| Objective:To retrospectively analyze the therapeutic effect of The Reinforcing Kidney and Spleen Theory combined with western medicine on OMG and its effect on GMG transformation.Methods: A retrospective analysis from January 2015 to January 2017 in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,West China Hospital of Sichuan University and Sichuan Provincial People’s Hospital outpatient and inpatient department.It was divided into the traditional Chinese medicine and Western medicine group(invigorating the spleen and tonifying kidney),combined with the prescribed or(and)prednisone tablets,immunosuppressive agents,and Western medicine group(bromide,prednisone and(or)immunosuppressive agents).Comparing the effects between the two groups of OMG were compared between the two groups at present;hormone or(and)the use of immunosuppressive drugs;comparison in the course of OMG transformation rate between survival curves;using COX proportional hazards regression model analysis of spleen and kidney,thymus,thymic hyperplasia,disease,hormone,immunosuppressants,age,influence sex on the conversion rate.Results:There were 63 cases of traditional Chinese medicine combined with western medicine,11 cases lost to visit,55 cases of Western medicine group,5 cases lost visit,102 cases finished finally,the course of disease was from 8 months to 25 years.Traditional Chinese medicine and Western medicine group hormone or immunosuppressant withdrawal the rate of the drug(58%)better than the western medicine group(26%)(P<0.05).The clinical efficacy of the two groups,the effective rate of traditional Chinese medicine and Western medicine group was 84%,western medicine group was 70%,the difference was statistically significant(P<0.05);Subgroup analysis: the effective rate of OMG of patients with clinical curative effect of traditional Chinese medicine and Western medicine group to the GMG conversion of 92%,western medicine group 70%,the difference was statistically significant(P<0.05),there were no significant differences between OMG patients with clinical curative effect of traditional Chinese medicine and Western medicine group and Western medicine group has been transforming to GMG(P>0.05).92.5% adult onset OMG patients were transformed into GMG,and the total conversion rate of.OMG to GMG in 2 years was lower in the TCM and WM group(30.8%)than in the western medicine group(54%)(P<0.05).Sub group analysis: two groups of patients with related diseases,traditional Chinese medicine and Western medicine group the conversion rate is lower than the western medicine group(P<0.05),two groups of patients with related diseases,no statistically significant difference between the conversion rate of two groups(P>0.05);the two groups of patients with hormone at the onset of disease,traditional Chinese medicine and Western medicine group conversion rate(35.7% compared with western medicine group)(51.3%)decreased,the difference was not statistically significant(P>0.05);two patients were not using hormone at onset,the conversion rate of traditional Chinese medicine and Western medicine group(10%)was better than western medicine group(67%)(P<0.05);juvenile patients with good prognosis,with the prolongation of the duration and only 3 cases of conversion.By the COX regression analysis of spleen and kidney is the influence factors of P=0.025 patients with OMG transformation to GMG(HR=0.470,95%CI:0.243~0.911),in addition,P=0.000 onset age and risk factors of GMG were transformed to(HR=1.038,95%CI:1.020~1.055).Conclusion:1.the effect of tonifying spleen and tonifying kidney prescription combined with western medicine in treating ocular myasthenia gravis is accurate.2.The effect of tonifying spleen and tonifying kidney prescription combined with western medicine on the treatment of ocular myasthenia gravis is better than that of just Western medicine.3.The majority of patients with OMG who had been converted to GMG were in 2 years.The conversion rate of OMG to GMG was lower than that in western medicine group after tonifying spleen and tonifying kidney combined with Western Medicine4.OMG patients with minor onset have a better prognosis,which is consistent with previous reports. |
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