| Objectives: 1.To study the correlation between the clinical characteristics of sleep disorder and TCM syndrome in WD patients.2.To observe the intervention of Jiawei Huanglian Wendan Decoction on sleep disturbance in WD patients with damp-heat syndrome.Methods: 120 patients with hepatolenticular degeneration from Encephalopathy Center of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2018 to December 2018 were assessed by Pittsburgh Sleep Quality Index(PSQI),Parkinson's Disease Sleep Scale(PDSS)and Epworth Sleepiness Scale(ESS).The WD of damp-heat syndrome was screened out and randomly divided into TCM medicine group,western medicine group and integrative group according to 1:1:1.There was no difference in gender,age and course of disease among the three groups(P>0.05).On the basis of conventional anti copper therapy,the TCM medicine group was treated with Jiawei Huanglian Wendan Decoction(Compound Granules),one dose a day,two times in the morning and evening.The western medicine group was treated with 1.5 mg of Eszopiclone,half an hour before going to bed at night.The integrative group was treated with 1.5 mg of Eszopiclone on the basis of the Chinese medicine group;the three groups were observed for a course of treatment,4 weeks for a course of treatment.The scores of PSQI,PDSS,ESS,clinical efficacy and adverse reactions of the three groups before and after treatment were observed,and their curative effects were evaluated statistically.Results: 1.In this study,there were 77 males(64.17%)and 43 females(35.83%)in 120 patients with WD sleep disorders,Female is less than male(male: female = 1.79:1).The oldest age was 52 years old and the youngest was 13 years old.The average age was(29.04±8.47)years old.The most common age of onset was from 20 to 30 years old(including 20 years old),accounting for 45.83%.The longest course of disease was 38 years and the shortest was 1 month.The average course of disease was about(8.09 ± 7.00)years.There were 72 cases(60%)over 5 years and 42 cases(35%)over 10 years.Brain type(57 cases,47.50%)and mixed type(42 cases,35.00%)were the most common clinical types,higher than liver type(20 cases,16.67%)and other types(1 case,0.83%).2.The order of TCM syndromes are damp-heat syndrome in 84 cases(70.00%),phlegm-blood stasis syndrome in 27 cases(22.50%),liver-kidney Yin deficiency syndrome in 6 cases(5.00%),spleen-kidney Yang deficiency syndrome in 2 cases(1.67%)and Liver-qi Stagnation Syndrome in 1 case(0.83%).3.Among 120 WD patients with sleep disorders,98 cases(81.67%)had difficulty in falling asleep,86 cases(71.67%)had awakening at night,43 cases(35.83%)had multiple dreams at night,50 cases(41.67%)had early awakening,48 cases(40%)had daytime sleepiness,and 37 cases(30.83%)had restless legs syndrome.Among them,difficulty in falling asleep,waking at night,early awakening and daytime sleepiness were the main manifestations of WD with sleep disorders.4.The total scores of PSQI,PDSS and ESS in the three groups after treatment were significantly different from those before treatment(P=0.000 < 0.01).The total scores of PSQI(P=0.033)and ESS(P=0.026)in TCM medicine group,western med-icine group were significantly different(P<0.05),but there was no difference in total scores of PDSS(P=0.066>0.05).Compared with integrative group,there was no difference in total PSQI score(P=0.782),PDSS score(P=0.900)and ESS score(P=0.821)between TCM medicine group and integrative group(P>0.05).5.In the TCM medicine group,2 cases were cured,6 cases were markedly effective,15 cases were effective,5 cases were ineffective,and the total effective rate was 82.14%.In the western medicine group,3 cases were cured,7 cases were markedly effective,11 cases were effective,7 cases were ineffective,and the total effective rate was 75%.In the integrative group,3 cases were cured,11 cases were markedly effective,12 cases were effective and 2 cases were ineffective,the total effective rate was 92.8%.There was no difference in the total effective rate among the three groups(P > 0.05).6.The 24-hour urinary copper content in 3 groups increased significantly after treatment compared with that before treatment(P=0.000 < 0.01).There was significant difference between TCM medicine group and western medicine group(P= 0.047 < 0.05),but no difference between TCM medicine group and integrative group(P= 0.639 > 0.05).Conclusion: 1.Sleep disorder is one of the common non-motor symptoms of WD.The most common sleep disorder in WD is insomnia,which is mainly manifested by difficulty in falling asleep,awakening at night,early awakening and daytime sleepiness.2.The most common TCM syndromes of WD with sleep disorders are damp-heat syndrome,followed by phlegm-blood stasis syndrome.3.The high-risk group of WD with sleep disorders is young people.The incidence of sleep disorders with longer duration is higher than that with shorter duration.The incidence of sleep disorders in males is higher than that in females.The incidence of brain-type and mixed-type sleep disorders is higher than that of liver-type sleep disorders.4.Jiawei Huanglian Wendan Decoction can effectively improve sleep disorder of damp-heat WD and increase 24-hour urinary copper excretion. |
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