Clinical Features Of Mental Symptoms Of Wilson Disease And Clinical Study Of The Intervention Treatment Of GDT

Objective:The clinical characteristics of mental symptoms of damp heat internal Wilson's disease were analyzed by psycho psychological scale;The study of the characteristics of CMRI in patients with Wilson's disease and its correlation with the clinical features;To observe and compare the clinical efficacy and safety of liver bean soup in the treatment of mental symptoms of damp heat internal Wilson's disease.Methods:?80 hospitalized patients were randomly divided into two groups,40 cases in each group.The control group was given DMPS+ olanzapine,The observation group was given the Chinese medicine GDT on the basis of the control group,4 courses of continuous treatment.?Before treatment,at the end of the 2 course of treatment,and at the end of 4 courses,the two groups were compared with the simple mental scale(BPRS),UWDRS III(mental symptom score),Montreal cognitive assessment scale(MoCA),TCM syndrome score,24 h urinary copper and side effects.?80 patients were examined by cranial magnetic resonance imaging(CMRI)before treatment.The characteristics of CMRI(T1WI,T2 WI,FLAIR)in patients with Wilson disease and their correlation with clinical symptoms were discussed.Results:?The clinical manifestations of Wilson's disease are complex,and are classified as affective disorder(88.8%),cognitive impairment(87.5%),behavioral abnormality(47.5%),and mental disorder(20%).?Clinical efficacy:1)Clinical total efficiency:The effective rate of the observation group was 85%,the effective rate of the control group was 62.5%.After the Ridit test,the analysis was made,c2=5.320,P<0.05.2)After treatment,the TCM syndrome score of the observationgroup was significantly lower than that before the treatment(p<0.01),and the change of the control group was not significant(p>0.05).3)BPRS score comparison: at the end of the 2 course of treatment and the end of the 4 course of treatment,the total score of BPRS in the two groups was significantly lower than before treatment(p<0.01),the decrease in the observation group at the end of 2 courses was better than that in the control group(P<0.05),and the reduction in the observation group at the end of 4courses was more significant(P<0.01).The BPRS scores of the two groups before and after treatment were compared.After treatment,the five factor scores in the observation group were significantly decreased(P<0.01),while in the control group,except for the lack of vitality factors,the other four factors scores were all decreased,the difference was statistically significant.Compared with the control group,the score in the observation group was significantly better than that of the control group(P<0.01).There was a correlation between the 22 factors of BPRS,and the R values were all > 0.2.The high incidence of symptoms in BPRS was affective disorder,tension,and excitement.The higher severity scores were excitability,affective disorder,and tension.4)Comparison of UWDRS III score:At the end of the 2 course of treatment and at the end of the 4 course of treatment,the score of UWDRS III in the observation group was significantly lower than that before the treatment(p<0.01);In group comparison,the decrease of the observation group at the end of the 2 course was better than that of the control group(p<0.05),and the decrease of the observation group at the end of the 4course was more significant(P<0.01).5)MoCA score comparison:Before and after treatment,the MoCA score of the two groups at the end of the 2 course of treatment increased(P<0.05),and the score of MoCA in the two groups at the end of the 4 course of treatment increased significantly(P<0.01);In group comparison,the increase of MoCA score in the observation group at the end of the 4 course was better than that of the control group(P<0.05).The most common symptoms of cognitive impairment were delayed memory(81.3%),spatial execution(58.8%),and attention deficit(50%).The observation group was better than the control group in the improvement of spaceexecution and delayed memory(P<0.05).6)24h urine comparison:At the end of the 2course of treatment and at the end of the 4 course of treatment,the increase of 24 h urine copper in the observation group was better than that of the control group,the difference was statistically significant.?The CMRI analysis:80 cases of CMRI had abnormal signals.Abnormal signals could involve multiple parts of the brain,mainly involving the lenticular nucleus,caudate nucleus,thalamus,frontal cortex,mesencephalon and cerebellum.The number of abnormal signals was more than that of the putamen(87.5%),the brainstem(62.5%),the frontal lobe(61%),and the thalamus(56%).59 cases of cerebral atrophy were mainly cerebral cortex atrophy(83.1%).Through correspondence analysis found that the clinical symptoms and the putamen,thalamus,brain atrophy,frontal lobe is significantly correlated(P<0.05);the excitement,irritability and loss of memory related brain atrophy,putamen,thalamus,frontal lobe lesions,decreased attention,spatial ability decline and brain atrophy,midbrain,putamen,frontal lobe lesions related to.?Comparison of side effects:The incidence of side effects in the observation group was10%,and the incidence of side effects in the control group was 20%,Differences are statistically significant(P<0.05).Conclusion:?The mental symptoms of Wilson disease rarely appear single,and the symptoms are overlapping.?The most common mental symptoms of damp heat internal Wilson disease are emotional disorders,followed by cognitive impairment and abnormal behavior,and the most rare are thinking disorders.?There are extensive lesions in the brain of patients with Wilson's mental symptoms.The lesions are concentrated in putamen,mesencephalon,thalamus and frontal cortex.Brain atrophy is also a common feature of their disease.? Gan Dou decoction can improve mental symptoms of Wilson disease with high safety.