加味四妙散联合糖皮质激素治疗多发性肌炎疗效观察 及对肌力、炎症因子水平的影响
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Curative Observation on the Modified Simiao Powder Combined with Glucocorticoid on Polymyositis and Its Effect on Muscle Strength and Levels of Inflammatory Factors
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    摘要:

    目的:观察加味四妙散联合糖皮质激素治疗多发性肌炎(PM) 的临床疗效及对肌力、炎症因子水 平的影响。方法:选取60 例PM 患者随机分为对照组与观察组各30 例。2 组均给予常规西药治疗,观察组联 合加味四妙散治疗。比较2 组治疗后临床疗效、不良反应发生情况,以及治疗前后中医证候积分、肌电图、肌 力分级、炎症因子[前列腺素E2 (PGE2)、白三烯E4 (LTE4)、前列腺素D2 (PGD2)] 水平变化。结果:观察 组总有效率为96.67%,对照组为73.33%,2 组比较,差异有统计学意义(P<0.05)。治疗前,2 组中医证候 主、次症积分及总积分比较,差异无统计学意义(P>0.05);治疗后,2 组主、次症积分及总积分均较治疗前 降低(P<0.05),且观察组主、次症积分及总积分均低于对照组(P<0.05)。治疗前,2 组运动单位电位时 限、波幅比较,差异无统计学意义(P>0.05);治疗后,2 组运动单位电位时限、波幅均较治疗前增大(P< 0.05),且观察组运动单位电位时限、波幅均大于对照组(P<0.05)。治疗前,2 组肌力达3 级率比较,差异无 统计学意义(P>0.05);治疗后,2 组肌力达3 级率均较治疗前升高(P<0.05),且观察组肌力达3 级率高于 对照组(P<0.05)。治疗前,2 组PGE2、LTE4、PGD2 水平比较,差异无统计学意义(P>0.05);治疗后,2 组 PGE2、LTE4、PGD2 水平均较治疗前降低(P<0.05),且观察组PGE2、LTE4、PGD2 水平均低于对照组(P< 0.05)。观察组未出现明显不良反应,对照组不良反应发生率为10.00%,2 组比较,差异无统计学意义(P> 0.05)。结论:加味四妙散联合糖皮质激素治疗PM 疗效显著,可进一步降低炎症反应,有助于恢复肌力,缓 解临床症状。

    Abstract:

    Abstract: Objective: To observe the clinical effect of Modified Simiao Powder combined with glucocorticoid on polymyositis (PM) and its effect on muscle strength and levels of inflammatory factors. Methods: A total of 60 cases of PM patients were randomly selected as the control group and the observation group,with 30 cases in each group. Both groups were treated with routine western medicine, and the observation group was additionally treated with Modified Simiao Powder. After treatment, the clinical effects and incidence of adverse reactions were compared between the two groups. Before and after treatment, the changes in traditional Chinese medicine (TCM) syndrome scores, electromyogram, muscle strength grading,and levels of inflammatory factors including prostaglandin E2 (PGE2),leukotriene E4 (LTE4) and prostaglandin D2 (PGD2) were compared between the two groups. Results:The total effective rate was 96.67% in the observation group, and 73.33% in the control group, the difference being significant (P<0.05). Before treatment,there was no significant difference being found in the comparison of main and secondary symptom scores of TCM syndromes and the total scores between the two groups (P>0.05). After treatment,main and secondary symptom scores of TCM syndromes and the total scores in the two groups were decreased when compared with those before treatment (P<0.05),and the main and secondary symptom scores and total score in the observation group were lower than those in the control group (P<0.05). Before treatment, there was no significant difference being found in the comparison of duration and amplitude of motor unit potential between the two groups (P>0.05). After treatment, the duration and amplitude of motor unit potential in the two groups were increased when compared with those before treatment (P<0.05),and the duration and amplitude of motor unit potential in the observation group were higher than those in the control group (P<0.05). Before treatment,there was no significant difference being found in the comparison of ratio of muscle strength reaching level 3 between the two groups (P> 0.05). After treatment, the rates of muscle strength reaching level 3 in the two groups were increased when compared with those before treatment (P<0.05),and the rate of muscle strength reaching level 3 in the observation group was higher than that in the control group (P<0.05). Before treatment,there was no significant difference being found in the comparison of levels of PGE2,LTE4,and PGD2 between the two groups (P>0.05). After treatment,the levels of PGE2,LTE4,and PGD2 in the two groups were decreased when compared with those before treatment (P<0.05), and the levels of PGE2, LTE4, and PGD2 in the observation group were lower than those in the control group (P<0.05). There were no significant adverse reactions in the observation group, and the incidence of adverse reactions was 10.00% in the control group, there being no significant difference (P>0.05). Conclusion: The combination of Modified Simiao Powder and glucocorticoids has a significant curative effect on PM,which can further reduce inflammatory reactions,help restore muscle strength,and alleviate clinical symptoms.

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范先志,柯梅芳,李群.加味四妙散联合糖皮质激素治疗多发性肌炎疗效观察 及对肌力、炎症因子水平的影响[J].新中医,2023,55(22):19-24

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  • 在线发布日期: 2023-11-28
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