益气除湿方治疗重症肌无力的临床研究  

Clinical Efficacy of Yiqi Chushi Recipe in Treating Myasthenia Gravis

作　　者：双晓萍[1] 谭子虎[2] 

机构地区：[1]湖北中医药大学,武汉430065 [2]湖北省中医院,武汉430061

出　　处：《中西医结合研究》2014年第2期61-64,共4页Research of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察益气除湿方治疗重症肌无力(myasthenia gravis,MG)气虚湿盛型的临床疗效及其对患者协同刺激分子PD-1/PD-L1表达的影响。方法选择2012年10月—2013年11月湖北中医药大学附属医院门诊及病房MGⅠ、Ⅱ型患者38例,随机分为治疗组(20例)和对照组(18例)。治疗组给予益气除湿方联合基础西药(强的松或嗅吡斯的明)治疗;对照组仅给予强的松或嗅吡斯的明治疗,两组疗程均为10周,采用重症肌无力定量评分(QMG)进行疗效评价,采用流式细胞技术分析治疗前后患者外周血CD4+T淋巴细胞上PD-1和CD4+单核细胞上PD-L1的表达,同时作安全性评价。结果治疗组显效率为70.0%,对照组显效率为45.0%,治疗组显效率高于对照组(P<0.05);治疗组总有效率为90.0%,对照组总有效率为89.0%,两组比较差异无统计学意义(P>0.05)。与治疗前比较,治疗组治疗后协同刺激分子PD-1/PD-L1的表达显著降低(P<0.05),对照组治疗后各指标无明显变化(P>0.05);与对照组治疗后比较,治疗组治疗后协同刺激分子PD-1/PD-L1的表达显著降低(P<0.05)。在治疗过程中,治疗组和对照组各有1例患者出现轻度腹泻、恶心、呕吐。结论益气除湿方可以明显改善重症肌无力患者临床症状,降低协同刺激分子PD-1/PD-L1的表达,且无明显不良反应。Objective To observe the efficacy of Yiqi Chushi Recipe （YCR） in treating myasthenia gravis （MG） patients and its effects on expression of PD-1/PD-L1.Methods 38 patients type with Ⅰ and Ⅱ MG from clinics and wards of the Affiliated Hospitai of Hubei University of Traditionai Chinese Medicine from October 2012 to November 2013 were randomly divided into the treatment group （20 cases） and the control group （18 cases） .Pa-tients in the treatment group were treated by YCR with basic western medicine （prednisone or olfactory pyridostig-mine） ,while those in the control group were only treated by basic western medicine.The duration of treatment was ten weeks.The efficacy was evaluated by the quantitative score of myasthenia gravis （QMG） and the levels of PD-1/PD-L1 expression on monocytes were measured by flow cytometry before and after treatment in both groups.Meanwhile ,the safety evaluation was performed.Results The significant effective rate of treatment group was 70.0% whereas 45.0% in the control group ,and there was significant difference （P〈0.05）.The total effec-tive rate of treatment group was 90.0% whereas 89.0% in the control group ,and there was no significant differ-ence （P＆gt;0.05）.Compared with the same group before treatment ,the levels of PD-1/PD-L1 expression decreased significantly in the treatment group （P〈0.05）.There was no obvious change in each index of the control group af-ter treatment （P＆gt;0.05）.Compared with the control group after treatment ,the peripheral blood levels of PD-1/PD-L1 expression decreased in the treatment group ,showing statistical difference （P〈0.05）.During the course of＆amp;nbsp;treatment ,there were one patient in the control group and one patient in the treatment group with mild diarrhea , nausea ,and vomit occurred.Conclusion YCR could significantly improve clinical symptoms of patients with MG , decrease the levels of PD-1/PD-L1 expression ,with no obvious adverse reaction.

关 键 词：重症肌无力 益气除湿方 临床疗效 PD-1 PD-L1 

分 类 号：R746.1[医药卫生—神经病学与精神病学]