应用冲脉理论分型治疗重症肌无力临床研究  

Clinical Research on Chongmai Theory for Typing Treatment of Myasthenia Gravis

作　　者：陈钢[1] 蒋方建 盛昭园[1] 臧海生 李庚和[1] 

机构地区：[1]上海市中西医结合医院

出　　处：《山西中医》2015年第2期12-14,共3页Shanxi Journal of Traditional Chinese Medicine

摘　　要：目的：探讨冲脉在重症肌无力治疗中的作用。方法：将508例重症肌无力病例按发病次数分为初发、复发、多发3组，辨证分型为脾气虚型、血虚络阻型、气阴两虚型、脾肾阳虚型进行治疗，观察各组的疗效和证型分布变化。结果：初发组的总有效率为91．24％（95％CI=87．74％-94．74％），复发组为79．86％（95％CI=73．31％～86．41％），多发组为53．98％（95％CI=44．79％-63．17％）；三组综合疗效比较，初发组〉复发组、多发组（P〈0．05）；复发组〉多发组（P〈0．05），且三组的95％CI不重叠。治前的证型构成为脾肾阳虚〉气阴两虚〉脾气虚〉阴平阳秘；其中脾肾阳虚、气阴两虚与脾气虚、血虚络阻的95％CI不重叠，P〈0．05；脾气虚与血虚络阻的95％CI不重叠，P〈0．05。治后的证型构成为脾肾阳虚〉气阴两虚〉阴平阳秘〉脾气虚〉血虚络阻；其中脾肾阳虚、气阴两虚、阴平阳秘与脾气虚、血虚络阻的95％CI不重叠，P〈0．05。结论：应用冲脉理论，采用分型论治治疗重症肌无力初发组的临床疗效优于复发组、多发组，其收益为OR=0．38（95％CI=0．21～0．69），NNT=9（95％CI=4．94～39．84）；OR=0．11（95％CI=0．06～0．20），NNT=3（95％CI=2．15～3．53）；复发组优于多发组，其收益为OR=0．30（95％CI=0．17～0．51），NNT=4（95％CI=2．67～6．88）。Objective：To discuss the effect of chongmai on myasthenia gravis. Method：508 cases of patients with myasthenia gravis were divided by the number of attack times into 3 groups of early onset, relapse and multiple-attack. The types of spleen-qi deficiency, blood deficiency and meridians stagnation, deficiency of both qi and yin, spleen-and kidney yang deficiency were treated by TCM syndrome types. The effects and distribution changes of syndrome types in each group were observed. Results ：The total effective rate of onset group was 91.2% （95% C I = 87.74% - 94.74% ）, relapse group was 79.86% （ 95 % CI = 73.31% - 86. 41% ）, muhiple-attack group was 53.98% （95% CI =44.79%-63.17% ）. Compared the comprehensive effects of three groups,onset group 〉 relapse group and multiple-attack groups （ P 〈 0. 05 ） ; relapse group 〉 multiple-attack groups （ P 〈 0.05 ）, and 95 % CI of three groups did not overlap. Syndrome types configuration before treatment was spleen-kidney yang deficiency 〉 deficiency of both qi and yin 〉 spleen-qi deficiency 〉 yin and yang relative equilibrium. Among them, 95% CI of pleen-kidney yang deficiency and deficiency of both qi and yin did not overlap 95% CI of spleen-qi de- ficiency and blood deficiency and meridians stagnation, P 〈 0. 05 ; 95 % CI of spleen-qi deficiency did not overlap 95% CI of blood deficiency and meridians stagnation, P 〈 0. 05. Syndrome types configuration after treatment was spleen- kidney yang deficiency 〉 deficiency of both qi and yin 〉 yin and yang relative equilibrium 〉 spleen-qi deficiency 〉 blood deficiency and meridians stagnation. Among them,95% CI of spleen-kidney yang deficiency, deficiency of both qi and yin,yin and yang relative equilibrium did not overlap 95% CI of spleen-qi deficiency, blood deficiency and meridians stagnation,P 〈 0.05. Conclusion：The clinical effect of chongmai theory and typing treatment on onset group of myasthenia gravis was better than on relapse group and muhiple-attack group. The ben-

关 键 词：重症肌无力 冲脉 证型 虚损 

分 类 号：R746.1[医药卫生—神经病学与精神病学]