| Objective: To observe and compare the clinical efficacy and safety of the Chinese medicine Gan Dou Tang(GDT)in the treatment of dysphagia of damp heat internal Depatolenticular degeneration(HLD).The study of the characteristics of CMRI in patients with Depatolenticular degeneration and its correlation with the clinical features.Methods: ? All the patients were divided into the control group and the observation group randomly,every group included 40 cases,the former group had treatment programmes of DMPS and the swallowing training,and the latter group had treatment programmes of DMPS,the swallowing training,and the traditional Chinese medicine prescription GDT,all the treatment programmes would carry out 4 courses.? The traditional Chinese medicine(TCM)syndrome score,the swallowing assessment scale score,the Barthel index score,the standardized swallowing assessment(SSA),and 24 h urinary copper would be evaluated at the beginning of the treatment,the end of the 2 courses and 4 courses.? At the beginning of the treatment,all the patients should made a cranial magnetic resonance imaging(CMRI)examination,which would have to compare the clinical characteristics of CMRI and the relevance between the clinical characteristics and symptoms.Results: ? The clinical efficiency:1)The total efficiency: Compared the contol group with the observation group,the effective rate is 47.5% to 65.0%.the statistical analysis showed that?2=6.480,P<0.05.2)the TCM syndrome score: compared with the beginning of treatment,the patients in the control group had no statistical significance(p>0.05),but the observation group patients had significantly changes(p<0.01).3)The comparision of the swallowing assessment scale score: there are sigificantly changes in the comparison of two groups at the end of 2 courses and 4 courses treatment(p<0.01);compared to the control group,the observation group had increases after the treatment of 2 course(P<0.05),and there were significantly increases in the observation group at the end of 4 courses(p<0.01).4)Comparison of TCM syndrome score: there had significantly decreases of the TCM syndrome score in the observation group after the 2 courses and 4 course of the treatment(p<0.01);The comparison between the two groups,there had decreases in the observation group at the end of the 2 courses(p<0.05),and the decreases had great changes at the end of the 4 courses(P<0.01).5)the Barthel index score comparison: there had no significance between the contol group and the observation group on the Barthel index score(P>0.05).6)Comparison of SSA: there had significantly decreases of the TCM syndrome score in the observation group after the 2 courses and 4 course of the treatment(p<0.05);but there had no significance between the contol group and the observation group in the comparison of the two groups(P>0.05).7)24h urine comparison: there was significantly increases in the observation group at the end of the 2 courses and 4 courses of treatment.? The analysis of CMRI in the patients : 93.8%(75cases)in all the patients,CMRI have abnormal signals.The most of the abnormal signals were situated at the basal ganglia,the brainstem,the frontal lobe,the thalamus and under the cerebral cortex.the putamen(82.5%),the brainstem(50.0%),the thalamus(46.3%),and the frontal lobe(27.5%)have the most number of the abnormal signals.Conclusion: ? The combination between GDT and swallowing training could have a better effect on HLD with dysphagia,there could have a significant effect on the TCM syndrome score and the swallowing assessment scale score.? There are multiple abnormal signals in the brain of HLD with dysphagia,mainly involving the basal ganglia,the brainstem,the frontal lobe,the thalamus and under the cerebral cortex.? GDT combined with swallowing training is better than the swallowing training alone in the treatment of the symptoms of damp heat syndrome in HLD,and GDT can improve the reflex of swallowing of HLD with high safety. |
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