健肌宁干预重症肌无力患者血清乙酰胆碱受体抗体的水平  

Clinical Study on Myasthenia Gravis Treated with Jianji'ning Granules Via Regulating Level of Serum Acetylcholine Receptor Antibody

作　　者：姜超[1,2] 刘萍[2] 梁燕[2] 邱少波[2] 鲍文晶[3] 张静生[3] 

机构地区：[1]陕西省中医医院脑病科,西安710003 [2]上海中医药大学附属龙华医院,上海200030 [3]辽宁中医药大学附属医院,沈阳110032

出　　处：《中国实验方剂学杂志》2014年第14期192-196,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：上海市科委基础研究重点项目(10JC1414500);上海市卫生局中医药科研基金计划项目(2010J002B)

摘　　要：目的:本研究旨在探讨健肌宁颗粒(JNG)联合西药对重症肌无力(MG)患者血清乙酰胆碱受体抗体(AchRAb)水平的影响,以为靶向的调整MG患者乙酰胆碱受体提供一定的理论依据。方法:采用酶联免疫吸附试验(ELISA)的方法检测了治疗前后6个月,60例MG患者的血清乙酰胆碱受体抗体水平(30例对照组),临床疗效评定采用重症肌无力定量积分表(QMG)进行治疗前后3,6个月的前后评定。结果:所有纳入的重症肌无力患者血清乙酰胆碱受体抗体阳性率约为81.67%(49/60),试验组为83.33%(25/30),对照组为90%(27/30),而试验组的血清中乙酰胆碱受体抗体水平(0.994±0.417)mmol·L-1明显低于对照组(1.068±0.358)mmol·L-1,但两组间治疗前没有显著差异,具有可比性。治疗6个月后,试验组血清中乙酰胆碱受体抗体水平(0.721±0.280)mmol·L-1显著低于对照组(0.907±0.387)mmol·L-1,并且与同组治疗前相比,血清中乙酰胆碱受体抗体水平亦急剧下降,两个组之间的差异显著(P<0.05)。治疗后QMG评分显著下降,实验组与对照组相比,差异显著(P<0.05),而且治疗后3,6个月,实验组总有效率为(50%,86.67%)明显高于对照组(23.33%,40%)。两组间治疗前后有显著差异(P<0.05),有明显统计学意义。两组间无明显不良反应发生。结论:健肌宁颗粒联合西药对重症肌无力患者血清乙酰胆碱受体抗体水平的干预显示了确切的疗效,值得进一步研究。Objective： To investigate the regulation action of Jianji＇ning granule （JNG） combined with western medicine on the level of serum acetylcholine receptor antibodies （AchRAb） in myasthenia gravis （MG） patients, so as to offer a theoretical basis of the targeting therapy with AchRAb. Method ： Sixty MG patients were randomly divided into trial group （30） and the control group （30）, then the level of serum anti-AchRAb were detected by the enzyme linked immunosorbent assay （ELISA） before and after treatment 6 months, and the clinical efficacy was compared according to the quantitative score of myasthenia gravis （QMG） was measured before and after treatment 3, 6 months. Result： The he positive rate of serum AchRAb was about 81.67% （49/ 60）, the trial group was 83.33% （25/30）, and the control group was 90% （27/30）; after 6 months of treatment, the serum AchRAb levels of the trial group （0. 721 ±0. 280） mmol·L^-1 were significantly lower than that in the control group （0. 907 ±0. 387） mmol·L^-1, simultaneously the serum AchRAb levels were decreased dramatically compared with the same group before treatment, there wasa significant difference between the two groups （P 〈0.05）. QMG scoring was decreased dramatically in the trial group after treatment compared with the control group （P 〈 0.05） , there was a significant difference, moreover, the total effective rate in the trial group （50% , 86.67% ） was significantly higher than those in the control groups （23.33% , 40% ） after 3, 6 months of treatment （P 〈 O. 05）. No obvious adverse reactions appeared in the two groups. Conclusion： The therapeutic effects of JNG combined with western medicine on improvement of clinical symptoms may be due in part to regulation of serum acetylcholine receptor antibody levels of patients, and it is worthy of further studying.

关 键 词：重症肌无力 健肌宁颗粒 乙酰胆碱受体 酶联免疫吸附试验 

分 类 号：R287.6[医药卫生—中药学]