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中医治疗肾上腺脑白质营养不良所致步态障碍:1例报告并文献复习

Traditional Chinese medicine for gait disturbance in adrenoleukodystrophy: A case report and review of literature.

作者信息

Kim Hyungsuk, Kim Taeoh, Cho Whisung, Chang Hokyung, Chung Won-Seok

机构信息

Department of Korean Medicine Rehabilitation, Kyung Hee University, Seoul 02447, South Korea.

出版信息

World J Clin Cases. 2021 Nov 6;9(31):9691-9698. doi: 10.12998/wjcc.v9.i31.9691.

Abstract

BACKGROUND

Adrenoleukodystrophy (ALD) is caused by a deficit in the gene, which leads to demyelination of neurons and dysfunction of the adrenal cortices and testicles. Of the three known phenotypes, 30%-50% of male ALD patients present with the adrenomyeloneuropathy phenotype, characterized by gait disturbance as the initial symptom.

CASE SUMMARY

A 46-year-old man with a prior diagnosis of ALD was admitted to a Korean medicine hospital for the treatment of gait disturbance. His ability to walk was severely impaired at admission, significantly affecting the patient's quality of life. He was treated with acupuncture, pharmacopuncture, electroacupuncture, and herbal medicine for 23 d. The 25-Foot Walk test (25FW), timed up and go (TUG), comfortable gait speed (CGS), numeric rating scale (NRS), Berg Balance Scale (BBS), Tinetti test, manual muscle test (MMT), and 3-level version of EuroQol-5 dimension (EQ-5D-3L) were used to evaluate the patient. The outcomes of the 25FW, TUG, and CGS improved during hospitalization. From the time of admission to discharge we observed: A decrease in NRS scores in the lower extremities and the lower back; an increase of 3 points in the BBS; a 1-point increase in the balancing part of the Tinetti Test; MMT and EQ-5D-3L performances remained unchanged.

CONCLUSION

Traditional Chinese medicine treatments could be a therapeutic option to alleviate issues related to gait disturbance in ALD.

摘要

背景

肾上腺脑白质营养不良(ALD)由该基因缺陷引起,导致神经元脱髓鞘以及肾上腺皮质和睾丸功能障碍。在三种已知的表型中,30%-50%的男性ALD患者表现为肾上腺脊髓神经病表型,其特征是以步态障碍为初始症状。

病例摘要

一名先前被诊断为ALD的46岁男性因步态障碍入住一家韩医院接受治疗。入院时他的行走能力严重受损,严重影响患者的生活质量。他接受了针灸、药针、电针和草药治疗23天。使用25英尺步行测试(25FW)、计时起立行走测试(TUG)、舒适步态速度(CGS)、数字评定量表(NRS)、伯格平衡量表(BBS)、Tinetti测试、徒手肌力测试(MMT)和欧洲五维健康量表3级版本(EQ-5D-3L)对患者进行评估。住院期间,25FW、TUG和CGS的结果有所改善。从入院到出院,我们观察到:下肢和下背部的NRS评分下降;BBS增加3分;Tinetti测试平衡部分增加1分;MMT和EQ-5D-3L表现保持不变。

结论

中医治疗可能是缓解ALD患者步态障碍相关问题的一种治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b09/8610874/7a68a128a453/WJCC-9-9691-g001.jpg

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