补脾强力复方治疗重症肌无力患者的疗效及其对血清细胞因子的影响(1)
摘要：目的 探讨补脾强力复方治疗重症肌无力患者的临床疗效及血清细胞因子的影响。方法 选择2017年9月～2019年5月在我科门诊及住院治疗的重症肌无力Ⅰ型和Ⅱa型患者共60例，采用随机数字表法分为对照组28例和治疗组32例。对照组给予强的松聯合溴吡斯的明治疗，治疗组在对照组基础上加用补脾强力复方治疗，疗程均为12周，采用重症肌无力临床相对评分法和临床绝对评分法评估患者临床疗效，用ELISA法检测两组患者外周血AchR-Ab、IFN-γ、TNF-α、IL-4、IL-17水平，观察补脾强力复方的临床疗效、细胞因子水平变化及不良反应发生情况。结果 治疗组愈显率为75.00%，与对照组的68.00%比较，差异无统计学意义(P>0.05);治疗组总有效率为91.00%，高于对照组的71.00%(P<0.05)。治疗后两组AChR-Ab、IFN-γ、TNF-α、IL-4、IL-17水平均低于治疗前(P<0.05)，治疗组AChR Ab、IFN-γ、IL-17水平降低优于对照组(P<0.05);两组IL-4、TNF-α变化比较，差异无统计学意义(P>0.05)。两组治疗期间均未见腹泻、腹痛、恶心、皮疹等不良反应，差异无统计学意义(P>0.05)。结论 补脾强力复方可在一定程度上提高重症肌无力的近期临床疗效，其机制与下调血清IFN-γ和IL-17 水平、降低血清AChR-Ab水平可能有关。
关键词：补脾强力复方;重症肌无力;细胞因子
中图分类号：R746.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.16.022
文章编号：1006-1959(2019)16-0073-06
Abstract：Objective To investigate the clinical efficacy and serum cytokine effect of spleen-strengthening compound in the treatment of patients with myasthenia gravis. Methods A total of 60 patients with myasthenia gravis type I and IIa who were treated in our outpatient department and hospitalized in our hospital from September 2017 to May 2019 were randomly divided into the control group (n=28) and the treatment group (n=32). The control group was treated with prednisone plus bromide， and the treatment group was treated with spleen-strengthening compound on the basis of the control group. The course of treatment was 12 weeks. The patients were evaluated by the clinical relative score of myasthenia gravis and the clinical absolute score. Clinical efficacy， ELISA method was used to detect the levels of AchR-Ab， IFN-γ， TNF-α， IL-4 and IL-17 in peripheral blood of the two groups. The clinical efficacy， cytokine level and adverse reactions of spleen-strengthening compound were observed.Results The cure rate of the treatment group was 75.00%， compared with 68.00% of the control group， the difference was not statistically significant (P>0.05); the total effective rate of the treatment group was 91.00%， which was higher than that of the control group 71.00%(P<0.05). After treatment， the levels of AChR-Ab， IFN-γ， TNF-α， IL-4 and IL-17 in the two groups were lower than those before treatment (P<0.05). The treatment group AChR Ab， IFN-γ， The level of IL-17 was lower than that of the control group(P<0.05). There was no significant difference in the changes of IL-4 and TNF-α between the two groups (P>0.05). No adverse reactions such as diarrhea， abdominal pain， nausea， and rash were observed during the two treatment periods，the difference was not statistically significant (P>0.05). Conclusion The combination of spleen and strong spleen can improve the short-term clinical efficacy of myasthenia gravis to a certain extent. The mechanism may be related to the down-regulation of serum IFN-γ and IL-17 levels and the decrease of serum AChR-Ab levels., 百拇医药(刘建辉 杨娅 况时祥 杨辉 唐桂华 宋先红)
关键词：补脾强力复方;重症肌无力;细胞因子
中图分类号：R746.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.16.022
文章编号：1006-1959(2019)16-0073-06
Abstract：Objective To investigate the clinical efficacy and serum cytokine effect of spleen-strengthening compound in the treatment of patients with myasthenia gravis. Methods A total of 60 patients with myasthenia gravis type I and IIa who were treated in our outpatient department and hospitalized in our hospital from September 2017 to May 2019 were randomly divided into the control group (n=28) and the treatment group (n=32). The control group was treated with prednisone plus bromide， and the treatment group was treated with spleen-strengthening compound on the basis of the control group. The course of treatment was 12 weeks. The patients were evaluated by the clinical relative score of myasthenia gravis and the clinical absolute score. Clinical efficacy， ELISA method was used to detect the levels of AchR-Ab， IFN-γ， TNF-α， IL-4 and IL-17 in peripheral blood of the two groups. The clinical efficacy， cytokine level and adverse reactions of spleen-strengthening compound were observed.Results The cure rate of the treatment group was 75.00%， compared with 68.00% of the control group， the difference was not statistically significant (P>0.05); the total effective rate of the treatment group was 91.00%， which was higher than that of the control group 71.00%(P<0.05). After treatment， the levels of AChR-Ab， IFN-γ， TNF-α， IL-4 and IL-17 in the two groups were lower than those before treatment (P<0.05). The treatment group AChR Ab， IFN-γ， The level of IL-17 was lower than that of the control group(P<0.05). There was no significant difference in the changes of IL-4 and TNF-α between the two groups (P>0.05). No adverse reactions such as diarrhea， abdominal pain， nausea， and rash were observed during the two treatment periods，the difference was not statistically significant (P>0.05). Conclusion The combination of spleen and strong spleen can improve the short-term clinical efficacy of myasthenia gravis to a certain extent. The mechanism may be related to the down-regulation of serum IFN-γ and IL-17 levels and the decrease of serum AChR-Ab levels., 百拇医药(刘建辉 杨娅 况时祥 杨辉 唐桂华 宋先红)