强力天麻杜仲丸联合基础免疫治疗显微镜下多血管炎继发周围神经病变临床研究  

Clinical Study of Qiangli Tianma Duzhong Pills Combined with Basic Immunotherapy in the Treatment of Peripheral Neuropathy Secondary to Microscopic Polyangiitis

作　　者：杨涓[1] 刘超 秦文熠[1] 贾萍[1] 吴大章 钱春艳[1] YANG Juan;LIU Chao;QIN Wenyi;JIA Ping;WU Dazhang;QIAN Chunyan(Department of Integrated Traditional Chinese Medicine and Western Medicine,The First Affiliated Hospital of Chongqing Medical University,Chongqing,China 400016;Chongqing Tongjunge Pharmaceutical Factory Co.,Ltd.of Taiji Group,Chongqing,China 401366)

机构地区：[1]重庆医科大学附属第一医院中西医结合科,重庆400016 [2]太极集团重庆桐君阁药厂有限公司,重庆401366

出　　处：《中国药业》2023年第10期102-105,共4页China Pharmaceuticals

基　　金：重庆市卫生计生委中医药科技项目[zy201602117];重庆市2018年全国中药特色技术传承人才培训项目[渝中医[2018]36号]。

摘　　要：目的探讨强力天麻杜仲丸联合基础免疫治疗显微镜下多血管炎(MPA)继发周围神经病变的临床疗效。方法选取医院2018年3月至2021年12月收治的MPA患者60例,按随机数字表法分为观察组和对照组,各30例。两组患者均予基础免疫(包括激素联合环磷酰胺、吗替麦考酚酯及他克莫司等免疫抑制剂)治疗,治疗1个月后,观察组患者加服强力天麻杜仲丸,每次12丸,每日3次。同时,根据两组患者病情逐渐减少激素使用量,免疫抑制剂续用。两组疗程均为12周。结果与对照组比较,观察组患者治疗后的红细胞沉降率、C反应蛋白、白细胞介素6水平及髓过氧化物酶(MPO)抗体滴度均明显下降(P<0.05),各周围神经传导速率及各中医症状评分均明显改善(P<0.05或P<0.01),简明健康状态量表(SF-36量表)的躯体疼痛、整体健康、精神健康维度评分均明显升高(P<0.05)。两组不良反应发生率均为20.00%。结论强力天麻杜仲丸联合基础免疫治疗MPA继发周围神经病变,可有效改善患者的周围神经传导及MPO抗体滴度,减轻炎性反应及中医症状,并提高其生活质量。Objective To investigate the clinical efficacy of Qiangli Tianma Duzhong Pills combined with basic immunotherapy in the treatment of peripheral neuropathy secondary to microscopic polyangiitis(MPA).Methods A total of 60 patients with MPA admitted to the hospital from March 2018 to December 2021 were selected and divided into the observation group and the control group by the random number table method,with 30 patients in each group.Patients in the two groups were given the basic immunotherapy(hormones combined with immunosuppressants such as cyclophosphamide,mycophenolate mofetil and tacrolimus),on this basis,the patients in the observation group were given Qiangli Tianma Duzhong Pills after one month of immunotherapy,12 pills each time,three times a day.Meanwhile,the dosage of hormone gradually decreased according to the condition of patients in the two groups,while immunosuppressants were used continuously.The treatment course in the two groups was 12 weeks.Results Compared with those in the control group,the erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),interleukin-6(IL-6)levels and myeloperoxidase(MPO)antibody titer in the observation group decreased significantly after treatment(P<0.05).Compared with those in the control group,the peripheral nerve conduction velocities and traditional Chinese medicine(TCM)symptom scores in the observation group improved significantly after treatment(P<0.05 or P<0.01).Compared with those in the control group,the body pain,overall health and mental health scores in the 36-Item Short Form(SF-36)in the observation group increased significantly after treatment(P<0.05).The incidence of adverse reactions in the two groups was 20.00%.Conclusion Qiangli Tianma Duzhong Pills combined with basic immunotherapy in the treatment of peripheral neuropathy secondary to MPA can effectively improve the peripheral nerve conduction and MPO antibody titer of patients,alleviate the inflammatory reaction and TCM symptoms,and improve their quality of life.

关 键 词：强力天麻杜仲丸 基础免疫 周围神经病变 显微镜下多血管炎 临床疗效 中医症状 

分 类 号：R969.4[医药卫生—药理学] R576[医药卫生—药学]