| Objective:Treatment of dysarthria in patients with WD by combining speech training with Gandou decoction(GDD),to objectively evaluate its clinical efficacy and safety,to identify more effective and feasible treatment options for patients with damp-heat-involving dysarthria in WD,to provide more theoretical support for the more widespread application of GDD combined speech training in clinical practice and to enrich the theoretical guidance for clinical use of Traditional Chinese Medicine(TCM).Methods:According to the diagnostic criteria and inclusion criteria,60 patients with WD dysarthria of damp-heat type were finally enrolled,randomly divided into control group and treatment group with 30 patients in each group,the treatment group was treated with Gandou decoction+speech training+DMPS,and the control group was treated with speech training+DMPS.Before and after treatment,the patients’ speech function was assessed with modified Frenchay Dysarthria Scale,Chinese rehabilitation research center Dysarthria Rating Scale and Voice handicap index(VHI),Unified wilson’s disease rating scale part I(UWDRS-I)was used to assessment of the patient’s neurological function,TCM syndrome score,24-hour urine copper to assess overall patient symptom improvement.The scores before and after treatment were compared between the two groups.Result:(1)Total clinical efficacy:90% in the treatment group and 70.00% in the control group,the difference in efficiency between the treatment and control groups was statistically significant(P<0.05)(2)TCM syndrome score:The comparison between the two groups before treatment was comparable(P>0.05).The score of the treatment group after treatment was significantly lower than that before treatment(P<0.01),the scores of the control group after treatment were not significantly different from those before treatment(P>0.05).(3)Modified Frenchay dysarthria scale: Before treatment,the total score and each sub-item score were comparable between the two groups(P>0.05),after treatment the total score and each sub-item score were significantly different between the two groups(P<0.05),there were significant differences between the two groups in the total score(P<0.01),subscores of which respiratory and jaw 2 were improved but not statistically different(P>0.05),suggesting that the degree of improvement in respiratory and jaw function was not significant in both groups;there was a statistical difference(P<0.05)in the 6 scores of reflex,lip,palate,larynx,tongue,and speech,suggesting that the treatment group improved better than the control group in the 6 functional areas of reflex,lip,palate,larynx,tongue,and speech.(4)China rehabilitation research center dysarthria classification rating:Comparison between the two groups of patients before treatment was comparable(P>0.05);the comparison between the two groups of patients within the same group after treatment was statistically significant(P<0.05),the comparison between the two groups was significantly different(P<0.01)(5)VHI scale:VHI scale scores were comparable between the two groups of patients before treatment(P>0.05),comparison scores within the same group were lower than before after treatment in both groups with significant differences(P<0.01),there was a significant difference between the two groups(P<0.01).(6)UWDRS-I scale: Comparison of the UWDRS-I scale between the two groups of patients before treatment was comparable(P>0.05);the comparison within the same group after treatment was lower in both groups than before,with significant differences(P<0.01).,there was significant difference between the two groups(P<0.01).(7)24-hour urine copper: Comparison of 24-hour urine copper between the two groups before treatment was comparable(P>0.05),there was a significant difference between the two groups of patients compared within the same group after treatment(P<0.01),there was significant difference between the two groups(P<0.01).(8)Incidence of adverse reactions: The incidence of adverse reactions in the two groups was not statistically significant(P>0.05).The incidence of adverse reactions was 10.00% in the treatment group and 16.67% in the control group,indicating that GDD has a good safety profile and few adverse reactions.Conclusion:1.GDD combined with speech training can improve the total clinical treatment efficiency of patients with damp-heat internalized WD dysarthria,increases 24-hour urinary copper excretion.2.GDD combined with speech training can improve the symptoms of dysarthria to some extent in patients with damp-heat internalized WD,especially in reflex,lip,palate,larynx,tongue and speech,TCM syndrome score and speech function scale were improved obviously.3.GDD combined with speech training can improve the neurological function of patients with WD,and the improvement of UWDRS-I is obvious. |
PDF Full Text Request