基于辨证论治的中药辅助治疗重症肌无力疗效分析

目的：探讨重症肌无力的中医辨证,分析中药辅助治疗的临床疗效;方法：选择2008年1月-2012年12月期间来我院就诊的重症肌无力患者114例作为研究对象,随机选取20例患者入传统治疗组,常规给予强的松、嗅吡斯的明、免疫球蛋白等药物,并配合血浆置换治疗,另94例患者在常规治疗基础上根据中医辨证分为肺热津伤（16例）、湿热浸淫（20例）、脾胃亏虚（30例）、肝肾亏损（28例）四组,分别给予清热润津汤、清热化湿散、参苓补脾汤、虎潜汤加减辅助治疗,随访所有病例的肌力及整体情况,评价临床绝对评分。结果：传统西医治疗组和配合中药治疗组的显效率分别为75.0%（15例）和88.3%（83例）,具备统计学差异（P〈0.05）。传统治疗组和配合中药治疗各组的临床绝对评分1]均较治疗前降低,且配合中药治疗组降低程度明显好于传统治疗组。结论：传统西医治疗手段配合祖国传统中药制剂对重症肌无力的临床疗效确切,值得临床推广,可以进一步探索组方以适用于更广大的患者,改善该病的愈后,提高患者生命、生活质量。

A clinical analysis of treating myasthenia gravis in TCM

Objective： To investigate clinical efficacy of TCM differentiation plus TCM medicine adjuvant therapy on myasthenia gravis. Methods： 114 patients were studied, 20 patients in the control group were given prednisone, olfactory pyridostigmine, immunoglobulin, plus plasmapheresis treatment. 94 patients were added the Qingre Runjin decoction, Qingre Huashi San, the Shenling Bupi decoction and the Huqian decoction. 94 patients were divided into four groups according to TCM differentiation, including 16 cases of Feire Jinshang, 20 cases of Shire Jinyin, 30 cases of Piwei kuixu and 28 cases of Ganshen Kuixu, and those were treated with the Qingre Runjin decoction, Qingre Huashi San, the Shenling Bupi decoction and Huqian decoction. All patients were followed up, myodynamia and the overall status were recorded, and clinical absolute scores were evaluated. Results： The significant efficiency in the control group was 75.0 % （15 cases） and 88.3% （83 cases） in the treatment group, the difference was statistically significant （P〈0.05）. Clinical absolute scores decreased in both, the scores in the treatment group decreased more obviously. Conclusion： Traditional western medicine plus TCM medicine was confirmed with good effects, was worthy of clinical promotion and further study, could improve the prognosis and patients’ living quality.