Clinical Study On Olfactory Function And Related Factors Of Traditional Chainese Medicine Syndromes In Wilson’s Disease

Objectives:(1)To compare the olfactory function of WD patients and healthy people by olfactory detection method,to analyze the differences between the two groups,and explore the factors that may affect the olfactory function,to improve the clinical recognition of WD olfactory dysfunction;(2)To observe the characteristics of TCM syndrome types and elements with olfactory dysfunction in WD patients,and reveal the effect of different syndromes on the incidence of olfactory dysfunction in WD,and provide the basis for clinical research on dialectical evidence of olfactory dysfunction.Methods:(1)Based on the inclusion and exclusion criteria,72 WD patients were collected as the case group and 60 healthy people as the control group.There was no significant difference in gender and age between the two groups.The olfactory function of all subjects was evaluated by CCCRC olfactory detection method,and the olfactory function of WD patients and healthy people was compared.The depressive self-rating scale(SDS)and the Hamilton Depression Scale(HAMD)were used to evaluate the depressive status of the subjects.The the uniform WD rating scale(UWDRS)and Wilson’s Goldstein ADL grading criteria were used to evaluate the severity of disease;And the patients were divided into liver type,brain type and mixed type according to the clinical classification criteria of WD.Analysis the the relationship between olfactory function and age,gender,duration of disease,depression,clinical classification and so on..(2)According to the results of CCCRC olfactory test,WD patients were divided into group(39 cases)and non-olfactory dysfunction group(31 cases),and conducted.a cross-sectional study.Based on the diagnostic criteria and scores of TCM syndromes,the TCM syndromes of WD,disease location and disease factors were established by using the look,listen,question and feel the pulse,the four ways of diagnosis in WD patients.The statistical methods were used to compare the two groups TCM syndromes distribution characteristics,TCM syndrome elements and distribution frequency distribution characteristics.Meanwhile,analysis the TCM syndrome elements on the risk of sense of olfaction in WD.Results:(1)The incidence of dysfunction in the WD case group was 56.9%(41/72),which was higher than those in the control group(21.7%,13/60),there had significantly difference(P<0.05);and the two groups objectives of olfactory dysfunction were mainly mild olfactory dysfunction.The correct recognition rate of seven kinds of olfactory in WD group was lower than those in control group.The WD group was significantly different from the healthy control group in distinguishing banana,chocolate,peanut butter,coffee and soap,and the difference had statistically significance(P<0.05).(2)The correlation analysis of WD olfactory function showed that there was no correlation between CCCRC scores and age,sex,duration of disease and depression in WD case group.WD olfactory dysfunction was associated with clinical typing,and there was a significant difference between brain type,liver type and mixed group(P<0.01),especially in brain type patients had Heavier olfactory dysfunction.In addition,WD dysfunction related to severity of the disease,the more severe the disease,the more obvious the olfactory dysfunction.(3)The incidence of phlegm-blood stasis mutual junction type was the highest(71.4%),followed by damp-heat intrinsic type,the incidence was 70.6%.The distribution of syndrome was not related to the incidence of olfactory dysfunction.Syndrome score,the olfactory disorder group and non-olfactory dysfunction group in the disease factors(liver,spleen,kidney)and the cause of disease factors(phlegm,blood stasis,blood deficiency,internal wet,Yin)on the TCM syndrome(P>0.05).In the syndromeelements score of brain marrow syndrome,the scores of syndrome in the brain of the olfactory dysfunction group were higher than those in the non-olfactory dysfunction group,and there was significant difference(P<0.05).(4)The frequency distribution of the TCM syndrome elements in the olfactory dysfunction group,descending order were the brain(79.5%),the liver(69.2%),the kidney(43.6%),the spleen(28.2%);etiology of disease factors were the phlegm(71.8%),the blood stasis(66.7%),the Yin deficiency(48.4%),the internal wet(35.5%),the blood deficiency(29.1%),and the two groups were only in the brain.There were statistically significant differences in the frequency of distribution(P<0.05).(5)Study on the risk of the onset of WD olfactory dysfunction of TCM syndromes,whether brain elements in the pathogenesis of risk was statistically significant for WD olfactory disorder(P<0.05).Excepted the brain,TCM syndrome elements(including liver,spleen,kidney,phlegm,blood stasis,blood deficiency,dampness and yin deficiency)on WD incidence of olfactory dysfunction degree was no statistically significance(P>0.05);Therefore,the mentality of brain marrow is the risk factors for WD to increase the incidence rate of olfactory dysfunction.Conclusion:(1)The incidence of olfactory dysfunction in patients with WD was higher than those in normal subjects,including the olfactory threshold and the recognition function decreased;(2)WD olfactory dysfunction is associated with the clinical classification of the disease and the severity of the disease,brain type and/or severe illness patients’ olfactory dysfunction is more obvious,but there are no correlation between olfactory dysfunction and age,gender,duration of disease,depression.(4)The incidence of olfactory dysfunction of WD was irrelevant with the distribution of TCM syndrome types;As far as TCM syndrome elements,The most common signs of patients with olfactory dysfunction is the brain,but patients with non-olfactorydysfunction is the liver;The common pathogenic elements are phlegm and blood deficiency in two groups.(5)In TCM syndrome elements,WD involving the brain may be one of the risk factors in patients with olfactory dysfunction.