition to the treatment in the control group. Clinical outcome and changes in 24-hour urinary copper, peripheral hemogram, liver function parameters, and portal venous flow indices were observed. The two independent samples t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. ResultsThe treatment group had a significantly higher overall response rate than the control group ［90% (27/30) vs 60% (18/30), χ2=443, P=0.03］. Compared with the control group at the end of two courses of treatment after surgery, the treatment group had significantly lower 24-hour urinary copper (t=41.07, P＜0.05) and levels of alanine aminotransferase and aspartate aminotransferase (t=7.29 and 6.13, both P＜0.01) and significantly higher levels of red blood cell count, platelet count, and hemoglobin (t=-5.49, -3.43, and -3.53, all P＜0.01). At the end of two courses of treatment after surgery, both groups had a reduction in portal venous flow, and the treatment group had a significantly greater improvement in portal venous flow than the control group (t=12.05, P＜0.01). ConclusionGandouling can improve the clinical outcome of WD patients with splenomegaly and hypersplenism after splenectomy.
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ObjectiveTo investigate the clinical effect of perioperative Gandouling intervention in patients with Wilson’s disease (WD) complicated by splenomegaly and hypersplenism and the changes in related indices. MethodsA total of 60 WD patients with splenomegaly and hypersplenism who were hospitalized in Encephalopathy Center, The First Affiliated Hospital of Anhui University of Chinese Medicine, from July 2016 to July 2018 were enrolled and randomly divided into control group and treatment group, with 30 patients in each group. The patients in the control group were given conventional Western medicine treatment including decoppering for 4 courses (each course of treatment was 8 days), followed by splenectomy and conventional decoppering at the end of week 1 after surgery for 2 courses; the patients in the treatment group were given Gandouling in addition to the treatment in the control group. Clinical outcome and changes in 24-hour urinary copper, peripheral hemogram, liver function parameters, and portal venous flow indices were observed. The two independent samples t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. ResultsThe treatment group had a significantly higher overall response rate than the control group ［90% (27/30) vs 60% (18/30), χ2=443, P=0.03］. Compared with the control group at the end of two courses of treatment after surgery, the treatment group had significantly lower 24-hour urinary copper (t=41.07, P＜0.05) and levels of alanine aminotransferase and aspartate aminotransferase (t=7.29 and 6.13, both P＜0.01) and significantly higher levels of red blood cell count, platelet count, and hemoglobin (t=-5.49, -3.43, and -3.53, all P＜0.01). At the end of two courses of treatment after surgery, both groups had a reduction in portal venous flow, and the treatment group had a significantly greater improvement in portal venous flow than the control group (t=12.05, P＜0.01). ConclusionGandouling can improve the clinical outcome of WD patients with splenomegaly and hypersplenism after splenectomy.