益肾补髓通络汤辅助甲基泼尼松龙治疗多发性硬化疗效及对炎性因子、HMGB1表达的影响  

Effect of Yishen Busui Tongluo Decoction with methylprednisolone on multiple sclerosis and its effect on the expression of inflammatory factors and HMGB1

作　　者：李建军 李佳 韩明霞 LI Jianjun;LI Jia;HAN Mingxia(Xi’an International Medical Center Hospital,Xi’an 710100,Shaanxi,China;The 986th Hospital of PLA,Xi’an 710054,Shaanxi,China;The First Hospital of Yulin City,Yulin 719000,Shaanxi,China)

机构地区：[1]西安国际医学中心医院,陕西西安710100 [2]解放军第986医院,陕西西安710054 [3]陕西省榆林市第一医院,陕西榆林719000

出　　处：《现代中西医结合杂志》2019年第36期4012-4016,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察益肾补髓通络汤辅助甲基泼尼松龙(甲泼尼龙)治疗多发性硬化患者的临床疗效及对炎性因子、高迁移率族蛋白B1(HMGB1)表达的影响。方法将82例多发性硬化急性发作期患者随机分为2组,对照组给予甲泼尼龙静滴序贯泼尼松口服治疗,观察组在对照组治疗基础上给予益肾补髓通络汤治疗,连续治疗12周,对比2组临床总有效率,观察2组神经功能缺损症状(肢体麻木、感觉异常、肢体无力、束带感、视力减退)、疾病影响评估[多发性硬化影响量表(MSIS-29)评分]、疲劳状况[疲劳影响量表(MFIS)评分]、血生化指标[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、干扰素-γ(IFN-γ)、HMGB1]改善情况,记录2组治疗期间不良反应。结果观察组治疗总有效率为92.7%(38/41),对照组为73.2%(30/41),观察组明显高于对照组(χ^2=5.513,P<0.05);2组治疗后肢体麻木积分、感觉异常积分、肢体无力积分、束带感积分、视力减退积分、MSIS-29评分、MFIS评分及IL-6、IFN-γ、HMGB1水平均较治疗前明显降低(P均<0.05),且观察组均明显低于对照组(P均<0.05);2组治疗后IL-10水平均较治疗前明显升高(P均<0.05),且观察组明显高于对照组(P<0.05);治疗期间,观察组不良反应发生率为9.7%(4/41),对照组为19.5%(8/41),组间比较差异无统计学意义(χ^2=1.562,P>0.05)。结论甲泼尼龙联合益肾补髓通络汤能够有效改善多发性硬化患者神经功能缺损,抑制炎症反应,促进免疫平衡,有利于控制疾病发展。Objective It is to observe the clinical effect of Yishen Busui Tongluo Decoction assisted by methylprednisolone in the treatment of patients with multiple sclerosis and its effect on the expression of inflammatory factors and high mobility group protein B1(HMGB1).Methods Eighty-two patients with multiple episodes of acute sclerosis were randomly divided into two groups.The control group was treated with methylprednisolone by intravenous drip and sequential prednisone by oral administration.The observation group was treated with Yishen Bushui Tongluo Decoction on the basis of treatment in the control group.Both groups were treated for 12 weeks.The total clinical effectiveness of the two groups were compared,and the improvements of the symptoms of neurological deficits(limb numbness,paresthesia,limb weakness,girdle sensation,vision loss),multiple sclerosis impact scale(MSIS-29)scores,fatigue status[fatigue impact scale(MFIS)scores],blood biochemical indicators[interleukin-6(IL-6),interleukin-10(IL-10),interferon-γ(IFN-γ),HMGB1]were observed and the adverse reactions during treatment in the two groups were recorded.Results The total effective rate of treatment in the observation group was 92.7%(38/41)and that in the control group was 73.2%(30/41).The rate in the observation group was significantly higher than that in the control group(χ^2=5.513,P<0.05).The scores of paresthesia,limb weakness,girdle sense,vision loss,MSIS-29 scores,MFIS scores,and levels of IL-6,IFN-γand HMGB1 after treatment were significantly lower than those before treatment in the two groups(P<0.05),and the above indicators in the observation group was significantly lower than those in the control group after treatment(P<0.05);the IL-10 level after treatment in the two groups was significantly higher than that before the treatment(P<0.05),and the level in the observation group was significantly higher than the control group(P<0.05).During the treatment period,the incidence of adverse reactions in the observation group was 9.7%(4/41)and that i

关 键 词：多发性硬化 益肾补髓通络汤 甲基泼尼松龙 炎性因子 高迁移率族蛋白B1 

分 类 号：R744.51[医药卫生—神经病学与精神病学]