复方黄杞汤治疗Ⅰ、Ⅱ型老年重症肌无力回顾性分析  

Retrospective Analysis of Compound Huangqi Decoction(复方黄杞汤)in the Treatment of Senile Myasthenia Gravis TypeⅠandⅡ

作　　者：黄延鹏 乔文军[2] HUANG Yanpeng;QIAO Wenjun(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《辽宁中医药大学学报》2024年第2期159-162,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：辽宁省科学技术厅重点研发项目(2020JH2/10300089);辽宁省科学技术厅重点实验室组建项目(2020JH13/10200022)。

摘　　要：目的观察复方黄杞汤治疗Ⅰ、Ⅱ型老年重症肌无力的疗效及对西药减停的影响。方法回顾性选取2021年1月—2022年1月就诊于辽宁中医药大学附属医院重症肌无力门诊的Ⅰ、Ⅱ型老年重症肌无力患者(年龄≥60岁)30例,其中男13例,女17例,Ⅰ型16例,Ⅱ型14例,25例患者初诊时服用西药治疗(Ⅰ型11例,Ⅱ型14例),19例患者单独服用溴吡斯的明片治疗(Ⅰ型10例,Ⅱ型9例),6例患者服用溴吡斯的明片联合醋酸泼尼松片治疗(Ⅰ型1例,Ⅱ型5例)。对其门诊病历及随访得出的信息进行回顾,收集其接受中药治疗前及治疗3个月、6个月、12个月时的重症肌无力绝对评分和相对计分以及服用西药量的变化情况,利用IBM SPSS Statistics 26.0软件进行统计分析。结果30例老年患者服药3个月、6个月、12个月后,重症肌无力临床绝对评分较上一时间节点均显著下降(P<0.05)。服药12个月后,Ⅰ型患者有效率为93.75%,Ⅱ型患者有效率为100%,总体有效率可达96.67%,且87.5%的Ⅰ型老年患者可达到临床基本痊愈,42.86%的Ⅱ型老年患者可达到临床基本痊愈,共66.67%的老年患者可达到临床基本痊愈。治疗后上述各时间节点溴吡斯的明片及醋酸泼尼松片用量较上一时间节点均显著下降,差异具有统计学意义(P<0.05)。服药12个月后,共有60%的患者停服溴吡斯的明片(Ⅰ型8例,Ⅱ型7例),50%的患者停服醋酸泼尼松片(Ⅰ型1例,Ⅱ型2例)。结论复方黄杞汤对Ⅰ、Ⅱ型老年重症肌无力的疗效明确,可明显改善Ⅰ、Ⅱ型老年重症肌无力患者临床症状,并能减少Ⅰ、Ⅱ型老年患者西药用量。Objective To observe the efficacy of Compound Huangqi Decoction(复方黄杞汤)in the treatment of typeⅠandⅡsenile myasthenia gravis and its influence on Western drug withdrawal.Methods Thirty patients with typeⅠandⅡsenile myasthenia gravis(aged≥60 years)admitted to the myasthenia gravis clinic of the affiliated hospital of Liaoning university of traditional Chinese medicine from January 2021 to January 2022 were retrospectively selected,including 13 males,17 females,16 typeⅠpatients,14 typeⅡpatients,and 25 patients receiving Western medicine at initial diagnosis(11 typeⅠpatients,14 typeⅡpatients),19 patients were treated with brompiramine tablets alone(10 patients in typeⅠand 9 patients in typeⅡ),and 6 patients were treated with brompiramine tablets combined with prednisone acetate tablets(1 patient in typeⅠand 5 patients in typeⅡ).The outpatient medical records and follow-up information were reviewed.The absolute score and relative score of myasthenia gravis at 0,3,6 and 12 months after receiving TCM treatment as well as the changes in the dosage of Western medicine were collected and analyzed statistically by IBM SPSS Statistics 26.0 software.Results The absolute clinical score of myasthenia gravis was significantly decreased in 30 elderly patients after 3 months,6 months and 12 months(P<0.05).After 12 months of medication,the effective rate of typeⅠpatients was 93.75%,and that of typeⅡpatients was 100%,and the overall effective rate could reach 96.67%,and 87.5%of typeⅠelderly patients could reach clinical basic recovery,42.86%of typeⅡelderly patients could reach clinical basic recovery,and a total of 66.67%elderly patients could reach clinical basic recovery.After treatment,the dosages of brominopiramine tablets and prednisone acetate tablets at all time points were significantly decreased compared with the previous time points,with statistical significance(P<0.05).After 12 months of medication,60%of patients stopped taking brompyristine tablets(8 patients in typeⅠand 7 pa

关 键 词：复方黄杞汤 老年重症肌无力 疗效评价 减停西药 

分 类 号：R25[医药卫生—中医内科学] R746.1[医药卫生—中医学]